Skip to main content

Hiding in plain sight: How thyroid conditions can go undetected

Written By: Simone Sonnier, UT Physicians | Updated: January 10, 2023
Doctor checking for thyroid symptoms

With the help of regular checkups and bloodwork, most underlying thyroid disorders can be easily diagnosed and treated.

Weight gain, fatigue, and depression are all common symptoms that can easily be attributed to everyday life stressors. However, they could also be warning signs of a thyroid imbalance. In recognition of Thyroid Awareness Month, Philip R. Orlander, MD, endocrinologist with UT Physicians, shares more about often overlooked thyroid conditions and their treatment options.

Hypothyroidism vs. hyperthyroidism

Thyroid conditions can occur on opposite ends of the spectrum — specifically, overactivity and underactivity. Although these complications can occur in anyone at any age, women over the age of 50 are at a greater risk.

Hypothyroidism is the most commonly diagnosed disorder that occurs due to underactive thyroid hormone production. Its cause is typically genetic or a result of an underlying autoimmune disease. Symptoms can include fatigue, weight gain, constipation, and changes in the hair, skin, or nails.

Philip R. Orlander, MD
Philip R. Orlander, MD

“Hypothyroidism can progress over a long period of time and its symptoms are so nonspecific that patients will usually rationalize them,” shared Orlander, professor, vice chair, and director of the Division of Endocrinology, Diabetes, and Metabolism at McGovern Medical School at UTHealth Houston.

While less common, hyperthyroidism happens when the thyroid produces an excessive amount of hormones. Patients can experience hyperactivity, diarrhea, and anxiousness. Similar to its counterpart, this condition can be the result of an autoimmune disease or a medication imbalance.

“Many times, hyperthyroidism occurs in patients who are actually being treated for hypothyroidism,” explained Orlander, the Edward Randall, III Chair in Internal Medicine at McGovern Medical School. “There’s a delicate balance to ensure their medication isn’t too high or too low, but it can occur and from there we have to correct it.”


Many patients discover their thyroid condition through routine bloodwork with their primary care physician. After this, they are referred to an endocrinologist, a physician who specializes in the care of thyroid disorders.

“If you are having consistent symptoms, you should definitely bring it up with your primary care provider either during your annual checkup or next visit,” he suggested.

While waiting for an appointment, Orlander suggests performing a self-exam to identify a possible goiter (an enlargement of the thyroid) or nodule (a lump on the thyroid). To do so, you’ll need a mirror and a glass of water.

  1. Facing the mirror, focus on the area of your neck directly above your collarbones. This is where the thyroid gland is located.
  2. While still looking into the mirror, tip your head back slightly, take a sip of water, and swallow.
  3. While you swallow, look closely at your thyroid for any bumps or swelling. You should repeat this process a few times.

Any discoveries or concerns should be discussed with your physician.


The most common way to treat hypothyroidism is with oral medication that supplies the patient with the hormone their body is lacking. Although the condition requires lifelong therapy, if a patient is consistent with their medications and maintains regular checkups with their endocrinologist, they can lead a normal, healthy life.

Hyperthyroidism has a wider array of treatment options including radioactive iodine or surgery. While the condition cannot be cured, it can transition to hypothyroidism, which is easier to manage.

“Whether your condition is complex or simple, UT Physicians has someone that can help,” said Orlander. “Give yourself that peace of mind and book an appointment.”

Request an appointment online or call 888-488-3627 to schedule your next visit with one of our experts.

As the clinical practice of McGovern Medical School at UTHealth Houston, UT Physicians has locations across the Greater Houston area to serve the community. To schedule an appointment, call 888-4UT-DOCS.