Conditions we treat
Your thyroid is a small, butterfly-shaped gland at the base of your neck that makes hormones controlling how your body uses energy. When it makes too little hormone (hypothyroidism) or too much (hyperthyroidism), nearly every system can be affected, from heart rate and mood to weight, menstrual cycles, and bones. Lumps in the gland, called thyroid nodules, are also very common and are usually benign. Most thyroid conditions can be managed effectively once they’re accurately diagnosed.
20 million
Americans have some form of thyroid disease
Up to 60%
of people with thyroid disease are unaware of their condition
Over 90%
of thyroid nodules are benign (noncancerous)
On this page
An endocrinologist evaluates and treats the full range of thyroid problems, including:
The thyroid doesn't make enough hormone, so the body slows down.
An autoimmune condition and the most common cause of hypothyroidism in the United States. It is 4 to 10 times more common in women than in men.
Excess thyroid hormone speeds the body up. Causes include Graves' disease, overactive nodules, thyroid inflammation (thyroiditis), and taking too much thyroid medication.
An autoimmune condition responsible for about 4 out of 5 cases of hyperthyroidism in the U.S. It can also affect the eyes.
Lumps in, or enlargement of, the gland. By age 60, about half of people have a nodule that can be found on exam or imaging.
Thyroid symptoms often develop slowly and can be mistaken for stress, aging, or other conditions. Common signs include:
Fatigue, feeling cold, dry skin, constipation, weight gain, low mood, forgetfulness, and heavier or irregular periods
A racing or irregular heartbeat, weight loss despite a good appetite, heat intolerance, tremor, anxiety, trouble sleeping, and more frequent bowel movements
Usually no symptoms, but sometimes a visible lump, a feeling of pressure, trouble swallowing, or hoarseness
The key first test is thyroid-stimulating hormone (TSH), a pituitary hormone that rises when the thyroid is underactive and falls when it is overactive. Free T4, and sometimes T3, show how much thyroid hormone is circulating. Antibody tests can identify Hashimoto’s disease (TPO antibodies) or Graves’ disease (TSI or TSH receptor antibodies).
For hyperthyroidism, a radioactive iodine uptake scan can help pinpoint the cause. Nodules are evaluated with thyroid ultrasound, and a fine-needle aspiration biopsy is recommended for nodules with certain sizes or ultrasound features. The American Thyroid Association’s thyroid nodule guide explains what to expect. Tell your clinician if you take biotin, which can interfere with some thyroid blood tests.
Treatment depends on the specific diagnosis, your symptoms, and your preferences. The American Thyroid Association’s hypothyroidism overview is a helpful starting point. Main approaches include:
A daily thyroid hormone pill, levothyroxine, replaces what your gland can't make. Blood tests are checked 6 to 8 weeks after starting or changing the dose until your levels are stable.
Beta-blockers can quickly ease a racing heart and tremor. Longer-term options include antithyroid medicine (most often methimazole), radioactive iodine, or surgery. Radioactive iodine and surgery often lead to hypothyroidism, which is then treated with levothyroxine, and radioactive iodine isn't used during pregnancy or breastfeeding.
Most benign nodules simply need periodic ultrasound monitoring. Suspicious or cancerous nodules are referred for surgery, and overactive nodules may be treated with radioactive iodine or surgery.
Thyroid hormone needs rise during pregnancy, and people taking levothyroxine often need a higher dose as soon as pregnancy is confirmed. If you have a thyroid condition and are pregnant or planning a pregnancy, contact your clinician promptly.
Thyroid disease often overlaps with other hormone conditions. People with type 1 diabetes have a higher risk of autoimmune thyroid disease, and thyroid problems can cause irregular periods that resemble PCOS. Untreated hyperthyroidism, or taking more thyroid hormone than you need, can contribute to bone loss and heart rhythm problems such as atrial fibrillation.
Your first visit includes a review of your symptoms, past lab results and imaging, medications, and supplements, along with a neck examination. Your endocrinologist then orders targeted tests, which may include thyroid labs, antibody tests, and an ultrasound, and explains what each result means for you.
For ongoing care, we adjust medication doses based on labs and symptoms, arrange biopsies when needed, and coordinate with your primary care doctor, obstetrician, surgeon, or eye specialist for Graves’ eye disease. Lab-review follow-ups often work well as virtual visits. Book a thyroid consultation in person or online.
Not exactly. Hashimoto’s disease is an autoimmune condition in which the immune system attacks the thyroid, and it is the most common cause of hypothyroidism in the United States. Some people have Hashimoto’s antibodies for years while their thyroid still works normally. Hypothyroidism describes the result: a thyroid that isn’t making enough hormone for the body’s needs.
Most thyroid nodules are not cancer. The American Thyroid Association notes that over 90% of nodules are benign. Still, every nodule deserves proper evaluation with a TSH blood test and a thyroid ultrasound. Depending on its size and ultrasound features, your endocrinologist may recommend a fine-needle biopsy or simply periodic monitoring over time.
Your needs can shift with weight changes, pregnancy, aging, other medicines or supplements, and how consistently you take the pill. Taking it at different times, or with food, coffee, calcium, or iron, can reduce absorption. Labs are usually rechecked 6 to 8 weeks after any dose change, so it may take a few adjustments to find your right dose.
Yes, though usually modestly. An underactive thyroid can cause some weight gain, much of it from fluid, while an overactive thyroid often causes weight loss despite a good appetite. Treating the thyroid condition may help, but thyroid hormone should never be used as a weight-loss treatment, because excess doses can harm the heart and bones.
Many thyroid visits can be virtual, especially reviewing lab results and adjusting medication. You can complete blood tests at a local lab and discuss the results with your TopInspired endocrinologist online. An in-person visit may be recommended for a neck exam, ultrasound, or biopsy, particularly for new or changing thyroid nodules.
Last reviewed September 19, 2026. This page is educational and is not a substitute for personal medical advice — see our medical disclaimer.
Related conditions
An autoimmune condition that requires daily insulin. We help you fine-tune insulin, CGM, and pump settings for safer, steadier glucose.
The most common form of diabetes. We personalize medications, glucose monitoring, and lifestyle plans to protect your heart, kidneys, and eyes.
Higher-than-normal blood sugar that rarely causes symptoms. Acting early can lower your chances of developing type 2 diabetes.
Keep reading on the TopInspired blog
TopInspired · Specialist care
Whether you’ve just been diagnosed or have managed diabetes or a thyroid condition for years, a TopInspired specialist can help you understand your numbers and build a plan that fits your life.
