Do You Need to See an Endocrinologist for Your Thyroid Disease?

Thyroid disease is often managed by hormone specialists called endocrinologists and thyroidologists, but some primary care doctors diagnose and manage it as well. Other healthcare practitioners, such as naturopaths and chiropractors, can provide complementary treatments.

The main types of thyroid disease are:

• Hypothyroidism (low thyroid hormone)
• Hashimoto's disease (autoimmune hypothyroidism)
• Hyperthyroidism (high thyroid hormone)
• Graves' disease (autoimmune hyperthyroidism)

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What is Thyroid Disease?

The thyroid is a butterfly-shaped gland at the front of your throat. It produces hormones that are crucial to many bodily functions, including growth, development, and metabolism. These hormones are called thyroxine (T4) and triiodothyronine (T3). Thyroid function depends greatly on another gland—the pituitary, which monitors hormone levels and tells your thyroid how much to produce.

The pituitary exerts this control over the thyroid with the aptly named thyroid-stimulating hormone (TSH). When thyroid hormone levels drop, the pituitary releases more TSH to stimulate the thyroid to increase production.

In thyroid disease, you can end up with either too much thyroid hormone—hyperthyroidism—or too little—hypothyroidism. Hyperthyroidism speeds up your body's systems and processes, while hypothyroidism slows them down, leading to opposite symptoms.

Who Treats Thyroid Disease?

Several types of healthcare providers can play a role in managing thyroid disease and its symptoms. Some people only see one healthcare provider for thyroid-related issues, while others have a medical team they work with to manage their disease. The types of healthcare providers you may want to consider include:

• Primary care doctors
• Endocrinologists or thyroidologists
• Holistic thyroid practitioners, including naturopaths and chiropractors

Primary Care Doctors

Your primary care doctor may be able to diagnose and manage your thyroid disease, especially if you have hypothyroidism. Most primary care doctors are comfortable monitoring TSH levels and adjusting thyroid hormone replacement medication accordingly.

When to Seek a Second Opinion

Some situations warrant a referral to an endocrinologist, a hormone specialist. You should ask for a referral from your primary care doctor if you find yourself in one of these situations after you or someone you're close to is diagnosed with thyroid disease:

• You're pregnant or trying to get pregnant.
• The thyroid disease is in a newborn or child.
• You're diagnosed with thyroid nodules or an enlarged thyroid gland (goiter).
• You have any type of hyperthyroidism, including Graves' disease.
• Your hypothyroidism is caused by a problem with the pituitary gland.
• You have thyroid eye disease.
• Thyroid cancer is suspected.
• You're not feeling better despite treatment.

Endocrinologists

An endocrinologist is a doctor who completes training in internal medicine (like a primary care physician) and then undergoes more training (usually two to three years) in the field of endocrinology. Endocrinologists diagnose and treat hormonal imbalances.

Even if you have "textbook" hypothyroidism, your healthcare provider may refer you to an endocrinologist. This can be for a number of reasons:

• Your case is complex due to multiple medical problems.
• Your doctor is inexperienced in treating the disorder.
• The doctor wants a specialist's opinion about your diagnosis or treatment.

Depending on your diagnosis and treatment plan, your endocrinologist may opt to manage your condition on their own. Alternatively, your endocrinologist and primary care doctor may work together to manage your condition.

Thyroid Specialist

Endocrinologists who get extra training and specialize in thyroid disorders are called thyroidologists. You may need to see a thyroidologist if you:

• Have thyroid nodules
• Have other growths on your thyroid
• Aren't getting better despite treatment

Team Treatment

Your endocrinologist or thyroidologist may work with your primary care doctor to manage your condition. For example, if your primary care doctor refers you to an endocrinologist for a diagnosis of Hashimoto's disease, the endocrinologist may find the right dosage of thyroid hormone replacement for you. It may then be up to your primary care doctor to keep track of your TSH levels going forward, with you seeing the specialist only for a yearly check-up or if a problem arises.

Holistic Thyroid Doctors

Many thyroid patients seek out a treatment plan that includes practitioners of different disciplines and takes a "whole body" approach. Naturopathic healthcare providers and chiropractors are sometimes involved in this type of thyroid treatment.

The care they can provide, however, is considered complementary, or in addition to the care and treatments provided by your healthcare provider(s). Be sure to check with your primary healthcare provider or endocrinologist on any treatment recommended by other types of practitioners.

Naturopathic Doctors

A licensed naturopathic doctor (ND) graduates from a four-year graduate-level holistic medical school. Their approach to healthcare tends to be more integrative than traditional doctors because NDs believe no part of your body operates in isolation from the rest.

So, for example, an ND may discuss how nutrition affects thyroid disorders and ensure you have a diet plan that supports your thyroid health. In addition, by ordering labs and imaging tests, an ND may evaluate other hormones, including sex hormones and the "stress hormone" cortisol.

Different Guidelines

While an integrative approach to your thyroid health may sound appealing, know that NDs do not necessarily follow the guidelines recommended by professional societies like the American Thyroid Association (ATA) or the American Association of Clinical Endocrinologists (AACE).

For instance, the standard medical approach to hypothyroidism is a synthetic form of T4. Many NDs instead prescribe desiccated thyroid hormone for hypothyroidism. This product is derived from the dried thyroid glands of pigs or cows and provides both T4 and T3.

Most expert organizations, such as the American Association of Clinical Endocrinology and the American Thyroid Association, don't recommend its usage for most patients because it tends to create hyperthyroidism.

Also, some NDs practice botanical medicine, recommending herbs for the care of various medical problems. Taking herbs and supplements can be beneficial in some cases, but it can also be especially harmful to a person with thyroid disease as those substances may interfere with your medication and/or the functioning of your thyroid gland itself.

Chiropractors

According to the American Chiropractic Association, chiropractors are designated as "physician-level providers" in the vast majority of states. While the doctor of chiropractic (DC) program is similar to the doctor of medicine (MD) program in the first two years, the programs diverge in the second half. During this time, the DC program focuses on diet, nutrition, and spinal manipulation, while the MD program emphasizes clinical medicine, including pathology and pharmacology.

Chiropractors can order laboratory tests and imaging, but they can't prescribe medication. That means they may be able to diagnose thyroid disease, but then they're required to send you to a medical doctor for treatment.

Chiropractors can, however, provide supportive thyroid care such as nutritional guidance or ways to ease musculoskeletal pain associated with thyroid disease (like carpal tunnel syndrome or joint aches).

Frequently Asked Questions

How does a healthcare provider check your thyroid?

Healthcare providers check your thyroid with blood tests and imaging. Blood tests look at levels of:

• TSH
• T3
• T4
• Autoantibodies, which indicate Hashimoto's or Graves' disease

Imaging tests, especially for hyperthyroidism, may include an ultrasound, thyroid scan, or a radioactive iodine uptake test to identify thyroid nodules and see how active the gland is.

What does an endocrinologist treat?

An endocrinologist treats hormone-related conditions, such as:

• Thyroid disorders
• Diabetes
• Osteoporosis and bone health
• Adrenal disorders
• Pituitary disorders
• Menopause issues
• Testosterone problems

A Word From Verywell

Finding a healthcare provider for your thyroid care can be challenging, as the relationship is an intensely personal one, and it's not always easy to find the right match. That's especially true if you face limitations due to geography and insurance. With advancements in telehealth, though, you may be able to find a specialist to consult with long-distance.