Thyroid and Endocrine Conditions: Specialist in Dubai
The thyroid sets the body's pace, and when it runs slow or fast the symptoms are vague enough to be blamed on everything else: tiredness, weight change, hair loss, palpitations, anxiety, feeling cold or hot, irregular periods. A blood test settles it. At Smart Care Polyclinic in Deira, an internal medicine specialist diagnoses and treats thyroid disease and the other common hormone conditions, and follows them up properly.
For: abnormal thyroid tests, symptoms of over- or underactivity, nodules, other hormone questions
Takes: a 30-minute consultation; bloods on site
Price: consultation AED 125
Book the internal medicine specialistor call +971 (0) 4379 3562
What it is
Thyroid function is read from TSH first, then the thyroid hormones. A high TSH with a low thyroxine is an underactive thyroid, treated with levothyroxine at a dose adjusted to bring the TSH into range and then checked every six to twelve months; the American Thyroid Association guideline is the reference for interpretation and treatment.1 A mildly raised TSH with normal hormones is subclinical and is treated selectively — in pregnancy, with symptoms, or with antibodies — rather than automatically.
An overactive thyroid — low TSH, high hormones — causes weight loss, palpitations, tremor, heat intolerance and anxiety and is usually Graves' disease or an overactive nodule; treatment is with antithyroid tablets, and radioiodine or surgery by referral where needed. Nodules are common, mostly benign, assessed by ultrasound and, where the features warrant, a needle sample by referral.
Other hormone conditions are assessed the same way, test first. Raised prolactin, low testosterone in men, high calcium, adrenal and pituitary questions, and the hormonal side of PCOS and menopause where they overlap with women's health. The Endocrine Society guidelines for prolactin and testosterone specify how and when the samples should be taken, which is why a single abnormal result is repeated properly before anything is diagnosed.23
Thyroid in pregnancy and fertility
Thyroid function is checked when planning or early in pregnancy because both underactivity and overactivity affect fertility and the baby, and levothyroxine doses usually need to rise in pregnancy. The specialist works alongside the gynaecologists on this.
Symptoms with normal tests
Tiredness, weight gain and hair loss with a normal TSH are not thyroid disease, and taking thyroid hormone for them causes harm. The specialist looks for the other causes — iron, vitamin D, sleep, mood, other conditions — rather than treating a normal gland.
The consultation, and what follows from it
Internal medicine consultation
Assessment, examination and a plan with every cost stated before anything further is done.
AED 125 was AED 200
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Questions patients ask
TSH with free T4, and free T3 where overactivity is suspected; thyroid antibodies to identify the autoimmune causes; and ultrasound for nodules or an enlarged gland. All are available on site.
For an underactive thyroid from autoimmune disease or after surgery, usually yes, with the dose checked regularly. Overactive thyroid may be treated for a course and then reviewed.
An underactive thyroid causes modest weight gain that reverses with treatment; it is rarely the cause of large weight gain, and treating a normal thyroid does not cause weight loss.
This guide is general information, not advice about you. Long-term conditions are managed on your own results and history, which is what the specialist consultation is for.
References
- Jonklaas J, Bianco AC, Bauer AJ, et al.. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670-751. PMID 25266247. doi:10.1089/thy.2014.0028The American Thyroid Association guideline on interpreting thyroid function tests and treating an underactive thyroid.
- Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, et al.. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism. 2011;96(2):273-88. PMID 21296991. doi:10.1210/jc.2010-1692The Endocrine Society guideline on raised prolactin — including how often stress, medication and the blood draw itself explain a mildly high result.
- Bhasin S, Brito JP, Cunningham GR, Hayes FJ, et al.. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2018;103(5):1715-1744. PMID 29562364. doi:10.1210/jc.2018-00229The Endocrine Society guideline on diagnosing low testosterone, including the requirement for a morning sample and confirmation on a second test.
Sources are listed for the specific statements they support. They are published research and guidance, not a substitute for a consultation — what applies to you is decided by a doctor who has assessed you.