Thyroid Disease

Hyperthyroidism, Hypothyroidism, Goiter

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Duke thyroid disease specialists 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). We pinpoint the cause of your abnormal thyroid levels and determine the most effective treatment for you. Our goal is to personalize your treatment plan to your specific needs so you feel like yourself again.

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Tests for Thyroid Disease

Your doctor may suspect thyroid disease if you experience some of the common symptoms, such as unexplained weight loss or gain, mood swings 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.

Thyroid Function Tests

Measures the amount of thyroid hormone in your blood, and can help diagnose functional disease, such as hypothyroidism (low levels of thyroid hormone) or hyperthyroidism (high levels of thyroid hormone).

Thyroid Ultrasound

This non-invasive test uses sound waves 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.

Radioactive Iodine Uptake Test

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.

Thyroid Scan

This scan also uses a radioactive tracer. A special camera takes 3D 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.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Non-Surgical Treatments for Thyroid Disease

There are many ways to treat thyroid disease. We work with you to identify the best solution to improve your daily life.


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. Follow-up blood tests may be necessary to ensure your body is responding well to your medication and dose.

Radioactive Iodine

This treatment 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 people with thyroid disorders. Our experience ensures that the dose is adequately determined for your needs.

Surgical Treatments for Thyroid Disease

Thyroid 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. 

Partial Thyroidectomy (Thyroid Lobectomy)

Removes a portion of your thyroid, usually a thyroid lobe. Minimally access options are available.


Removes your entire thyroid gland.


Removes one or more parathyroid gland. Minimal access options are available.

Thyroid Radiofrequency Ablation (RFA)

Also known as thyroid RFA, this minimally invasive, outpatient treatment targets benign, abnormal thyroid tissue. It is performed by a board-certified interventional radiologist, who has expertise in image-guided surgery. During the procedure, a thin needle is inserted through your skin to the thyroid tissue. The tip of the needle emits heat to destroy a thyroid nodule. Some large nodules may require multiple sessions. This treatment is beneficial because it targets only abnormal tissue, sparing healthy tissue around it. 

Ablation is a technique used regularly to treat a variety of benign and cancerous growths, however it is not recognized by insurance companies as a standard of care for benign thyroid nodules that cause pain or make daily activities harder, but don’t disrupt hormone levels or threaten your health. As a result, treatment of thyroid RFA costs incurs out of pocket costs. Imaging and doctor visits are typically covered by your insurance.

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Why Choose Duke

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 thyroid treatments.  

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.

Best Hospital for Endocrinology and Diabetes in NC

When it comes to your care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our diabetes and endocrinology program is rated as high performing among the nation's top hospitals, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 06/16/2022 by