Thyroid disease is an umbrella term that covers several different diseases, all of which affect the function of the thyroid gland. The thyroid is a small gland in your throat. It produces hormones that can travel around the body and help to regulate regular bodily functions.
Because the thyroid's main function is to produce hormones, it is part of the endocrine system. This is a series of organs throughout the body that are responsible for producing hormones to regulate other bodily systems.
Thyroid dysfunction is usually a result of autoimmunity, where the body begins to produce antibodies to attack itself, effectively telling the immune system to target and destroy working cells in the body. This causes the thyroid to stop working, as the cells are being destroyed by the immune system when they aren’t supposed to be.
This autoimmunity can be genetic and inherited, or it can be triggered by environmental causes or a mix of both. Thyroid disorders are actually quite common, so it's a good idea to be familiar with the symptoms.
The main signs of the most common thyroid disease (hypothyroidism or underactive thyroid) are:
Unexplained weight gain
Slow movement or slow thoughts
Muscle aches, cramps, or weakness
Dry or scaly skin
Brittle hair and nails
Loss of sex drive
Tingling, numbness, or pain in the hand
Irregular or heavy periods
Severe symptoms are uncommon, as most cases get caught before progressing to this stage. These symptoms include:
Low-pitched and hoarse voice
Slower heart rate
Thyroid diseases have different progressions depending on the cause of the disease. If it is genetic, it will have a different rate of progression to a thyroid issue caused by cancer or an environmental cause.
However, the diseases all follow the same general trends. To begin with, the disease is subclinical, and if not treated, it runs the risk of progressing to overt. These stage names are just terms clinicians use to classify the severity of the disease, which is usually related to how long you have had dysfunctional thyroid activity.
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As thyroid disease can be diagnosed by a simple blood test, you will often be diagnosed by your GP. However, because your thyroid is so important in regulating the other organs around the body, they may refer you to a specialist for treatment. These specialists are known as endocrinologists.
Endocrinologists are doctors who specialize in endocrinology. This field of study is related to the endocrine system, the series of organs that produce the regulating hormones we mentioned earlier.
Endocrinologists are usually seen at least once, usually shortly after diagnosis. They will review the diagnosis and treatment plan to ensure that your primary healthcare provider is capable of managing your condition. However, it is unusual to continue seeing them regularly.
A primary care doctor is your GP or the first doctor you consult when you start seeing symptoms. This doctor will be responsible for ordering tests to investigate symptoms you present with and may make a referral to an endocrinologist to confirm their suspicions of the disease.
Often, your primary care physician will work with the endocrinologists to help you create a management strategy to minimize the effect of your disease on your way of life and overall health.
Once your management strategy has been reviewed by the endocrinologist, you will likely maintain treatment with your primary care physician. This is to save you money, as your primary care physician will probably be less expensive than the specialist endocrinologist.
A multidisciplinary care team can provide more perspectives and experience than a single person. Most people won’t need a large team of healthcare professionals because they won’t experience symptoms that are unmanageable by a general practitioner.
You won’t always need to see an endocrinologist. In some cases, your physician might feel comfortable diagnosing and managing your treatment on their own. This is often the case if you have clinically typical symptoms or don’t have other complicating conditions.
However, some doctors will always use an endocrinologist as a consultant, and this is also completely fine. This might occur if your doctor wants to ensure they follow the best treatment plan for your specific condition or if you have a more complicated medical history.
They may also consult an endocrinologist if they haven’t had much experience in managing thyroid conditions.
An endocrinologist should be consulted when you are pregnant or trying to conceive, have a thyroid nodule or an enlarged gland, or when the pituitary gland is involved in your hypothyroidism. You should also see an endocrinologist whenever suggested by your primary care physician.
If you are unsatisfied with the next steps, you can either change physician, move practice, or consult your local patient advocacy group. You can also seek a second opinion if your symptoms don’t get better with your treatment plan.
You can look for endocrinologists yourself with this search engine. Please note that specialists will often require a referral before accepting patients.¹
Some patients also like to take a more holistic approach to their healthcare and will sometimes consult naturopaths. If you choose this approach, include your primary care physician and endocrinologist in your healthcare plan, and ensure everyone involved is aware of each treatment step.
There are many different kinds of endocrinologists, depending on the special service they offer. Some of these specialties include:
Diabetes or metabolism
For patients with a thyroid condition, a thyroid endocrinologist will be consulted.
Thyroid diseases are diagnosed through a blood test. This test will measure the level of serum thyroid stimulating hormone (TSH), which is a hormone that activates the thyroid gland. If it is too low, you will have hyperthyroidism (overactive thyroid). If it is too high, you will have hypothyroidism (underactive thyroid).
Treatment for thyroid disorders will depend on the cause of your disorder. Since so many different causes and treatments are available, it is difficult to make an exhaustive list of treatments. Most commonly, thyroid issues can be managed through medication, although, in some cases, surgery or radiation may be needed.
Thyroid conditions include hypothyroidism and hyperthyroidism. These occur when the thyroid gland in the neck isn’t functioning properly and can be caused by a wide range of conditions.
Most often, this disorder can be managed by your primary care physician. However, you may occasionally need to see a specialist called an endocrinologist to get the best possible treatment.
Endocrinologists can be consulted for thyroid issues, but the first port of call for a healthcare issue should be your primary care physician. They will be able to refer you to an endocrinologist if needed.
If you have thyroid issues, your doctor can tell you whether to see an endocrinologist or an ear, nose, and throat (ENT) specialist. Most often, a thyroid issue will be best suited to an endocrinologist.
If you suspect you have a thyroid problem, you should consult your primary care physician for a blood test.
If hypothyroidism goes untreated, you can get severe symptoms, such as a slow heart rate or anemia. However, the condition is often caught before it progresses to this stage.
Please tell your thyroidologist that the ATA referred you! | American Thyroid Association
Hypothyroidism: When to see an endocrinologist | Everday Health
Do you need to see an endocrinologist for your thyroid disease? |Patient Empowerment Network