Hypothyroidism: Recognizing When to See a Specialist

Understanding Thyroid Disorders and When to See a Specialist

The thyroid gland is a small, butterfly-shaped organ located at the base of your neck. It produces thyroid hormones that regulate your metabolism. When the thyroid gland does not function properly, it can cause problems. Thyroid disorders are common, especially among women and older adults. The most common thyroid conditions are hypothyroidism and hyperthyroidism.

Hypothyroidism

Hypothyroidism, also called underactive thyroid, develops when the thyroid gland fails to produce enough thyroid hormones. Common causes are autoimmune disease, such as Hashimoto's thyroiditis, therapies that damage the thyroid, such as radiation, medications, thyroid surgery, and benign tumors or nodules.

The symptoms of hypothyroidism develop gradually over years and can include fatigue, weight gain, dry skin, hair loss, muscle weakness, elevated blood cholesterol levels, pain, stiffness or swelling in the joints, memory issues, depression, slowed heart rate, constipation, heavy or irregular menstruation, and sensitivity to cold.

Hyperthyroidism

Hyperthyroidism results when the thyroid gland makes too much thyroid hormone. Common causes are Graves’ disease, thyroid nodules, and thyroiditis (inflammation of the thyroid gland).

The symptoms of hyperthyroidism tend to appear suddenly and can include sudden weight loss, rapid or irregular heartbeat, sweating, feeling hot or a high temperature, hair loss, diarrhea, menstrual irregularities, bulging eyes, muscle weakness, sleep issues, and irritability.

When to See Your Primary Care Provider

Your primary care physician can diagnose and manage most thyroid disorders. They will review your symptoms, perform a physical exam focusing on the thyroid gland, and order blood tests to check levels of thyroid hormones.

Based on the results, your doctor may prescribe thyroid hormone pills to regulate thyroid function. They will also monitor your condition and adjust medications as needed. Follow up is important to ensure you receive the proper thyroid treatment.

Reasons to See an Endocrinologist

Although primary doctors can treat thyroid problems in most people, there are some situations when you may benefit from seeing a specialist such as an endocrinologist:

• Your thyroid symptoms are difficult to control or not responding as expected to medications.
• Your thyroid lab test results are abnormal and your doctor is not sure what is causing them.
• You have a thyroid nodule or goiter that should be evaluated.
• You are pregnant or trying to get pregnant.
• A biopsy is needed to evaluate cells from your thyroid.
• Thyroid cancer is suspected.
• You need radioactive iodine treatment or thyroid surgery.
• There is a thyroid abnormality in your family history.
• You have an associated disorder like diabetes or pituitary disease that affects the thyroid.

What is an Endocrinologist?

Endocrinologists are specially trained thyroid doctors who diagnose and treat people with complex hormone problems. They have several additional years of training and experience focused on hormonal conditions beyond what primary care providers receive.

Endocrinologists often serve as consultants to primary doctors when challenging thyroid cases arise. They are experts at managing advanced thyroid disorders and interpreting intricate test results.

Endocrinology Evaluation and Testing

During your appointment, the endocrinologist will review your symptoms, medical history, medications, and family background. They will conduct a thorough physical exam concentrating on the thyroid gland and neck region.

The specialist may order blood tests checking levels of thyroid hormones, thyroid antibodies, and other markers that indicate how the thyroid gland is functioning. They may also request repeat testing after some time to trace patterns.

If you have thyroid nodules or indications of thyroid cancer, your endocrinologist may recommend specialized imaging such as a thyroid ultrasound, CT scan of the neck/chest, PET scan, or neck MRI.

In some cases, a fine needle aspiration biopsy is done to extract cells from the thyroid or nodules for examination under a microscope.

Choosing an Endocrinologist

Look for an endocrinologist near you when specialized thyroid care is needed. Ask your primary doctor for recommendations or search online doctor directories and health plan networks.

Consider endocrinologists associated with highly-rated hospitals, medical schools, or specialized thyroid centers. Review the doctor’s credentials, training, and thyroid-related qualifications.

Schedule a consultation to meet with the endocrinologist and determine if you feel comfortable with them. Evaluate their listening skills, explanations, and how thoroughly they answer your questions.

Ongoing follow up appointments may be needed to continually monitor thyroid function and response to treatment over months or years.

What to Expect With an Endocrinologist

Here are a few things you can expect during your appointment with a thyroid specialist:

• Detailed review of your symptoms and medical history.
• Thyroid-related physical examination, feeling areas in your neck.
• Discussion of all medications you currently take.
• Potential changes to your thyroid medications or doses based on the latest test results.
• Orders for additional thyroid function tests (blood work, imaging, or biopsies).
• Referrals to other specialists such endocrine surgeons.
• Close monitoring at follow up appointments every few weeks to months.

Having a knowledgeable endocrinologist overseeing complex thyroid cases can help optimize health outcomes. They have the tools to accurately diagnose causes and fine-tune treatment plans.

Partnering With Your Thyroid Doctors

Whether seeing your primary care provider or an endocrinologist, being an engaged, informed patient is key. Here are some tips:

• Clearly describe your symptoms and how they impact your daily functioning.
• Keep track of symptoms in a journal to help identify patterns.
• Come prepared with a list of questions and concerns to address.
• Ask about the purpose of tests and what results mean.
• Help monitor your health progress between appointments.
• Notify your doctor promptly about any new or worsening symptoms.
• Understand next steps for diagnosis, testing, treatments.

Staying on top of your thyroid condition takes commitment, but worthwhile for preserving health. Do not hesitate to utilize the expertise of endocrinologists when additional care is required beyond your usual doctor.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.