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Do You Need to See an Endocrinologist for Your Thyroid Disease?

This resources was originally published by the Verywell Health here.


In most cases, the diagnosis of a thyroid condition is made by a person’s primary care doctor, who may then refer you to an endocrinologist, a physician who treats hormone problems like thyroid disease and others. But that’s not always the case—or necessary. Sometimes, your general practitioner is comfortable managing your thyroid condition on his own, and this is perfectly sensible for certain thyroid diagnoses.

There are other healthcare practitioners, such as naturopaths and chiropractors, who also treat thyroid patients. While their expertise may be helpful as a complement to your thyroid care, it should not be a substitute for that of a primary care doctor or endocrinologist.

How to Work With Your Thyroid Medical Team

As managing thyroid disease can be challenging and is, in most cases, a lifelong commitment, it’s important to have the right team of professionals helping you along the way.

Thyroid Disease Doctor Discussion Guide

Get our printable guide for your next doctor’s appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Primary Care Doctors

Your primary care doctor may be able to manage your thyroid disease, especially if you are diagnosed with hypothyroidism. This is because most primary care doctors are comfortable and trained to monitor thyroid stimulating hormone (TSH) levels and adjust thyroid hormone replacement medication accordingly

That said, there are some specific situations that warrant a referral to an endocrinologist.

  • If you are pregnant or planning pregnancy
  • A newborn or child with a thyroid condition
  • Presence of thyroid nodules or an enlarged thyroid gland (goiter)
  • Any type of hyperthyroidism, including Graves’ disease
  • Secondary hypothyroidism (if a pituitary problem is causing hypothyroidism)
  • Thyroid eye disease
  • Suspected thyroid cancer

Endocrinologists

An endocrinologist is a doctor who completes training in internal medicine (like a primary care physician) and then undergoes more training (usually two to three years) in the field of endocrinology.

Endocrinologists diagnose and treat hormonal imbalances, usually due to various gland conditions, such as:

  • Thyroid disorders
  • Diabetes
  • Osteoporosis and bone health
  • Adrenal disorders
  • Pituitary disorders
  • Menopause issues in women
  • Testosterone problems in men2

While primary care doctors can manage some endocrine conditions, like “textbook” hypothyroidism and diabetes, other conditions warrant the care of an endocrinologist, like pituitary or adrenal gland problems or hyperthyroidism.

Even if you have “textbook” hypothyroidism, do not be surprised if your primary care doctor refers you to an endocrinologist. This can be for a number of reasons—perhaps you have multiple other medical problems (making your case a complex one), or perhaps your doctor does not have a lot of experience treating patients with such a disorder.

Sometimes, primary care doctors simply want an “extra set of eyes” from an endocrinologist, whether that’s taking a second look at your diagnostic test results and/or modifying your treatment plan—all of this is OK, if not, a sign of good care.

Depending on your diagnosis and treatment plan, your endocrinologist may opt to manage your condition on his own, as in the case of Graves’ disease or monitoring thyroid nodules.

Alternatively, your endocrinologist may work alongside your primary care doctor to manage your condition. For example, your primary care doctor may refer you to an endocrinologist for an initial diagnosis of Hashimoto’s disease. Once your endocrinologist stabilizes your thyroid hormone replacement dose, your primary care doctor may then follow your TSH levels. You may then only see your endocrinologist if a problem arises, or once a year for a check-in.

Other Practitioners

Many thyroid patients look to seek out 360-treatment plan—that is, one that includes the expertise of practitioners of different disciplines and takes a “whole body” approach. Naturopaths and chiropractors are two professionals who are sometimes consulted.

If you consult with these or other practitioners, be sure that you only do so as an adjunct to your care by a primary care doctor or endocrinologist. He or she should also be aware of any treatments recommended by other clinicians.

Naturopathic Doctors

A licensed naturopathic doctor (ND) graduates from a four-year graduate level holistic medical school. Their approach to healthcare tends to be more integrative perhaps than traditional doctors in that NDs believe no part of your body operates in complete isolation from the rest of the system.3

So, for example, an ND may discuss the aspects of how nutrition affects thyroid disorders and make sure that you have a diet plan that works to support your thyroid health. In addition, by ordering labs and imaging tests, an ND may evaluate other hormones such as the sex hormone estrogen and cortisol (the “stress hormone” produced by your adrenals glands).

