My Top Ten Nonendocrine Consults

1. Smelly armpits
2. Excessive sweating (sounds like me)
3. Weight gain
4. Weight loss
5. Unsatiable appetite
6. Low libido (usually the men)
7. High libido (the couple of cases I saw were men, brought in by their wives!)
8. Tachycardia (the clincher for this was the couple of consults I got came from of all people a cardiologist!)
9. Fatigue
10. Short penis (that patient was pretty disappointed when contrary to his GP's promise, I had no medicine to give him to lengthen his member)

Yup, that's all real, not made-up stuff. True, rarely can hormonal disorders cause some of the above symptoms, but so can dozens of other pathologic and physiologic conditions. But to blame it on 'hormones' with no biochemical data seems a bit presumptious on the referring doctors' part. So, it's no surprise that I end up disappointing most patients I see when I tell them their tests came back OK.

I was befuddled when I saw that consult yesterday for a problem with smelly armpits. Apparently, this is a sign of a hormonal problem. My alma mater must not have trained me well. Whatever that disease is, I must have a terminal case of it!