Thyroid Disorder Treatment in Southlake, TX

Thyroid problems get both overtreated and undertreated, often in the same clinic. We test carefully, treat when treatment is warranted, and are equally willing to tell you that a slightly abnormal TSH does not need a prescription.

Testing

TSH is the starting point and the most sensitive test available. If it is abnormal we add free T4, and free T3 in specific situations. Thyroid antibodies get checked when we are looking for Hashimoto’s or Graves’ disease, because that changes what to expect over the following years.

A single abnormal TSH is not a diagnosis. It moves with acute illness, pregnancy, time of day, and biotin supplements, which are in most hair and nail products and interfere with the assay itself. We repeat it, off biotin, before starting anyone on a lifelong medication.

Hypothyroidism

Fatigue, cold intolerance, constipation, dry skin, hair thinning, heavy periods, muscle aches and slowed thinking.

Treatment is levothyroxine, started at a dose based on your weight, age and heart history, then rechecked at six weeks. Older patients and anyone with coronary disease start low and go slow, because pushing thyroid hormone quickly can provoke angina and arrhythmia.

We adjust in small increments. Overshooting into a suppressed TSH is not harmless: it accelerates bone loss and raises atrial fibrillation risk, particularly in older adults. That is why we do not chase symptoms with dose increases past a normal range, and why bone density matters here. See osteoporosis.

Subclinical hypothyroidism, a mildly high TSH with a normal T4, often needs nothing at all. We treat it when TSH is above 10, when antibodies are positive and rising, when symptoms are convincing, or when someone is trying to conceive.

Hyperthyroidism

Weight loss, racing heart, tremor, heat intolerance, anxiety, insomnia and diarrhea.

This one needs a cause identified rather than simply suppressed, so we work with endocrinology on uptake scans and definitive treatment. Untreated hyperthyroidism causes atrial fibrillation and accelerates bone loss, so it does not get to sit and be watched.

Beta blockers control symptoms quickly while the workup proceeds, which makes a real difference to how you feel in the first two weeks.

Nodules

Found on exam or, far more often, incidentally on a scan ordered for something else.

Ultrasound characterizes them and biopsy follows only when size and features warrant it. Most are benign and need periodic imaging rather than intervention. Being told you have a thyroid nodule is alarming and usually turns out to be unremarkable.

Thyroid and pregnancy

Requirements rise early in pregnancy and targets are tighter than outside it. If you are on levothyroxine and become pregnant, tell us immediately rather than at your first obstetric visit, because the dose usually needs to increase within weeks.

Ongoing monitoring

Once your dose is stable, TSH once a year is enough for most people. We recheck sooner after any dose change, a significant weight change, pregnancy, or starting estrogen, all of which shift requirements.

Thyroid disease and mood overlap heavily and we screen for both. See depression and anxiety. Thyroid is also one of the first things we check in anyone presenting with persistent fatigue.

Thyroid care runs through our chronic condition management program. See our primary care Southlake practice overview.