Complement to Your Thyroid Care

While an integrative approach to your thyroid health is appealing, NDs do not necessarily follow the guidelines recommended by professional societies like the American Thyroid Association (ATA) or the American Association of Clinical Endocrinologists (AACE).

For instance, for the treatment of hypothyroidism, many NDs prescribe desiccated thyroid hormone, which is derived from the dried thyroid glands of pigs or cows and provides both T4 (thyroxine) and triiodothyronine (T3). Alternative names include natural thyroid, thyroid extract, porcine thyroid, pig thyroid; brand names include Nature-throid and Armour Thyroid.

This type of thyroid hormone replacement medication provides a ratio of T4:T3 that is not natural to humans (4:1 instead of 16:1), which tends to produce some degree of hyperthyroidism. That is why most expert bodies (the AACE and ATA, for instance) do not recommend its usage, except for perhaps select patients. Instead, for the vast majority of patients, experts recommend sticking with levothyroxine alone (brand names: Synthroid, Levoxyl, and Tirosint).4

Lastly, some NDs practice botanical medicine, recommending herbs for the care of various medical problems. Taking herbs and supplements can be especially harmful to a person with thyroid disease as they may interfere with your medication and/or the functioning of your thyroid gland.

Chiropractors

According to the American Chiropractic Association, chiropractors are designated as “physician-level providers,” in the vast majority of states. While the doctor of chiropractic (DC) program is similar to the doctor of medicine (MD) program in the first two years, the programs diverge in the second half. During this time, the DC program focuses on diet, nutrition, and spinal manipulation, while the MD program emphasizes the study of pharmacology.5

Complement to Your Thyroid Care

While your chiropractor may have been the one to diagnose your thyroid disease (they can order laboratory tests and imaging studies, like a naturopath), once diagnosed, your chiropractor must refer you to a medical doctor for proper treatment—for instance, thyroid hormone replacement for hypothyroidism and either an anti-thyroid drug, surgery, or radioactive iodine ablation for hyperthyroidism.

Chiropractors can, however, provide supportive thyroid care, such as nutritional guidance or ways to ease musculoskeletal pain associated with the underlying thyroid disease (like carpal tunnel syndrome or joint aches).

Chiropractors are legally prohibited from prescribing thyroid medication, which means that they cannot treat or cure thyroid conditions.

A Word From Verywell

The decision to find a doctor for your thyroid care can be a challenging one, as the relationship is an intensely personal one, and it’s not easy to find the right match, particularly when you may be limited by geography and insurance.

Remain proactive in seeking out the right doctor-patient relationship. And keep a positive mindset, too. When you find that trusting, compassionate partnership, you will just know it.

Tests for Thyroid Cancer

This resources was originally published by the American Cancer Society here.


Thyroid cancer may be diagnosed after a person goes to a doctor because of symptoms, or it might be found during a routine physical exam or other tests. If there is a reason to suspect you might have thyroid cancer, your doctor will use one or more tests to confirm the diagnosis. If cancer is found, other tests might be done to find out more about the cancer.

Medical history and physical exam

If you have any signs or symptoms that suggest you might have thyroid cancer, your health care professional will want to know your complete medical history. You will be asked questions about your possible risk factorssymptoms, and any other health problems or concerns. If someone in your family has had thyroid cancer (especially medullary thyroid cancer) or tumors called pheochromocytomas, it is important to tell your doctor, as you might be at high risk for this disease.

Your doctor will examine you to get more information about possible signs of thyroid cancer and other health problems. During the exam, the doctor will pay special attention to the size and firmness of your thyroid and any enlarged lymph nodes in your neck.

Imaging tests

Imaging tests may be done for a number of reasons:

  • To help find suspicious areas that might be cancer
  • To learn how far cancer may have spread
  • To help determine if treatment is working

People who have or may have thyroid cancer will get one or more of these tests.

Ultrasound

Ultrasound uses sound waves to create images of parts of your body. You are not exposed to radiation during this test.

This test can help determine if a thyroid nodule is solid or filled with fluid. (Solid nodules are more likely to be cancerous.) It can also be used to check the number and size of thyroid nodules as well as help determine if any nearby lymph nodes are enlarged because the thyroid cancer has spread.

