Thyroid disorders
The thyroid is a small gland in the neck that sets the body's speed. When it runs slow or fast, it can cause tiredness, weight change, hair loss and palpitations. Blood tests help assess thyroid function; interpretation depends on symptoms, medicines and other findings.
Who should see an internist about this
- A blood test showed abnormal TSH, T3 or T4.
- You feel tired, cold, constipated, or are gaining weight without reason.
- Your heart races, your hands shake, or you lose weight without reason.
- You have a swelling in the front of your neck or a thyroid nodule on a scan.
- You take thyroid medicine and want your dose reviewed.
- Thyroid disease runs in your family, or you are planning a pregnancy.
What happens at your visit
Dr. James asks about your symptoms, medicines, supplements and family history, then examines your neck, pulse, skin and reflexes. He reviews your thyroid function tests (the blood tests TSH, T4 and T3) and may repeat them or add an antibody test to find the cause.
If a lump or nodule is suspected, an ultrasound may be arranged. He then explains in plain words whether the gland is underactive, overactive, or simply needs watching.
Underactive thyroid is often treated with thyroid hormone replacement. The dose needs monitoring: too much can cause palpitations and other problems, while too little may leave symptoms unresolved. The need for treatment and response vary. Overactive thyroid has different treatment options and risks, which should be discussed individually.
How to prepare
- Bring your previous thyroid reports so trends can be compared.
- Bring your medicine and supplement list. Biotin, a common hair supplement, can disturb thyroid test results, so mention it.
- If you take thyroid tablets already, take them as usual and note the dose.
After your visit
You leave knowing what your numbers mean and the plan: start, adjust or simply monitor. Repeat tests are scheduled at the right interval, not too early to be useful and not too late to matter. Pregnancy plans are discussed early, because thyroid targets are stricter then.
Common questions
What do TSH, T3 and T4 mean?
TSH is the signal from your brain telling the thyroid how hard to work. T4 and T3 are the hormones the thyroid makes. A high TSH usually means the gland is underactive; a low TSH suggests it is overactive. Dr. James reads all three together, never one number alone.
Will I need thyroid medicine for life?
An underactive thyroid usually needs a daily hormone tablet long-term. The dose needs monitoring: too much can cause palpitations and other problems, while too little may leave symptoms unresolved. An overactive thyroid sometimes settles after a course of treatment, and its options and risks should be discussed individually. Your situation is reviewed at each visit so the dose stays right.
My TSH is slightly high but I feel fine. Do I need treatment?
Maybe not. A mildly raised TSH with normal hormone levels is called subclinical hypothyroidism, and sometimes only monitoring is needed. Whether to treat depends on the exact numbers, your symptoms, your age and whether pregnancy is planned.
Can thyroid problems cause weight gain and hair loss?
Yes. An underactive thyroid slows the body down, so weight gain, dry skin, hair loss, constipation and feeling cold are typical. Treating the thyroid often improves these, though weight usually needs diet and activity changes too.
How often do I repeat the blood test?
After starting or changing a dose, the test is usually repeated in about six to eight weeks, because the body needs time to settle. Once stable, once or twice a year is enough for most people.
