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

Doctors can treat hypothyroidism (low thyroid function) and other thyroid disease, though hormone specialists called endocrinologists and thyroidologists are among the healthcare providers you may see for these conditions.

Some primary care providers and complementary medicine providers also diagnose and treat hypothyroidism. Seeing a thyroid specialist may be necessary in certain conditions, though, such as when your thyroid disorder is caused by another medical condition.

This article explains hypothyroidism, its symptoms, and the healthcare providers who treat it. The article will help you to learn more about the reasons for seeing a specialist to treat thyroid disorders, including hypothyroidism.

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When Should You Get Your Thyroid Checked?

Hyperthyroidism speeds up your body's systems and processes, while hypothyroidism slows them down, leading to opposite symptoms.

Autoimmune disorders also can lead to these conditions, such as hypothyroidism due to Hashimoto's disease or hyperthyroidism caused by Graves' disease.

Thyroid Hormones and Function

The thyroid (a butterfly-shaped gland at the front of your throat) produces hormones called thyroxine (T4) and triiodothyronine (T3). Thyroid function depends greatly on thyroid-stimulating hormone (TSH) released from the pituitary gland. In thyroid disease, you can have too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) with different symptoms.

When you experience symptoms that may be thyroid-related, it's important to see a healthcare provider and begin the process of an accurate diagnosis.

Most people will first make an appointment with their primary care provider to discuss the following symptoms and any necessary testing.

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 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 providers
  • Endocrinologists or thyroidologists
  • Holistic thyroid practitioners, including naturopaths and chiropractors

Primary Care Providers

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

Healthcare providers check your thyroid with blood tests and imaging, usually beginning with a blood test for TSH level. The American Society for Clinical Pathology recommends that if TSH level is not normal, more tests are needed and may include:

Your provider can begin treatment with levothyroxine. In some cases, your healthcare provider may need to make decisions about test results considered subclinical (you don't have typical symptoms).

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.

Doctor and patient
Terry Vine​ / Getty Images  

When to See a Thyroid Specialist

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, and treat people with:

  • Thyroid disorders
  • Diabetes
  • Adrenal disorders
  • Pituitary disorders

Some cases and special situations may warrant a second opinion or specialist care for your hypothyroidism. They can include:

  • Pregnancy, 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.

You also may wish to see a specialist when your hypothyroidism is caused by a problem with the pituitary gland, or other health conditions including thyroid eye disease or suspected thyroid cancer.

Endocrinologists

Even if you have "textbook" symptoms of 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 healthcare provider is inexperienced in treating the disorder.
  • The primary care provider 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 provider may work together to manage your condition.

Primary Care vs. Specialist

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

Thyroidologist

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

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

Your thyroidologist may order specialized tests, such as molecular testing used to diagnose cancer. This may lead to surgery or other recommended treatments.

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.

Complementary Thyroid Providers

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, the 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, the 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).

Some NDs practice botanical medicine, recommending herbs for the care of various medical problems. Taking herbs and supplements can be beneficial in some cases. Yet 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.

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. However, some studies find the use of desiccated thyroid extract offers benefits in some cases.

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. Later, 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).

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

How to Find a Thyroid Doctor

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. You also have access to resources, such as the online ATA database. It can help you to locate a board-certified endocrinologist or thyroidologist in your area. It includes information about diabetes care and other hypothyroidism-related specialties.

Summary

Hypothyroidism is a thyroid disorder in which you have low thyroid function. It's often important to see a hypothyroidism doctor or specialist for treatment, although in many cases your primary healthcare provider can begin the diagnosis with basic blood tests.

Once your hypothyroidism is suspected, you may be referred to an endocrinologist or thyroid specialist (thyroidologist) for care. This is especially true if your hypothyroidism is related to an underlying health condition that requires care beyond the expertise of your primary care provider.

In most cases, hypothyroidism is managed with medication, but treatment depends on the cause of your thyroid disorder. In some cases, your providers will work as a team so be sure to discuss your care with your providers and don't hesitate to ask questions about your treatment.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Hormone Health Network. The value of an endocrinologist.

  3. Carteret Health Care. Do you need an endocrinologist for hypothyroidism?

  4. American Thyroid Association. Molecular testing in thyroid nodules.

  5. Association of Accredited Naturopathic Medical Colleges. The difference between a traditional naturopath and a licensed naturopathic doctor in North America.

  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. Shakir MKM, Brooks DI, McAninch EA, Fonseca TL, Mai VQ, Bianco AC, et al. Comparative Effectiveness of Levothyroxine, Desiccated Thyroid Extract, and Levothyroxine+Liothyronine in Hypothyroidism. J Clin Endocrinol Metab. 2021 Oct 21;106(11):e4400-e4413. doi:10.1210/clinem/dgab478.

  8. American Chiropractic Association. Certification, licensure and education.

Additional Reading

By Mary Shomon
Mary Shomon is a writer and hormonal health and thyroid advocate. She is the author of "The Thyroid Diet Revolution."