For thyroid nodules that are too small to feel, this test can be used to guide a biopsy needle into the nodule to get a sample. Even when a nodule is large enough to feel, most doctors prefer to use ultrasound to guide the needle.

Radioiodine scan

Radioiodine scans can be used to help determine if someone with a lump in the neck might have thyroid cancer. They are also often used in people who have already been diagnosed with differentiated (papillary, follicular, or Hürthle cell) thyroid cancer to help show if it has spread. Because medullary thyroid cancer cells do not absorb iodine, radioiodine scans are not used for this cancer.

For this test, a small amount of radioactive iodine (called I-131) is swallowed (usually as a pill) or injected into a vein. Over time, the iodine is absorbed by the thyroid gland (or thyroid cells anywhere in the body). A special camera is used several hours later to see where the radioactivity is.

For a thyroid scan, the camera is placed in front of your neck to measure the amount of radiation in the gland. Abnormal areas of the thyroid that have less radioactivity than the surrounding tissue are called cold nodules, and areas that take up more radiation are called hot nodules. Hot nodules usually are not cancerous, but cold nodules can be benign or cancerous. Because both benign and cancerous nodules can appear cold, this test by itself can’t diagnose thyroid cancer.

After surgery for thyroid cancer, whole-body radioiodine scans are useful to look for possible spread throughout the body. These scans become even more sensitive if the entire thyroid gland has been removed by surgery because more of the radioactive iodine is picked up by any remaining thyroid cancer cells.

Radioiodine scans work best if patients have high blood levels of thyroid-stimulating hormone (TSH, or thyrotropin). For people whose thyroid has been removed, TSH levels can be increased by stopping thyroid hormone pills for a few weeks before the test. This leads to low thyroid hormone levels (hypothyroidism) and causes the pituitary gland to release more TSH, which in turn stimulates any thyroid cancer cells to take up the radioactive iodine. A downside of this is that it can cause the symptoms of hypothyroidism, including tiredness, depression, weight gain, sleepiness, constipation, muscle aches, and reduced concentration. One way to raise TSH levels without withholding thyroid hormone is to give an injectable form of thyrotropin (Thyrogen) before the scan.

Because any iodine already in the body can affect this test, people are usually told to avoid foods or medicines that contain iodine for a few days before the scan.

Radioactive iodine can also be used to treat differentiated thyroid cancer, but it is given in much higher doses. This type of treatment is described in Radioactive iodine (radioiodine) therapy.

Chest x-ray

If you have been diagnosed with thyroid cancer (especially follicular thyroid cancer), a plain x-ray of your chest may be done to see if cancer has spread to your lungs.

Computed tomography (CT) scan

The CT scan is an x-ray test that makes detailed cross-sectional images of your body. It can help determine the location and size of thyroid cancers and whether they have spread to nearby areas, although ultrasound is usually the test of choice. A CT scan can also be used to look for spread into distant organs such as the lungs.

One problem using CT scans is that the CT contrast dye contains iodine, which interferes with radioiodine scans. For this reason, many doctors prefer MRI scans for differentiated thyroid cancer.

Magnetic resonance imaging (MRI) scan

MRI scans use magnets instead of radiation to create detailed cross-sectional images of your body. MRI can be used to look for cancer in the thyroid, or cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the thyroid. MRI can provide very detailed images of soft tissues such as the thyroid gland. MRI scans are also very helpful in looking at the brain and spinal cord.

Positron emission tomography (PET) scan

PET scan can be very useful if your thyroid cancer is one that doesn’t take up radioactive iodine. In this situation, the PET scan may be able to tell whether the cancer has spread.

Biopsy

The actual diagnosis of thyroid cancer is made with a biopsy, in which cells from the suspicious area are removed and looked at in the lab.

If your doctor thinks a biopsy is needed, the simplest way to find out if a thyroid lump or nodule is cancerous is with a fine needle aspiration (FNA) of the thyroid nodule. This type of biopsy can sometimes be done in your doctor’s office or clinic.

Before the biopsy, local anesthesia (numbing medicine) may be injected into the skin over the nodule, but in most cases an anesthetic is not needed. Your doctor will place a thin, hollow needle directly into the nodule to aspirate (take out) some cells and a few drops of fluid into a syringe. The doctor usually repeats this 2 or 3 more times, taking samples from several areas of the nodule. The biopsy samples are then sent to a lab, where they are looked at to see if the cells look cancerous or benign.

