Thyroid Disorders
The thyroid is a small gland in the neck that produces hormones involved in metabolism, energy, temperature regulation and heart function. When it produces too little or too much hormone, symptoms can affect many different parts of the body.
Dr Kasi Subbiah provides specialist assessment and ongoing care for adults with suspected or established thyroid conditions in Belfast and by video consultation where appropriate.
Thyroid conditions assessed
- Hypothyroidism (an underactive thyroid)
- Hyperthyroidism and thyrotoxicosis (an overactive thyroid)
- Graves' disease
- Hashimoto's thyroiditis
- Thyroid nodules and goitre
- Abnormal thyroid blood-test results
- Thyroid conditions during pregnancy
- Persistent symptoms despite treatment
- Thyroid cancer follow-up
Specialist Care
When a specialist assessment may help
Abnormal thyroid blood-test results
Symptoms continue despite treatment
Uncertainty regarding treatment dose
Hyperthyroidism or Graves' disease suspected
Thyroid nodule or goitre identified
Pregnancy related thyroid care
What happens during your consultation?
Your consultation includes a detailed review of symptoms, medical history, medications, and previous results. The assessment may include TSH and hormone interpretation, antibody reviews, physical examination, and thyroid imaging arrangements. Treatment is always tailored to your specific circumstances.
Personalised thyroid treatment
Treatment may include thyroid-hormone replacement for hypothyroidism or specialist management of hyperthyroidism. The aim is to provide a clear explanation of results and an individual plan for treatment and follow-up.
Symptoms of an underactive thyroid
- Persistent tiredness
- Feeling unusually cold
- Weight gain
- Constipation
- Difficulty concentrating or thinking clearly
- Low mood
- Dry skin or hair loss
- Heavy or irregular periods
Symptoms of an overactive thyroid
An overactive thyroid produces more thyroid hormone than the body needs.
- Palpitations or a fast or irregular heartbeat
- Anxiety, irritability or difficulty sleeping
- Tremor
- Feeling unusually hot or sweating more
- Unexplained weight loss
- Muscle weakness or persistent tiredness
- Neck swelling or goitre
- Changes affecting the eyes, particularly in Graves' disease
Thyroid nodules and imaging
Thyroid nodules are lumps within the thyroid gland. Many are benign, but they should be assessed according to their clinical and ultrasound features. Where clinically appropriate, thyroid imaging can be arranged through the clinic. This may include an ultrasound to assess a thyroid nodule, goitre or other structural concern. The results will be interpreted alongside the clinical assessment and thyroid blood tests. Occasionally, further investigation such as a fine-needle aspiration is recommended.
Pregnancy-related thyroid care
Specialist assessment is available for thyroid conditions during pregnancy and when planning pregnancy. Thyroid medication and monitoring requirements can change during pregnancy, so timely review and coordination with the patient's wider maternity team may be important.
Thyroid-cancer follow-up
Specialist follow-up is available for suitable patients who have previously received treatment for thyroid cancer. Care may include reviewing thyroid-hormone replacement, interpreting surveillance results and coordinating further investigation or specialist input where required.
Frequently asked questions
Can thyroid problems cause tiredness or weight changes?
Both underactive and overactive thyroid conditions can affect energy and weight. However, these symptoms are common and may have other causes. Blood tests and a clinical assessment are needed before attributing them to the thyroid.
What blood tests are used to assess thyroid function?
Initial assessment commonly includes TSH and a thyroid hormone measurement such as free T4. Additional tests may be appropriate depending on the results, symptoms and suspected diagnosis.
Why might symptoms continue when thyroid results are normal?
Persistent symptoms may have causes unrelated to the thyroid. A specialist review can check the diagnosis, treatment, medication use and previous results while considering whether another explanation should be investigated.
Do all thyroid nodules need treatment?
No. Management depends on factors including the nodule's size, appearance, symptoms, thyroid function and ultrasound findings. Some nodules only require observation, while others need further investigation.