Thyroid Disease

Thyroid Disease Care at UVM Health

Thyroid disease affects the small butterfly-shaped thyroid gland at the front of your neck. This gland makes thyroid hormone, which controls how your body changes food into energy to fuel body functions (your metabolism).

Different conditions can affect the thyroid gland. Depending on the type of thyroid disease, your body may make too much thyroid hormone (hyperthyroidism) or not enough (hypothyroidism).

Untreated thyroid disease increases your risk for heart problems, infertility, osteoporosis and other serious health complications. Some thyroid conditions require lifelong care.

Why Choose UVM Health?

Endocrinologists at University of Vermont Health specialize in comprehensive, compassionate care for both common and complex thyroid diseases. As one of the only comprehensive endocrinology programs in the region, we offer:

Coordinated approach: Your care team includes board-certified, fellowship-trained endocrinologists who specialize in thyroid disease. If you need surgery, we partner with UVM Health ear, nose and throat (ENT) doctors (otolaryngologists) to manage your care.
Research-based care: As part of a health system anchored by an academic medical center, our physicians are researchers, many of whom are training the next generation of endocrine disorder specialists.
Streamlined access to care: You have access to skilled endocrinologists at locations throughout the region. You also have the option of scheduling digital health visits or communicating with your care team via MyChart.

Types of Thyroid Disease

We offer a full range of treatments for all thyroid diseases, including:

Hyperthyroidism: An overactive thyroid gland makes too much thyroid hormone.
Hypothyroidism: An underactive thyroid gland doesn’t make enough thyroid hormone.
Goiter: An enlarged thyroid gland that may or may not affect thyroid hormone levels.
Grave’s disease: An autoimmune disease that causes an overactive thyroid gland (hyperthyroidism) and goiter.
Hashimoto’s thyroiditis (Hashimoto’s disease): An autoimmune disease that leads to an underactive thyroid gland (hypothyroidism).
Thyroiditis: Inflammation and swelling in the thyroid gland.
Thyroid nodule: An abnormal growth (lump) on the thyroid gland. Nodules are usually benign (not cancerous).
Thyroid cancer: A cancerous (malignant) growth forms on the thyroid gland.

Symptoms of Overactive Thyroid Gland (Hyperthyroidism)

Too much thyroid hormone speeds up your metabolism. You may experience:

Irritability, fatigue or trouble sleeping
Muscle weakness
Rapid or irregular heartbeat (arrhythmia)
Sweating or heat intolerance
Weight loss despite eating more

Symptoms of Underactive Thyroid Gland (Hypothyroidism)

Low thyroid hormone levels slow your metabolism. You may experience:

Extreme fatigue
Feeling cold even in warm temperatures
Heavy, irregular periods or infertility
Muscle weakness or pain
Pale, dry skin or dry, thinning hair
Slow heart rate
Unexplained weight gain

Thyroid Disease Risk Factors

Females 60 and older are most at risk for thyroid disease. You’re also more likely to develop thyroid disease if you have:

An autoimmune disease, such as Type 1 diabetes or lupus
Family history (parent or sibling) of thyroid disease
Not enough iodine (a mineral that supports thyroid function) in your diet
Pituitary gland disorders, including noncancerous pituitary adenomas (tumors)
Pregnancy
Prior thyroid gland treatments, such as surgery or radiation therapy

Diagnosing Thyroid Disease

Thyroid disease can be difficult to diagnose because its symptoms are similar to those of many other conditions. We use a range of tests to identify and accurately diagnose thyroid disease, including:

Blood tests: Different blood tests can measure levels of thyroid-stimulating hormone (TSH), thyroid hormones (T-4 and T-3) and thyroid antibodies.
Radioactive iodine uptake (RAIU) test: You swallow a small, safe amount of radioactive iodine (also called radioiodine). Your provider uses a scanning device to see how much radioiodine your thyroid gland absorbs over a certain period.
Thyroid ultrasound: Your provider uses ultrasound technology to identify and examine thyroid growths (such as nodules and cysts) and goiter.
Biopsy: Your provider uses a thin needle to remove cells from an enlarged thyroid or nodule. A lab expert tests the cells for signs of cancer.

Thyroid Disease Treatments

Keeping thyroid hormones within a healthy range is key to preventing complications and helping you feel your best. We partner with you to select the most effective treatment for your symptoms and needs.

Active Surveillance

People with thyroid nodules, Hashimoto’s thyroiditis or small goiters may not need immediate treatment. Our team will carefully monitor your health and recommend treatment only if your symptoms worsen.

During active surveillance, you may need frequent:

Blood tests: To measure thyroid hormone levels
Imaging scans: To monitor the size of the thyroid gland or nodules
Physical examinations: To evaluate thyroid disease symptoms

Medications for Hyperthyroidism (Overactive Thyroid)

Medications can treat an overactive or enlarged thyroid gland, as well as noncancerous thyroid nodules. Your doctor may prescribe:

Antithyroid medications: Stop the gland’s production of thyroid hormone, helping to ease symptoms.
Beta blockers: Lessen certain cardiovascular symptoms of hyperthyroidism, such as heart palpitations and rapid heart rate. These medications don’t affect thyroid hormone levels.
Radioactive iodine (radioiodine) therapy: Damages cells in your thyroid gland, causing it to shrink and produce less thyroid hormone. This treatment may cause the thyroid to permanently stop working.

Surgery (Thyroidectomy)

Some people with hyperthyroidism, a large goiter, thyroid nodule or thyroid cancer need surgery to remove part or all of the thyroid gland (a partial or complete thyroidectomy). Thyroidectomy often results in hypothyroidism.

If you need a thyroidectomy, we will refer you to a UVM Health ear, nose and throat (ENT) specialist.

Our lab experts will test your thyroid gland tissue for signs of cancer (biopsy). If you need treatment for thyroid cancer, UVM Health cancer specialists provide advanced, compassionate care.

Medications for Hypothyroidism (Underactive Thyroid)

People with an underactive or nonfunctioning thyroid must take a synthetic hormone called levothyroxine for life to manage thyroid hormone levels. This lab-made hormone replaces the thyroid hormone your body doesn’t make.

After starting hormone replace therapy, you’ll need regular blood tests to ensure your thyroid hormone levels stay in a healthy range. This step protects your health and prevents complications.

You may need thyroid hormone replacement therapy if you have: