How Thyroid Patients Can Find the Best Doctors for Thyroid Care

Do You Need a Thyroid Specialist?

Doctor Talking with Patient
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Do you need a thyroid specialist?

I frequently hear from thyroid patients who wonder what type of doctor to see for thyroid conditions, or who complain that their doctors don't understand how to diagnose and treat their thyroid conditions. I wish I had a solution, and could recommend the best practitioner -- one with the perfect mix of skills and expertise -- for each patient. But the reality is, many of us have to be our own advocates, and figure out which direction to go to find the best doctor for you.

There are some general guidelines to keep in mind, however, that can help you get on track in your effort to find a great doctor.

Realize that You Can't Get Everything In One Person

Regularly, thyroid patients write to me saying something along the lines of: "I need a really great thyroid doctor, one who can also be my primary care doctor, is up on all the latest thyroid information, has an open-mind about natural thyroid drugs, has a terrific bedside manner, has evening and weekend hours, takes my insurance, never runs late and won't keep me waiting, and, oh, by the way, the doctor needs to be no more than a 15 minute drive from me."

While I understand that we all wish for Dr. Perfect, the doctor who meets all of your criteria is a myth. My first thought when I hear this sort of wish list is to recommend that you scale back your expectations, and prioritize what's most important to you, because you are very unlikely to find one doctor who can meet all of your needs.

For example, few thyroid experts also provide primary care. Some of the best and smartest thyroid doctors could use a little polish in the bedside manner department. If a doctor is in your HMO or takes your insurance, he or she probably isn't willing to work with natural thyroid drugs. And I know thyroid patients who are driving hours -- some are even flying hours -- to see great thyroid doctors.

In my own case, while I've been treated by my doctor for more than a decade for my thyroid care, she doesn't take any insurance, she sometimes runs quite late, and doesn't handle any primary care medicine. Every doctor has his or her own list of pros and cons.

You probably won't be able to get everything you want in one person, so decide what is really important to you, and what is realistic -- for example, if there's no way you pay out of pocket, or travel a long distance to see a doctor, those are important considerations.

Choose the Best Doctor For Your Needs

Ultimately, the type of doctor you choose for your thyroid care depends on a number of factors, including the nature of your condition, what you can afford, your location, and availability of physicians in your area, among other considerations.

Some thyroid patients and practitioners assume that an endocrinologist -- the kind of specialist who handles endocrine diseases like thyroid problems and diabetes -- is always necessary for thyroid issues. And if you have Graves' disease, hyperthyroidism, nodules, a goiter, suspected thyroid cancer, or thyroid eye disease, then an endocrinologist is very important. And if you have new onset of Hashimoto's thyroiditis -- the autoimmune disease that causes hypothyroidism -- I would argue that at least an initial evaluation by an endocrinologist is a good idea. The American Association of Clinical Endocrinologists maintains a database of certified endocrinologists, and the American Thyroid Association maintains an online Thyroid Specialist Database that list endocrinologists around the United States.

Keep in mind, however, that we are facing a severe shortage of practicing endocrinologists in the United States. Endocrinologists are at the front lines of the epidemic of diabetes, and are also specialists in thyroid disease, osteoporosis, infertility, and a host of other hormone issues, so demand far exceeds supply. That means that waiting lists can be months to see an endocrinologist, and that trend is likely to get worse as the shortage becomes more acute.

Thyroid cancer is relatively rare, and even some endocrinologists have little experience with it. So if you have suspected or diagnosed thyroid cancer, you'll definitely want to deal with a physician -- usually an endocrinologist -- who has extensive, and demonstrable expertise working specifically with thyroid cancer patients. It's not enough to just see an endocrinologist, or a head and neck surgeon; see a thyroid cancer expert. has a specialists list, and the Thyroid Cancer Survivor's Association also maintains lists of thyroid cancer experts around the US and internationally.

