Thyroid problems: underactive, overactive and lumps

How thyroid problems show up, the tests your GP may order, and when you might see an endocrinologist.

What the thyroid does

The thyroid is a small gland at the front of the neck. It makes hormones that help control energy, heart rate, body temperature and weight. Thyroid problems are common, especially in women, and most are very treatable.

Common thyroid problems

• Underactive thyroid (hypothyroidism): may cause tiredness, feeling cold, weight gain, dry skin, constipation or low mood.
• Overactive thyroid (hyperthyroidism): may cause a fast or irregular heartbeat, weight loss, sweating, shaky hands, anxiety or trouble sleeping.
• Thyroid nodules or goitre: a lump or swelling in the neck. Most nodules are harmless, but some need checking.

Symptoms can be vague and overlap with many other conditions, so a blood test is the usual first step.

Tests and who you will see

Your GP will usually order a blood test for thyroid stimulating hormone (TSH), and sometimes other thyroid hormones or antibodies. An ultrasound may be used to look at a lump.

Many people with an underactive thyroid are managed by their GP. Your GP may refer you to Endocrinology, a hormone specialist, if:

• You have an overactive thyroid
• Results are unclear or treatment isn't working well
• You are pregnant or planning pregnancy and have a thyroid condition
• A nodule needs more checking, such as a fine needle biopsy

Some people with large nodules or certain conditions see General surgery or ENT surgery to talk about thyroid surgery.

Thyroid treatment often needs fine-tuning. You will usually have repeat blood tests until your levels are stable, then less often. Tell your doctor if you become pregnant, start new medicines, or your symptoms change.

Referrals and costs

You need a GP referral to claim a Medicare rebate for a specialist. Fees vary, so ask before you book, see Bulk billing, rebates and gap fees explained. Bring your past blood results and a list of your medicines and supplements, as some supplements can affect thyroid tests. Spec Book shows endocrinologists' soonest appointments and lets your GP send the referral directly.

When to get urgent help

Call 000 or go to an emergency department if you have a very fast or irregular heartbeat with chest pain or fainting, severe confusion, or a neck swelling that makes it hard to breathe or swallow.

General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.