Bleeding at the biopsy site is very rare except in people with bleeding disorders. Be sure to tell your doctor if you have problems with bleeding or are taking medicines that could affect bleeding, such as aspirin or blood thinners.

This test is generally done on all thyroid nodules that are big enough to be felt. This means that they are larger than about 1 centimeter (about 1/2 inch) across. Doctors often use ultrasound to see the thyroid during the biopsy, which helps make sure they are getting samples from the right areas. This is especially helpful for smaller nodules. FNA biopsies can also be used to get samples of swollen lymph nodes in the neck to see if they contain cancer.

Sometimes an FNA biopsy will need to be repeated because the samples didn’t contain enough cells. Most FNA biopsies will show that the thyroid nodule is benign. Rarely, the biopsy may come back as benign even though cancer is present. Cancer is clearly diagnosed in only about 1 of every 20 FNA biopsies.

Sometimes the test results first come back as “suspicious” or “of undetermined significance” if FNA findings don’t show for sure if the nodule is either benign or malignant. If this happens, the doctor may order lab tests on the sample (see below).

If the diagnosis is not clear after an FNA biopsy, you might need a more involved biopsy to get a better sample, particularly if the doctor has reason to think the nodule may be cancer. This might include a core biopsy using a larger needle, a surgical “open” biopsy to remove the nodule, or a lobectomy (removal of half of the thyroid gland). Surgical biopsies and lobectomies are done in an operating room while you are under general anesthesia (in a deep sleep). A lobectomy can also be the main treatment for some early cancers, although for many cancers the rest of the thyroid will need to be removed as well (during an operation called a completion thyroidectomy).

Lab tests of biopsy (or other) samples

In some cases, doctors might use molecular tests to look for specific gene changes in the cancer cells. This might be done for different reasons:

  • If FNA biopsy results aren’t clear, the doctor might order lab tests on the samples to see if there are changes in the BRAF or RET/PTC genes. Finding one of these changes makes thyroid cancer much more likely.
  • For some types of thyroid cancer, molecular tests might be done to see if the cancer cells have changes in certain genes (such as the BRAFRET/PTC, or NTRK genes), which could mean that certain targeted drugs might be helpful in treating the cancer.

These tests can be done on tissue taken during a biopsy or surgery for thyroid cancer. If the biopsy sample is too small and all the molecular tests can’t be done, the testing may also be done on blood that is taken from a vein, just like a regular blood draw.

Blood tests

Blood tests are not used to find thyroid cancer. But they can help show if your thyroid is working normally, which may help the doctor decide what other tests may be needed. They can also be used to monitor certain cancers.

Thyroid-stimulating hormone (TSH)

Tests of blood levels of thyroid-stimulating hormone (TSH or thyrotropin) may be used to check the overall activity of your thyroid gland. Levels of TSH, which is made by the pituitary gland, may be high if the thyroid is not making enough hormones. This information can be used to help choose which imaging tests (such as ultrasound or radioiodine scans) to use to look at a thyroid nodule. The TSH level is usually normal in thyroid cancer.

T3 and T4 (thyroid hormones)

These are the main hormones made by the thyroid gland. Levels of these hormones may also be measured to get a sense of thyroid gland function. The T3 and T4 levels are usually normal in thyroid cancer.

Thyroglobulin

Thyroglobulin is a protein made by the thyroid gland. Measuring the thyroglobulin level in the blood can’t be used to diagnose thyroid cancer, but it can be helpful after treatment. A common way to treat thyroid cancer is to remove most of the thyroid by surgery and then use radioactive iodine to destroy any remaining thyroid cells. These treatments should lead to a very low level of thyroglobulin in the blood within several weeks. If it is not low, this might mean that there are still thyroid cancer cells in the body. If the level rises again after being low, it is a sign that the cancer could be coming back.

Calcitonin

Calcitonin is a hormone that helps control how the body uses calcium. It is made by C cells in the thyroid, the cells that can develop into medullary thyroid cancer (MTC). If MTC is suspected or if you have a family history of the disease, blood tests of calcitonin levels can help look for MTC. This test is also used to look for the possible recurrence of MTC after treatment. Because calcitonin can affect blood calcium levels, these may be checked as well.

