Common Thyroid Conditions
An endocrinologist evaluates and treats the full range of thyroid problems, including:
- Hypothyroidism (underactive thyroid): the thyroid doesn't make enough hormone, so the body slows down.
- Hashimoto's disease: 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.
- Hyperthyroidism (overactive thyroid): excess thyroid hormone speeds the body up. Causes include Graves' disease, overactive nodules, thyroid inflammation (thyroiditis), and taking too much thyroid medication.
- Graves' disease: an autoimmune condition responsible for about 4 out of 5 cases of hyperthyroidism in the U.S. It can also affect the eyes.
- Thyroid nodules and goiter: 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.
Signs and Symptoms of Thyroid Problems
Thyroid symptoms often develop slowly and can be mistaken for stress, aging, or other conditions. Common signs include:
- Underactive thyroid: fatigue, feeling cold, dry skin, constipation, weight gain, low mood, forgetfulness, and heavier or irregular periods
- Overactive thyroid: a racing or irregular heartbeat, weight loss despite a good appetite, heat intolerance, tremor, anxiety, trouble sleeping, and more frequent bowel movements
- Nodules: usually no symptoms, but sometimes a visible lump, a feeling of pressure, trouble swallowing, or hoarseness
How Thyroid Disorders Are Diagnosed
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.
Thyroid Treatment Options
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:
- Hypothyroidism: 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.
- Hyperthyroidism: 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.
- Nodules: 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.
Your Thyroid Visit at TopInspired.com
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.
Living Well With a Thyroid Condition
- Take levothyroxine the same way every day, typically on an empty stomach and separated from calcium and iron supplements, which can reduce absorption
- Keep follow-up lab appointments, especially after a dose change, pregnancy, or significant weight change
- Avoid high-dose iodine or kelp supplements unless your clinician recommends them
- If you have Graves' disease, avoid smoking, which is linked to Graves' eye disease
- Report new neck lumps, voice changes, or trouble swallowing promptly
When to see a TopInspired endocrinologist
- Your TSH or thyroid hormone levels are abnormal, including borderline results
- A thyroid nodule, goiter, or neck lump has been found on exam or imaging
- You have symptoms of hyperthyroidism or a diagnosis of Graves' disease
- You have ongoing symptoms or trouble finding the right levothyroxine dose
- You're pregnant or planning a pregnancy and have a thyroid condition
- You notice eye bulging, irritation, or double vision alongside thyroid disease
- You have a family history of thyroid cancer or past radiation to the head or neck
Thyroid Disorders: frequently asked questions
Is Hashimoto's the same as hypothyroidism?
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.
Should I worry about a thyroid nodule?
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.
Why does my levothyroxine dose keep changing?
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.
Can thyroid problems affect my weight?
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.
Can I be treated for a thyroid condition virtually?
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.
Sources & further reading
- American Thyroid Association: General Information / Press Room
- American Thyroid Association: Hypothyroidism
- American Thyroid Association: Hyperthyroidism
- American Thyroid Association: Thyroid Nodules
- NIDDK: Hashimoto's Disease
- NIDDK: Graves' Disease
Last reviewed September 19, 2026. This page is educational and is not a substitute for personal medical advice — see our medical disclaimer.
