Thyroid disease is one of the most common medical conditions in the UK and one of the most commonly under-diagnosed. NHS thyroid testing is often limited to TSH alone, and "normal" reference ranges can miss patients who are genuinely symptomatic. Our approach is comprehensive testing, careful interpretation, and individualised treatment.
Educational information — not a substitute for clinical assessment
This page describes thyroid disease in general terms to help you decide whether assessment may be helpful. It is not a diagnostic tool. If you recognise yourself in what follows, please book a consultation.
The thyroid is a butterfly-shaped gland in the front of the neck that produces hormones (T4 and T3) that regulate metabolism, energy, body temperature, growth, brain function, and many other processes. When the thyroid produces too little hormone (hypothyroidism) or too much (hyperthyroidism), symptoms can affect almost any body system.
Thyroid hormones are produced under the control of TSH (thyroid stimulating hormone) from the pituitary gland. When thyroid hormone levels fall, TSH rises to compensate — making TSH the most sensitive single marker of thyroid function.
of UK adults have hypothyroidism; many remain undiagnosed. Women are affected 5–10 times more often than men. Diagnosis is straightforward when you test properly.
The most common thyroid problem. Symptoms develop gradually and are often attributed to ageing, stress, or "just being tired":
TSH mildly elevated with normal T4 levels. May or may not need treatment — depends on symptoms, antibody status, age, and TSH level. Subject to careful clinical judgement; not always treated routinely.
Less common than hypothyroidism but important to recognise:
Hyperthyroidism needs specialist endocrinology assessment for diagnosis and treatment planning. Untreated hyperthyroidism can cause significant cardiovascular complications.
The two main autoimmune thyroid conditions:
Autoimmune thyroid disease commonly co-exists with other autoimmune conditions (coeliac, type 1 diabetes, vitiligo, pernicious anaemia, others). We screen accordingly.
Lumps within the thyroid gland. Very common (around half of adults if examined carefully or scanned). The vast majority are benign, but the small minority that are cancerous warrant identification and management. Assessment includes:
We arrange specialist referral for nodules requiring further evaluation.
Many people are told their thyroid is "normal" after a single TSH test. That’s not always sufficient. A proper thyroid evaluation includes TSH, free T4, free T3, thyroid antibodies, and key co-factors (ferritin, vitamin D, B12) that affect both thyroid function and symptoms.
Symptoms, duration, family history of thyroid or autoimmune conditions, medications, recent pregnancy, prior treatments, neck symptoms.
Including neck examination for goitre or nodules, pulse, blood pressure, reflexes, skin and hair changes, weight.
For palpable nodules, goitre, or other clinical findings.
Treatment, monitoring, or referral as appropriate.
The standard treatment is thyroid hormone replacement. Treatment is lifelong for most causes (autoimmune, post-surgical). NICE NG145 outlines current treatment principles:
UK law prevents naming specific prescription medications on this website — specific options are discussed in clinic.
Treatment depends on cause and severity. Options include antithyroid medication, radioactive iodine, or surgery. We refer to endocrinology for hyperthyroidism management.
Treatment decisions in subclinical hypo- or hyperthyroidism depend on TSH level, antibody status, symptoms, age, and other factors. Not all subclinical disease is treated; some warrants monitoring only.
Thyroid management during pregnancy is specialist territory — targets are different, doses often need adjustment, and outcomes (maternal and fetal) depend on good control. We refer to obstetric and endocrine teams as needed.
Once stable, most patients need annual TSH/T4 review. We can perform this and adjust dosing as needed, or share care with your NHS GP. Common reasons dose may need adjustment:
Consider booking if:
Several possibilities: subclinical thyroid issues at the upper normal range, conversion problems (T4 not converting to active T3), nutritional contributors, other conditions mimicking thyroid (iron deficiency, perimenopause, depression, sleep apnoea). A fuller assessment often clarifies.
For most patients with established disease on treatment, TSH is sufficient. For diagnostic workup or when patients aren’t feeling well despite normal TSH, fuller testing including T4, T3, and antibodies adds clinical value.
Current prices are on our Fees page. We quote before testing.
NICE NG145 recommends a trial of T3 in patients with persistent symptoms despite optimised T4 alone. This requires careful supervision and isn’t suitable for everyone. We can discuss whether this fits your situation.
NDT (e.g. some specific preparations) is used by some practitioners for hypothyroidism. NICE doesn’t routinely recommend it; some patients prefer it. We can discuss the evidence and considerations honestly in consultation.
This is common. Positive antibodies indicate immune attack on the thyroid but doesn’t always mean immediate treatment. Annual monitoring is appropriate to detect when thyroid function starts to decline.
If you’ve gained weight from untreated hypothyroidism, some weight loss is expected once treatment normalises metabolism. Thyroid medication isn’t a weight-loss treatment for people with normal thyroid function.
Yes, but it’s important to have thyroid optimised before conception and properly managed during pregnancy. We support pre-conception planning.
Most UK PMI policies cover thyroid investigation and management. We provide procedure codes.
Care at MHW Clinic is delivered by a small clinical team, with Dr Haydar Bolat as Clinical Director. The specific clinicians involved in your care depend on the plan agreed with you at consultation.
UK-registered GP and Clinical Director at MHW. Conducts comprehensive thyroid assessments including history, examination, full thyroid blood panel interpretation, and individualised treatment. Refers to endocrinology where specialist input is needed.
View profileLanguages spoken across the team: English, Turkish, Bulgarian, Bengali, Hindi, Albanian, Azerbaijani, German, Romanian. We can also arrange professional telephone interpreters in most other languages at no extra cost. More on languages and interpreters →
This page was reviewed by Dr Haydar Bolat, Clinical Director at MHW Clinic. Content is based on NICE Guideline NG145 (Thyroid disease: assessment and management), British Thyroid Association guidance, and current UK clinical practice and current UK clinical practice. It is updated when guidance changes. Educational information only — not a substitute for clinical assessment.
Comprehensive panel, careful interpretation, individualised treatment. Book a consultation if you suspect thyroid issues.