When to See an Endocrinologist
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Most people with hypothyroidism take synthetic thyroid hormone replacement medication to make up for what the body isn’t producing. Usually, a primary care doctor can manage this condition, which is common and affects nearly 5 percent of Americans age 12 and older, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
But there are situations in which you may need to have an endocrinologist, a doctor who specializes in the endocrine system, oversee your care. An endocrinologist is particularly knowledgeable about the function of the thyroid gland and the body’s other hormone-secreting glands.
When to See a Thyroid Specialist
Tamara Wexler, MD, PhD, an endocrinologist at NYU Langone Health in New York City, recommends seeing an endocrinologist at least once when you’re first diagnosed with hypothyroidism to review your condition, your test results, and your treatment plan. “After one or two visits, you may not need to keep seeing them regularly,” she says. That’s when your primary care doctor can usually take over.
Other times it’s smart to see an endocrinologist are when:
Symptoms of hypothyroidism don’t get better despite treatment. If you’ve been taking medication to replace your thyroid hormone for a while but your symptoms persist, you might want to see an endocrinologist for a second opinion, says Cathy Doria-Medina, MD, an endocrinologist with Optum Primary Care in Torrance, California. Some people with hypothyroidism have a more difficult time finding the concentration of thyroid hormone medication that works best for them. In these situations, a specialist often can help, she says.
You have a thyroid nodule or lump. Your thyroid gland is located in the front of your neck, just below your voice box. If you have a lump, nodule, or other growth on your thyroid, an endocrinologist should examine it. Most are harmless (benign), but once in a while, a more serious change is happening. About 4 to 6.5 percent of thyroid nodules are cancerous, according to the Cleveland Clinic. And sometimes — though it’s rare — thyroid nodules actually cause hypothyroidism.
You have an enlarged thyroid gland, or goiter. A goiter is an enlargement of part or all of your thyroid gland. If you have one, see an endocrinologist to help you figure out why it has developed, and what treatment will help. “If you have a goiter, you should see an endocrinologist whether you have hypothyroidism or not,” Dr. Wexler says.
A pituitary gland disorder is causing hypothyroidism. This gland, along with the hypothalamus, sits at the base of the brain and controls your body’s production of thyroid hormone. In some people, the pituitary gland fails to release TSH, or thyroid-stimulating hormone, although this is relatively unusual. TSH is important because it helps the thyroid gland produce essential thyroid hormones that influence your metabolism and other bodily functions. Hypothyroidism is a complicated condition, so if possible, see an endocrinologist to help you with next steps.
You are pregnant or are trying to conceive. Be sure to educate yourself about the effect of pregnancy on your condition, and vice versa, if you have an underactive thyroid. Pregnancy changes your hormone levels considerably. If you want to get pregnant, or you become pregnant, you should see an endocrinologist to monitor your thyroid hormone medication treatment closely and be sure you’re getting enough. Some women need between 25 to 50 percent more thyroid hormone while pregnant. Another reason to work with an endocrinologist during pregnancy: Untreated hypothyroidism increases the risk of having a miscarriage.
How to Find an Endocrinologist for Hypothyroidism
Your primary care doctor most likely has names of endocrinologists they can refer you to. Or you can visit the American Thyroid Association website to search for endocrinologists in your area.
Additional reporting by Andrea Peirce.
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