The lowest rates of complications for thyroid surgery are seen with surgeons who specialize in thyroid surgery, and who perform several hundred thyroid surgeries a year, so if you need a thyroid surgery, definitely see an experienced thyroid surgeon. My article on finding a top thyroid surgeon includes a variety of databases and resources for thyroid surgeon referrals.

As a patient advocate, I would argue that an endocrinologist or thyroidologist is not necessarily the best choice for everyone with a thyroid condition, especially if you have borderline thyroid problems that doctors are refusing to treat, or if you are hypothyroid, and you don't feel well on your treatment, but your doctor is not interested in offering you any alternatives. In those situations, patients frequently turn to other types of doctors -- ranging from general practitioners, to internists, to holistic and integrative doctors, to osteopathic physicians, to gynecologists. Physicians from a broad spectrum of specialties are becoming more adept at diagnosing and treating hormone imbalances, including thyroid conditions. To find these physicians, some patients user the directories provided by the American Holistic Medical Association, the database of doctors who prescribe the natural drug Armour Thyroid and the patient-recommended Thyroid Top Doctors Directory, among other sources.

Be Willing to Pay if You Can, If Needed

If you are covered by an HMO, or participate in medical insurance, or have medical coverage from the US military, or you live outside the US and have access to government-sponsored health care, like the National Health Service in the United Kingdom, there are some pros and cons for the thyroid care you're likely to receive.

If you need the services of a conventional endocrinologist, you should be fine, because these sorts of health care systems typically have qualified specialists who can capably treat you.

If you have subclinical or autoimmune thyroid disease, or you do not do well on a standard levothyroxine treatment, however, you may be frustrated by the limited choice of doctors you have, and the level of attention those doctors give to thyroid diagnosis and treatment.

You will find that doctors in these sorts of systems are rarely allowed to use innovative or controversial tests and treatments, such as Free T3 tests, Reverse T3 tests, T3 drugs, and natural desiccated thyroid medications, and usually can't spend the time to help identify, test for, diagnose and treat complex autoimmune and hormonal imbalances.

Doctors who are part of HMOs, reimbursed by insurance companies, or who are part of government-run health care programs, must follow official guidelines set up by those companies or governments that carefully outline which diagnostic tests and treatments are the standard of care, and impose time limits for office visits. HMOs, insurers and government health-care programs typically require doctors to follow narrow and conventional guidelines, such as relying on TSH tests for diagnosis and management, and using only levothyroxine drugs like Synthroid for thyroid hormone replacement.

When you need more personalized thyroid care, you can decide to fight the system, yes. But it can a long, hard fight, and you may not win. Sometimes you may encounter a more open-minded practitioner who is willing to think outside the box on your behalf. If you do, take advantage of that relationship, and hope that the practitioner doesn't move or leave or get fired! Frequently, however, the best solution is to pay out of pocket to see a great "private" practitioner.

I've heard patients say that it's not fair, and they refuse to pay extra for something they feel they should be getting as part of their existing service. Believe me, I understand the frustration, and it isn't fair, and it does seem ridiculous to have to pay extra for something that you're already paying for. But the reality is, if you can afford it, even several visits with a truly knowledgeable practitioner could mean returning to wellness, versus years of fighting with sub-par doctors, while coping with chronic illness.​

Know When It's Time for a Second Opinion or a New Doctor

Finally, I think it's important to know when it's time to look for fresh ideas and new perspectives.

Sometimes, when you feel like your practitioner could use an additional pair of eyes to look at the situation, a second opinion can be a terrific addition to your care. It's important to know when it's time as a thyroid patient to seek a second opinion. In other situations, however, a second opinion is not enough, and it's really time for a new doctor. Many of us are reluctant to "fire" a doctor, but it's often the most important first step toward wellness. Learn about the 10 signs that you need a new thyroid doctor. And if you're still wondering if it's time, listen to what other patients have to say about it. More than 130 thyroid patients have shared their own stories about how they knew it was time for a new thyroid doctor. You may recognize your own situation, or feel compelled to tell your own story about how you knew it was time to look for a new practitioner for your thyroid care.