Whenever you think about an organ, you should always think about its structure and its function. There are two common thyroid problems to consider. One is a problem with function. Hypothyroidism means low thyroid. The most common cause of low thyroid is an autoimmune reaction called “Hashimoto’s Diseasse”. This is when antibodies are inappropriately directed to the thyroid and literally destroy thyroid cells, and their ability to make thyroid hormone. Consequently, you must take thyroid hormone replacement pills. Hypothyroidism can be serious if left untreated. Most cases of hypothyroidism are picked up by the patient’s laboratory values. Once an internist finds that there’s low thyroid, chances are the patient is best managed by an endocrinologist. This is because they have a higher degree of understanding about the nuances of the pathophysiology, meaning the particular disease itself. Additionally, endocrinologists have an enhanced ability of dealing with the treatment, and that often takes a nuanced approach. What are some of the ways you might know you have thyroid disease? As mentioned, the doctor may find thyroid tests that are off, and need to be treated or interpreted by an endocrinologist. The other way to know is with the onset of symptoms. The symptoms that you may have from low thyroid are often very common symptoms such as fatigue and weight gain. Most people who have fatigue and weight gain do not have low thyroid. But if you have a significant change in the level of your energy or you have a gain in weight, or problems thinking and feeling a little cloudy in your mind, then you really may want to get your thyroid levels checked by an endocrinologist. The other problem with the thyroid is the opposite functional problem, and that’s an overactive thyroid. Again, this is most commonly caused by an auto-immune problem called “Grave’s Disease”. With this problem the anti-bodies connect to a receptor on the thyroid itself and tell it to produce more thyroid hormone. When this happens, the thyroid hormone can cause symptoms such as jitteriness, problems sleeping (either difficulty falling asleep or waking in the middle of the night), heart palpitations, heart dysrhythmia (such as atrial fibrillation). If you have any of these symptoms, you should be checked for an overactive thyroid. An endocrinologist is a specialist in hormones. Why should we worry about the hormones? The definition of a hormone is a substance that is secreted from a cell into the bloodstream and acts on another cell or organ in a different part of the body. Hormones are very fundamental to so many of our body processes. There are a variety of hormones, for example, that control heart function. One of the major ones is the thyroid hormone. In fact, hormones control so many body processes that having good hormone balance is part of living a healthy live. There are hormone problems that can lead to death; however, most are detected earlier, and the other good news is that we have treatments available for many hormone problems. Thyroid Cancer If you or your doctor feels a lump in your neck, chances are that needs a biopsy because that may be thyroid cancer. Thyroid cancer is typically painless and all you feel is the lump. Sometimes you may have other symptoms, such as pain or hoarseness, but the most common symptom is a lump in your neck. Author Dr. Joseph J. Pinzone serves as the endocrinologist and primary concierge medicine physician for AMAI patients, board-certified in Internal Medicine as well as Endocrinology, Diabetes and Metabolism. Connect with AMAI on Google+.