Hypothyroidism is one of the common is medical conditions encountered in general medical practice specifically in endocrinology. It affects almost warning 50 females. The diagnosis can often be delayed leading to significant symptoms suffering for many years prior to confirmation of diagnosis.
The common symptoms of primary hypothyroidism include:
- Persistent lethargy and tiredness
- Unexplained weight gain or difficulty in losing weight
- Low mood or depression
- Dry skin and hair loss
- Disturbances of the menstrual cycles
- Reduced fertility
If you are experiencing any of these symptoms, it is worthwhile having a thyroid checkup.
There is significant confusion and misinformation available widely regarding the optimal management of primary hypothyroidism. Our approach is open-minded. We appreciate that in not an insignificant proportion of patients, traditional treatment with levothyroxine might not suffice. We explore different options of management including combinations of T3 and T4. These could be in the form of fixed T4/T3 ratios such as ARMOUR Thyroid or ERFA Thyroid. Alternatively we can recommend alternative ratios which can be compounded on an individually prescribed basis by our compounding pharmacists.
Thyrotoxicosis is another thyroid condition frequently encountered in clinical practice.
There are three main causes of presentation with biochemical thyrotoxicosis:
- Graves Thyrotoxicosis
- Toxic Nodular Disease
- Sub-acute thyroiditis
The primary aim of the initial workup is to differentiate between the different causes of thyrotoxicosis.
An often-misdiagnosed condition is sub-acute viral Thyroiditis. It needs to be differentiated from other causes of thyrotoxicosis, as the management approach is very distinct. We're able to provide the appropriate clinical assessment as well as diagnostic workup appropriate to differentiate between the different causes of thyrotoxicosis.
The presentation with thyroid enlargement is a common scenario in clinical practice. The vast majority are benign enlargements of the thyroid Gland.
Thyroid cancer is relatively rare but appropriate and timely diagnosis is of the essence in improving outcomes. We are able to provide the appropriate diagnostic workup to differentiate between the different etiologies or thyroid enlargement. We are able to advice on the most appropriate modalities of treatment including the relatively new approach of radio frequency ablation of benign thyroid lumps.
We provide bedside thyroid ultrasonography at the initial appointment to guide management and further investigations as appropriate. This often leads to rapid confirmation of diagnosis and early appropriate management to be initiated. This is particularly useful in the differentiation of the toxic phase of subacute inflammatory thyroiditis from other causes of thyrotoxicosis.