Carcinoembryonic antigen (CEA)

People with MTC often have high blood levels of a protein called carcinoembryonic antigen (CEA). Tests for CEA can help monitor this cancer.

Other blood tests

You might have other blood tests as well. For example, if you are scheduled for surgery, tests will be done to check your blood cell counts, to look for bleeding disorders, and to check your liver and kidney function.

Medullary thyroid carcinoma (MTC) can be caused by a genetic syndrome that also causes a tumor called pheochromocytoma. Pheochromocytomas can cause problems during surgery if the patient is under anesthesia (in a deep sleep). This is why patients with MTC who will have surgery are often tested to see if they have a pheochromocytoma as well. This can mean blood tests for epinephrine (adrenaline) and a related hormone called norepinephrine, and/or urine tests for their breakdown products (called metanephrines).

Vocal cord exam (laryngoscopy)

Thyroid tumors can sometimes affect the vocal cords. If you are going to have surgery to treat thyroid cancer, a procedure called a laryngoscopy will probably be done first to see if the vocal cords are moving normally. For this exam, the doctor looks down the throat at the larynx (voice box) with special mirrors or with a laryngoscope, a thin tube with a light and a lens on the end for viewing.

What’s the Difference Between Hypothyroidism and Hyperthyroidism?

This article was originally published by the US News on April 19, 2019 here.


The two conditions have similar-sounding names but are actually quite different.

IN THE WORLD OF medicine, many conditions have names that may seem unfamiliar to English speakers. Some of these diseases have names borrowed from other languages, and Greek is a usual suspect when it comes to terms that may not be immediately recognizable to many of us.

This is true for two common medical conditions that have to do with the thyroid gland. The terms hypothyroidism and hyperthyroidism describe two problems that can arise in the thyroid gland – a small, butterfly-shaped structure in the neck that produces hormones that regulate a wide range of bodily functions. At first glance, these words may seem identical. But a tiny change in a couple letters alters the meaning of the two terms substantially, referring to two different conditions.

What Is Hypothyroidism?

In Greek, “‘hypo’ means low or below normal,” says Dr. Joseph Wanski, an endocrinologist with L.A. Care Health Plan in Los Angeles. “Hypothyroidism defines the clinical condition of low or underactive laboratory levels of the thyroid hormone because the thyroid gland does not make enough” of the hormones that the body requires.

These hormones are important because they’re involved with all sorts of bodily functions from how the heart works to how fast your metabolism runs. “The thyroid gland in the neck manufactures a protein called thyroid hormone, which is crucial to the day-to-day function of every cell in the body,” says Dr. John Duncan, pediatric endocrinologist with Health First Medical Group in Melbourne, Florida. “Without it, all chemical functions within the cell slow down.”

Therefore, the term hypothyroidism is used to describe a state of inadequate levels of thyroid hormone, and it “accounts for the majority of issues people experience with their thyroid gland,” says Dr. Brian Jameson, an endocrinologist with Geisinger in Danville, Pennsylvania. “Hypothyroidism is also known as underactive thyroid. In other words, everything in the body slows down. When levels of two key thyroid hormones, thyroxine (T4) and triiodothyronine (T3) are too low in the blood, people experience symptoms.”

Symptoms associated with hypothyroidism include:

  • Fatigue.
  • Dry skin and hair.
  • Brittle nails.
  • Slowing of bowels or development of constipation.
  • Weight gain.
  • Puffy face.
  • Muscle cramps.
  • Irregular, infrequent or heavier than normal menstrual periods.
  • Forgetfulness.
  • Depression.
  • A hoarse voice.
  • Pain, stiffness or swelling of the joints.
  • Muscle weakness, aches or stiffness.

If hypothyroidism occurs in a child, it can result in short stature. In teenagers, it may cause an “alteration of pubertal characteristics,” Wanski says. Duncan points out that although being overweight is sometimes blamed on so-called glandular issues, AKA hypothyroidism, “not all individuals with excessive weight will be hypothyroid.”

What Is Hyperthyroidism?

At the other end of the thyroid spectrum is hyperthyroidism, in which the thyroid becomes overactive and generates too much thyroid hormone. “Hyperthyroidism is also known as overactive thyroid,” Jameson says. “In other words, everything in the body speeds up. When levels of two key thyroid hormones, thyroxine (T4) and triiodothyronine (T3) are too high in the blood, people experience symptoms.”

