Thyroid disease specialists with Duke’s nationally ranked endocrinology program spend time understanding your thyroid blood levels so they can prescribe the right treatment for you. We specialize in diagnosing and treating the full range of benign thyroid disorders, including hyperthyroidism (overactive thyroid like Graves' disease), hypothyroidism (underactive thyroid) and postpartum hypothyroidism and goiter (large thyroid).
Comprehensive care for thyroid disease and disorders
If you have thyroid disease, your thyroid gland may be overactive (producing too much thyroid hormone) or underactive (producing too little). These conditions can affect your mood, weight, energy levels, sleep patterns and ability to concentrate.
We use convenient in-office tests to obtain a fast and accurate diagnosis. If you have thyroid nodules, we use precise diagnostic tools to determine if the nodules are cancerous, and we have experienced surgeons skilled in removing them with minimal risks and scarring. We pinpoint the cause of your abnormal thyroid levels and determine the most effective treatment for you: medication; one-time radioactive iodine therapy or when necessary, surgery. Our goal is to personalize your treatment plan to your specific needs so you feel like yourself again.
Thyroid disease at Duke: Why choose us
- Experts in precise dosing. Our team has the experience and advanced training to make sure we get your treatment dose right, whether it’s medication to control thyroid blood levels or radioactive iodine treatments to shrink or destroy tissue in an overactive thyroid. Both of these treatment approaches require precise dosing, tailored to each patient’s needs.
- Specialized nuclear medicine. If you have Graves' disease or hyperthyroidism, we may recommend radioactive iodine therapy to control your thyroid hormone levels. Our team includes highly trained radiologists who administer our radioactive iodine treatments. Their experience working with proper dosing for thyroid patients means safe and effective results for you.
- Leaders in thyroid surgery. Our surgeons handle more than 600 cases every year, making us one of the busiest endocrine surgery teams in North America. We have performed thousands of successful thyroid-specific surgical procedures using open and minimal access techniques. Our less invasive options lead to less pain, fewer complications, minimal scarring and shorter hospital stays.
- Team approach. Our endocrinologists work closely with other Duke specialists to manage and treat every aspect of your thyroid disease, to guide your care and manage your treatment plan. We work with endocrine surgeons, otolaryngologists (ear, nose, throat and neck specialists) and radiologists specially trained in nuclear medicine treatments for thyroid patients.
- Patient education. If your doctor prescribes hormone replacement therapy for hypothyroidism, we work closely with you to make sure you understand how your thyroid medication works. When and what you eat, what supplements you take and even what time you take your medication can impact its effectiveness. We give you step-by-step directions before you leave our office and closely follow how your body reacts to the medication so we can make adjustments.
For most hyperthyroid patients, we recommend medication or radioactive iodine treatments to manage thyroid disease. If these therapies fail, surgery is a good option. You may do better with surgery than with medicine or radioactive iodine. We offer:
We use the latest medications available to control your thyroid function. If you have hypothyroidism (underactive thyroid), your medication serves as a hormone replacement therapy. If you have hyperthyroidism (overactive thyroid), your medication prevents your thyroid from producing too much thyroid hormone. Typically, you will take your medication every day at the same time. Follow-up blood tests may be necessary to ensure your body is responding well to your medication and dose.
This is typically a one-time treatment that uses targeted radiation – ingested in pill or liquid form – to shrink or destroy thyroid tissues in patients with hyperthyroidism and Graves' disease. Our radiologists specialize in dosing radioactive iodine for thyroid patients. Our experience ensures that the dose is adequately determined for your needs.
Surgery by an experienced endocrine surgeon is a good option for treating thyroid disease, especially large goiters and Graves' disease. If you have serious symptoms associated with these conditions, such as difficulty swallowing, unexplained voice changes or pressure sensations in the neck when lying flat, surgery may be your first-line treatment. Our thyroid surgeons vast experience results in fewer complications, shorter hospital stays, less scarring and pain, and faster recoveries.
When necessary, we perform the following surgeries:
- Partial thyroidectomy (thyroid lobectomy). Removes a portion of your thyroid, usually a thyroid lobe. Minimally access options are available.
- Thyroidectomy. Removes your entire thyroid gland, when necessary.
- Parathyroidectomy. Removes one or more parathyroid gland. Minimal access options are available.
Your doctor may suspect thyroid disease if you experience some of the common symptoms, such as unexplained weight loss or gain, moodiness or depression, and fatigue. In many cases, abnormal thyroid levels may turn up when your doctor orders a blood test as part of a routine physical exam. Your doctor may order one of the following tests to confirm your diagnosis.
Blood test measures the amount of thyroid hormone your thyroid makes, and can help diagnose functional disease, such as hypothyroidism (low levels of thyroid hormone) or hyperthyroidism (high levels of thyroid hormone).
A non-invasive test that uses sound waves, not radiation, to take pictures of organs and tissues inside your body. A thyroid ultrasound shows the thyroid gland’s size and shape. An enlarged thyroid with nodules or growths may indicate thyroid disease.
Determines the cause of an overactive thyroid gland. A radioactive substance called a tracer is injected into your bloodstream. The test determines how much tracer your thyroid gland absorbs, which can tell your doctor how well it is working.
Similar to the radioactive iodine uptake test, the scan also uses a radioactive tracer. A special camera takes 3-D pictures of your thyroid gland as it absorbs the tracer. The pictures help your doctor determine which parts of your thyroid are overactive or underactive.