Do You Always Need an Endocrinologist for Your Thyroid Condition?

Many people think that the best doctor to treat every thyroid condition is an endocrinologist.

Endocrinology is a specialty that offers advanced training in the endocrine system, which includes various glands and organs such as the thyroid, pancreas, ovaries, testes, and adrenal glands, among others. While many endocrinologists specialize in diabetes treatment, more recently, an increasing number are specializing in the profitable area of reproductive endocrinology (also known as "fertility doctors.") With an aging population, endocrinologists are also increasingly being called on to help manage osteoporosis.

Surprisingly, despite the prevalence of thyroid disease, few endocrinologists choose to focus their work on thyroid diagnosis and treatment. Those who do work with thyroid patients tend to concentrate mainly on handling more acute thyroid situations such as thyroid cancer, thyroid storm, and Graves' disease. A small subset of endocrinologists want to differentiate themselves, and refer to themselves as "thyroidologists." Thyroidologists tend to be very traditional endocrinologists.

Let's take a closer look at the "thyroid," reasons for seeing an endocrinologist over a general practitioner, also known as an internist, primary care physician, or family doctor.

When should you absolutely use an endocrinologist?

First, if you have thyroid cancer, you should see an endocrinologist. Keep in mind that you can't just pick any endocrinologist off a list. You only want one who has expertise in treating thyroid cancer patients. Since thyroid cancer is not especially common—an estimated 50,000 cases a year are diagnosed in the U.S.—many endocrinologists may never have even diagnosed or treated thyroid cancer. (A good source to find physicians who specialize in diagnosing and treating thyroid cancer is the Thyroid Cancer Survivors' Association).

Second, if you have acute Graves' disease, thyroid nodules, or a goiter, see an endocrinologist. But again, you will need an endocrinologist who has specific expertise in treating thyroid patients. You do not want a diabetes specialist who handles a thyroid patient here and there on the side. The American Thyroid Association "Find a Specialist" directory or the endocrinologists listed in the Thyroid Top Docs Directory are a good resource.

Third, if you are planning on conceiving or pregnant and you have a thyroid condition, or you have a newborn or young child diagnosed with a thyroid disorder, see an endocrinologist. It's especially important to manage your thyroid during pregnancy because poor treatment can endanger your pregnancy and result in problems for the newborn. And managing thyroid issues in newborns and young children is better handled by an endocrinologist and not something that should typically be left to a pediatrician.

Fourth, if you have a "harder to diagnose" thyroid imbalance, subclinical/borderline thyroid disease, a "normal" TSH but thyroid symptoms, or you're being treated for hypothyroidism but you still don't feel well, an endocrinologist can hopefully provide you with the specialized care you need, whether that's taking a second look at your diagnostic test results and/or modifying your treatment plan.

Lastly, you should see an endocrinologist if you have secondary hypothyroidism, a rare condition in which your pituitary gland, which sits at the base of the brain, is not producing a hormone called thyrotropin-releasing hormone (TRH) that normally triggers the thyroid to produce thyroid hormone.

What kind of doctor should do thyroid surgery? 

If you need to have surgery to remove all or part of your thyroid, choose a surgeon who is an expert in thyroid surgery. Keep in mind that many ear/nose/throat and general surgeons are not considered thyroid surgery experts; and you'll want a surgeon who does dozens of thyroid surgeries a year, at a minimum. For more information, read Finding a Top Thyroid Surgeon.)

A Word from Verywell

The decision to find a doctor for your thyroid care can be a challenging one, as the relationship is an intensely personal one, and it's not easy to find the right match, particularly when you may be limited by geography and insurance. Remain proactive in seeking out the right doctor-patient relationship. And keep a positive mindset, too—when you find that trusting, compassionate partnership, you will just know it.