This overstimulation of the thyroid gland results in “a massive surplus of thyroid hormone. This accelerates all the chemical functions and all the cells,” Duncan says. This condition can cause a range of symptoms including:

  • Sleeplessness.
  • Rapid heart rate.
  • Heart failure.
  • Weight loss.
  • Tremor.
  • Bulging eyes or a fullness in the front of the neck.
  • More frequent bowel movements.
  • Seizures.
  • Heart disease.

Hyperthyroidism may also cause “an assortment of other undesirable clinical consequences,” Duncan says.

What Causes Hypothyroidism and Hyperthyroidism?

Duncan says that in most cases, these diseases are caused by “aberrant immunity cell function where white blood cells ‘attack’ the thyroid, which triggers under-function or over-function of the gland. However, there are infants who can be born without a thyroid gland (congenital hypothyroidism)” or the thyroid can be underdeveloped or “located in the wrong place,” Jameson adds. With hyperthyroidism, “there are infants who can inherit the immunity proteins and be born with hyperthyroidism,” Duncan says.

With hypothyroidism, “the most common cause is an autoimmune disease called Hashimoto’s thyroiditis,” Jameson says. “This disease causes the immune system to mistakenly attack a healthy thyroid gland. As a result, the thyroid becomes inflamed and is no longer able to make enough thyroid hormones. It may also become enlarged and develop lumps and bumps known as nodules.” Wanski adds that other causes of hypothyroidism include:

  • Radiation to the thyroid.
  • Thyroid surgery.
  • Damage to the pituitary gland, a pea-sized structure behind the nose at the base of the brain that regulates hormones throughout the body.
  • Certain medications.

The National Institute of Diabetes and Digestive and Kidney Disease reports that an autoimmune disorder called “Graves’ disease is the most common cause of hyperthyroidism in the United States. Wanski says other causes of hyperthyroidism include:

  • The development of a nodule or lump (or multiple nodules) in the thyroid gland that begins to produce excess hormone.
  • Certain medications.
  • Viral infections.

Jameson adds that in some cases, thyroid nodules can begin producing hormones when they shouldn’t, a condition called toxic nodular goiter. “Thyroid inflammation, also known as thyroiditis,” may also lead to the development of hyperthyroidism

Who’s Likely to Develop Thyroid Problems?

The American Thyroid Association reports that “more than 12 percent of the U.S. population will develop a thyroid condition during their lifetimes.” And because an “estimated 20 million Americans have some form of thyroid disease,” it may be something you’ll have to deal with at some point.

Although anyone can develop a problem with the thyroid at any age, there are a few risk factors that may make a thyroid issue more likely, including:

  • Being female.
  • Having recently been pregnant.
  • Being 60 or older.
  • Having a family history of thyroid or autoimmune disease.
  • Having a personal history of thyroid problems or surgery.
  • Having an autoimmune disease.

Duncan says problems with the function of the thyroid gland are “far more common in women than men,” ranging from 5 to 8 times more likely to develop in females. “Approximately 5 percent of women will eventually develop a thyroid problem.”

How Are These Conditions Diagnosed?

If hypo- or hyperthyroidism is suspected, your doctor will perform a physical examination and take a thorough medical history. A blood test can determine whether your body’s level of thyroid hormones is in the normal range or too high or too low.

Sometimes, your doctor may find a goiter upon examination. This is the term used to describe an enlarged thyroid, which may be obvious as a lump on the side of your throat. A goiter can be a sign of any issue with the thyroid, including hypo- or hyperthyroidism, cancer or simply a lack of dietary iodine. (Iodine is routinely added to table salt in the U.S. to help ward off this issue.)

If signs of hyperthyroidism are found, your doctor may want to conduct additional tests, including:

  • Radioiodine uptake test, in which a small dose of a radioactive iodine is administered and the amount that’s absorbed by the thyroid is measured.
  • Thyroid scan, in which a radioactive iodine isotope is injected and a camera creates an image of the thyroid once the isotope has been absorbed.
  • Thyroid ultrasound, in which sound waves are used to create an image of the thyroid.

Although your primary care physician may be able to diagnose and manage many thyroid issues, some patients may need to see an endocrinologist – a specialist doctor who focuses on diseases affecting the endocrine system and hormones.

