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, provide complementary treatment to thyroid patients.

The main types of thyroid disease are:

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How to Work With Your Thyroid Medical Team

Thyroid Disease Doctor Discussion Guide

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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. They're called thyroxine (T4) and triiodothyronine (T3). Thyroid function depends greatly on another gland—the pituitary, which monitors hormone levels and tells your thyroid when and 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.

Hyperthyroidism (Overactive)
  • Unintended weight loss

  • Unusually hot and sweaty

  • Difficulty falling asleep

  • Wake up at night a lot

  • Racing heart at bedtime

  • Severe hair loss

  • Shorter, lighter periods

  • Skin rashes

Hypothyroidism (Underactive)
  • Unintended weight gain

  • Unusually cold

  • Waking up exhausted

  • Long naps

  • "Marathon" sleep sessions

  • Some hair loss

  • Heavy, painful periods

  • Dry, scaly skin

Who Treats Thyroid Disease?

Several types of doctors can play a role in managing thyroid disease and its symptoms. Some people only see one doctor for thyroid-related issues, while others have a medical team they work with to manage their disease. The types of doctors 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, who's 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
Doctor and patient
Terry Vine​ / Getty Images  

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 doctor may refer you to an endocrinologist. This can be for a number of reasons:

  • A complex case due to multiple medical problems
  • A doctor who's inexperienced in treating the disorder
  • The doctor wanting a specialist's opinion about your diagnostic test results or treatment plan

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.

Primary Care vs Specialist

While primary care doctors can manage some endocrine conditions, like "textbook" hypothyroidism and diabetes, an endocrinologist is generally better for hyperthyroidism and pituitary or adrenal gland problems.

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, once your endocrinologist stabilizes your thyroid hormone replacement dose, it may then be up to your primary care doctor to keep track of your TSH levels, with you seeing the specialist only for a yearly check-up or if a problem arises.

Holistic Thyroid Doctors

Many thyroid patients look to seek out 360-treatment plan—that is, one that includes practitioners of different disciplines and takes a "whole body" approach. Naturopathic doctors 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 doctor(s). Be sure to check with your primary doctor 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 replacement TSH, which prompts the body to make more T3 and T4. Many NDs instead prescribe desiccated thyroid hormone for hypothyroidism. This product is derived from the dried thyroid glands of pigs or cows and directly provides both T4 and T3 rather than TSH.

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.

Other Names for Desiccated Thyroid

  • Natural thyroid
  • Thyroid extract
  • Porcine thyroid
  • Pig thyroid

Brand names include Nature-throid and Armour Thyroid.

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 the study of 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).

Chiropractors are legally prohibited from prescribing thyroid medication, which means that they cannot treat or cure thyroid conditions.

Frequently Asked Questions

How does a doctor check your thyroid?

Doctors check your thyroid with blood tests and imaging. Blood tests are to look at:

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

Imaging, especially for hyperthyroidism, may include:

  • Ultrasound to diagnose or examine thyroid nodules
  • Thyroid scan, which uses a small amount of radioactive iodine to identify nodules that over-produce thyroid hormone
  • Radioactive iodine uptake test, which measures how much iodine your thyroid takes from your blood (iodine is a necessary component of thyroid hormones)

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 doctor 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.

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Article Sources
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  6. Riza E, Linos A, Petralias A, De martinis L, Duntas L, Linos D. The effect of Greek herbal tea consumption on thyroid cancer: a case-control study. Eur J Public Health. 2015;25(6):1001-5. doi:10.1093/eurpub/ckv063

  7. American Chiropractic Association. Certification, licensure and education. Updated 2019.

  8. Hormone Health Network. The value of an endocrinologist.

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