Specialists You Might Need
In some people, thyroid disease requires more than just an endocrinologist or your primary care doctor. For instance, if you have Graves' disease and develop eye problems, you may need an ophthalmologist. If you have thyroid cancer, you may need a surgeon to remove your thyroid. If your thyroid problems begin to affect your emotional state, you may require the services of a psychiatrist. And almost everyone with thyroid disease needs a good pharmacist who can spot potential drug interactions.
Finding these specialists often begins with your primary care doctor. If you're lucky, you'll get a good referral, and that's good enough. But if you don't like the specialist your doctor recommends, check around with friends and family again, or do your own research on the Internet. You can also go back to your primary doctor for another recommendation. Here are some of the key players who might wind up on your medical team.
Doctor in Nuclear Medicine
The use of radioactive iodine in the treatment of thyroid disorders has been around since the 1940s. But even though the treatment is nothing new, it does require a doctor who is skilled in the use of nuclear medicine and who works in a facility in compliance with the laws of your state.
According to the Society of Nuclear Medicine, doctors who administer radioactive iodine (RAI) should be board certified in nuclear medicine, radiology, or radiation oncology, “or be able to document equivalent training, competency, and experience in the safe use and administration of I-131,” which is iodine-131, the isotope most commonly used.
Doctors who pursue a career in nuclear medicine train for at least three years after graduating from medical school. They must go through a year of preparatory training in a program approved by the Accreditation Council for Graduate Medical Education (ACGME) and then two or more years of a nuclear medicine residency in a program accredited by the ACGME. They also receive training in clinical nuclear medicine and in other health sciences. Generally, it is your endocrinologist who refers you to a doctor who specializes in nuclear medicine.
Thyroid Surgeon
Several kinds of doctors are able to do surgical procedures on the thyroid. General surgeons; head and neck surgeons; and ear, nose, and throat surgeons are all potentially capable of doing thyroid surgery. But the most important criterion for your choice of a surgeon is the surgeon's experience. The amount of experience the surgeon has is inversely related to the complications rate — that means the more experienced the surgeon, the less likely you'll suffer complications. Judging a surgeon's experience involves asking some simple questions ahead of time. In addition to those above that you might ask a doctor, good questions for a surgeon include:
How many thyroid surgeries do you do in a year? Ideally, the surgeon should do twenty to twenty-five surgeries. Some people — including the New York Thyroid Center — recommend looking for surgeons who do fifty a year.
How many thyroid surgeries have you done in your career? Again, the more surgeries a surgeon has done, the better skilled he is. Someone who has done 500 or more procedures is generally considered experienced, according to the New York Thyroid Center.
What kind of training did you have? A skilled surgeon will discuss any specialty training he might have had in endocrine surgery — and specifically thyroid surgery.
Are you involved in research in thyroid disease? Involvement in any type of thyroid research is a good indicator that the surgeon is interested in learning as much as possible about the thyroid.
Ophthalmologist
In people who have Graves' disease, the eyes may be affected. That's when you might need the help of an ophthalmologist, a medical doctor who treats the eyes. Unlike an optometrist, an ophthalmologist can prescribe medications and do surgery.
Eye problems that result from Graves' disease are called Graves' ophthalmology. In the scheme of eye disorders, this is a relatively rare condition. For the best treatment and care, you should find an ophthalmologist who specializes in thyroid-related eye disease. These doctors are more likely to have the skills, expertise, and resources to treat your eye problems. And in the event you need surgery to correct your eye disease, you will most definitely want an ophthalmologist who specializes in thyroid-related eye disease.
Mental Health Professional
It's not unusual for serious health problems to affect your mental well-being. Many patients wind up suffering from depression or anxiety as a result of their health issues. If you are one of them, you should seek out a mental health professional. Don't be shy about getting this kind of help. Mood disorders like depression can be very serious and affect your ability to take care of yourself.
Mental health professionals can come from many backgrounds, including psychiatry, psychology, social work, and counseling. A psychiatrist is a medical doctor who, in addition to counseling and therapy, can prescribe medications. A psychologist is a mental health professional who can offer counseling and do psychotherapy but is not a medical doctor. Some people may also need a psychopharmacologist, a psychiatrist who specializes in administering medicines for difficult psychiatric problems.
Social workers are people who have at least a master's degree in social work and may provide counseling services. Some people may also seek counseling from a trusted clergy person.
Pharmacist
Before you got sick, you probably saw a pharmacist only a few times a year. But if you have a thyroid disorder, your pharmacist may become an important ally.
Pharmacists can alert you to potentially dangerous drug interactions and possible side effects from any medications you're prescribed. They can tell you whether an over-the-counter remedy or herbal supplement will interact with a prescription medication you're taking. They can also advise you on whether you should take certain drugs with food or on an empty stomach. A good relationship with a pharmacist can become vital to your health, so choose one you like, and use that person for all your prescriptions.