How Are These Conditions Managed?

Both hypo- and hyperthyroidism can be dangerous, and “if left untreated, hypothyroidism can lead to unconsciousness and death,” Wanski says. On the other hand, hyperthyroidism “can cause significant weight loss, infertility, a heart irregularity called atrial fibrillation and double-vision.”

Therefore, it’s important to get appropriate medical care if you have either condition. “If you’re feeling unwell and experience any of the common symptoms of a thyroid problem, talk to your doctor,” Jameson says. “Treatment is relatively simple and can help you get back to feeling like yourself again.”

Depending on which condition you’re dealing with and what’s causing it, you may have a few options for treating it.

“In hypothyroidism, tablets of thyroxine – synthetic thyroid hormone identical to negative thyroid hormone – are administered daily and monitored through blood testing,” Duncan says. These medications restore normal levels of hormones and alleviate many of the symptoms of hypothyroidism.

With hyperthyroidism, the treatment may be somewhat more complicated. “Being multifactorial, hyperthyroidism may require one or more therapies,” Duncan says, but “the goal is to diminish or eliminate the overproduction of thyroid hormone.” Treatment options may include:

  • Anti-thyroid medications. These drugs slow the production of excess amounts of hormones.
  • Beta-blockers. Although usually used to treat high blood pressure, these medications can treat some of the symptoms of hyperthyroidism including tremor, palpitation and rapid heart rate.
  • Radioactive iodine. This approach destroys some or all of the thyroid to stop the overproduction of thyroid hormones.
  • Surgery. A thyroidectomy may be undertaken in certain instances to remove most of the thyroid gland and possibly the parathyroid glands, and Jameson says this approach may be a better option for pregnant women or “people who are unable to tolerate other medical treatments.” This approach will necessitate the use of medications for the rest of your life to replace the hormones that can no longer be manufactured within the body.

The most common treatment for hyperthyroidism tends to be radioactive iodine, which is typically administered as an oral pill, and may only require a single dose to be effective. Iodine is an element that is “essential for proper function of the thyroid gland, which uses it to make the thyroid hormone,” the American Thyroid Association reports. The thyroid absorbs iodine, and if it is radioactive, this can shrink or destroy the gland. This therapy is also sometimes used to treat thyroid cancer.

If the treatment destroys the gland or suppresses the thyroid too much, you may develop hypothyroidism as a side effect, but this can be addressed by medications that replace the loss of needed hormones. Hypothyroidism is generally considered easier to treat than hyperthyroidism.

Regardless of which condition you’re being treated for, it’s important to seek appropriate care, especially if you have other medical conditions, as “those may also be adversely affected by the problem until therapy has been introduced,” Wanski says.

The same is true for hyperthyroidism, which can have significant health consequences if it’s not addressed properly. If it’s “left untreated long enough, it can even cause seizures or severe heart disease,” Duncan says.

Jameson adds that “thyroid cancer is also a concern” in people with thyroid problems, particularly those with hypothyroidism. “Thyroid cancer is relatively common, and about three times as many women get thyroid cancer as men. It generally occurs in the nodular goiter of hypothyroidism but can be seen in people whose glands function properly. It’s rare to see thyroid cancer associated with hyperthyroidism.”

Even though it can happen, Jameson says you shouldn’t panic about developing cancer if you’re diagnosed with a thyroid problem. “Thyroid cancer is a very treatable cancer in most instances, usually with surgical removal of all or part of the thyroid and subsequent radioactive iodine tablets to treat the remaining cancer afterward.”

Signs and Symptoms of Thyroid Cancer

This resources was originally published by the American Cancer Society here.


Thyroid cancer can cause any of the following signs or symptoms:
  • A lump in the neck, sometimes growing quickly
  • Swelling in the neck
  • Pain in the front of the neck, sometimes going up to the ears
  • Hoarseness or other voice changes that do not go away
  • Trouble swallowing
  • Trouble breathing
  • A constant cough that is not due to a cold

If you have any of these signs or symptoms, talk to your doctor right away. Many of these symptoms can also be caused by non-cancerous conditions or even other cancers of the neck area. Lumps in the thyroid are common and are usually benign. Still, if you have any of these symptoms, it’s important to see your doctor so the cause can be found and treated, if needed.