Thyroid Problems: Symptoms, Tests, and GP Treatment
The Small Gland That Affects Almost Everything
The thyroid is a butterfly-shaped gland at the base of the neck, just below the Adam’s apple. It produces hormones that regulate metabolism, body temperature, heart rate, energy levels, mood, weight, and even fertility. When the thyroid stops working properly, the effects ripple through almost every body system.
Thyroid disorders are common — particularly in women, where roughly one in eight will develop a thyroid problem at some point. Many cases go undiagnosed for years because the symptoms are vague, develop gradually, and are easily attributed to ageing, stress, or busy modern life. The reality is that thyroid disease is one of the most overlooked causes of fatigue, weight changes, and mood disturbance in Australian adults.
The good news: thyroid problems are usually easy to diagnose with a simple blood test, and most are highly treatable.
The Two Main Types of Thyroid Problem
Hypothyroidism (Underactive Thyroid)
The thyroid produces too little hormone, slowing the body down. This is the more common type, particularly in women over 40.
Symptoms:
- Persistent tiredness, even after sleep
- Unexplained weight gain
- Feeling cold all the time
- Dry skin and brittle hair
- Hair loss or thinning, particularly the outer eyebrows
- Constipation
- Heavy or irregular menstrual periods
- Depression or low mood
- Slow heart rate
- Muscle aches and weakness
- Brain fog, poor concentration, memory problems
- Puffy face, especially around the eyes
- Hoarse voice
Hyperthyroidism (Overactive Thyroid)
The thyroid produces too much hormone, speeding the body up. Less common but can cause significant symptoms.
Symptoms:
- Unexplained weight loss despite normal or increased appetite
- Rapid or irregular heartbeat, palpitations
- Tremor (especially in the hands)
- Anxiety, irritability, mood swings
- Sweating, heat intolerance
- Difficulty sleeping
- Frequent bowel motions or diarrhoea
- Muscle weakness
- Lighter or absent menstrual periods
- Bulging eyes (Graves’ disease)
- Fatigue (paradoxical, despite hyperactivity)
- Goitre — visible or palpable enlargement of the thyroid
Common Causes of Thyroid Disease in Australia
Hypothyroidism Causes
- Hashimoto’s thyroiditis — an autoimmune condition where the immune system attacks the thyroid. The most common cause in Australia
- Iodine deficiency — re-emerging in some Australian populations despite iodised salt
- Thyroid surgery — partial or complete removal
- Radiation treatment — for thyroid cancer or hyperthyroidism
- Certain medications — lithium, amiodarone, interferon
- Postpartum thyroiditis — temporary inflammation after pregnancy
Hyperthyroidism Causes
- Graves’ disease — autoimmune, the most common cause
- Toxic nodular goitre — overactive nodules within the thyroid
- Thyroiditis — inflammation, often viral, causing temporary hormone release
- Excess iodine intake
- Excess thyroid hormone replacement in patients on treatment
How a GP Diagnoses Thyroid Problems
The diagnosis usually starts with a simple blood test:
- TSH (Thyroid Stimulating Hormone) — the most sensitive test. High TSH suggests hypothyroidism; low TSH suggests hyperthyroidism
- Free T4 (thyroxine) — the main thyroid hormone in circulation
- Free T3 (triiodothyronine) — the active form of thyroid hormone
- Thyroid antibodies (TPO, anti-Tg, TSI) — confirm autoimmune cause
If results are abnormal or a goitre is found, your GP may order:
- Thyroid ultrasound — assesses size, structure, and any nodules
- Fine needle aspiration biopsy — for suspicious nodules
- Radioactive iodine uptake scan — to identify toxic nodular disease
Thyroid testing is often included in routine health checks, particularly for women over 40. If you have any of the symptoms above or a family history of thyroid disease, ask your GP to test.
Treatment Options
Hypothyroidism Treatment
Treatment is straightforward: a daily dose of thyroxine (typically Eutroxsig or Oroxine in Australia). Once the dose is adjusted to your needs (usually after 6–8 weeks of fine-tuning), most patients feel significantly better. Treatment is lifelong but inexpensive, well-tolerated, and PBS-subsidised.
Your GP will monitor your TSH every 6–12 months once your dose is stable. Take thyroxine on an empty stomach, ideally first thing in the morning, and wait at least 30 minutes before food, coffee, or other medications.
Hyperthyroidism Treatment
Treatment depends on the cause and severity:
- Anti-thyroid medications (carbimazole, propylthiouracil) — reduce hormone production. First line for Graves’ disease
- Beta-blockers — manage symptoms like tremor and rapid heart rate while waiting for other treatments to work
- Radioactive iodine therapy — destroys overactive thyroid tissue. Permanent solution for many patients
- Thyroid surgery — for large goitres, suspicious nodules, or pregnancy
Most patients with hyperthyroidism are referred to an endocrinologist for ongoing management, with the GP coordinating care.
Thyroid Cancer
Thyroid cancer is uncommon but rates have been rising in Australia. Most thyroid cancers are highly curable when detected early. See your GP if you notice:
- A new lump or swelling in the neck
- A lump that grows over weeks to months
- Hoarseness that does not resolve
- Difficulty swallowing or breathing
- Swollen lymph nodes in the neck
Note: most thyroid lumps and nodules are benign, but they should always be assessed.
Frequently Asked Questions
Can thyroid problems cause weight gain that won’t shift?
Yes. Hypothyroidism can slow metabolism enough to cause unexplained weight gain or make it very difficult to lose weight despite diet and exercise. Treating the underlying thyroid problem usually makes weight management easier, but it’s rarely a magic solution on its own.
I’m tired all the time. Should I get my thyroid tested?
Yes — fatigue is one of the most common symptoms of hypothyroidism and the easiest way to rule it in or out is a TSH blood test. Your GP can request this as part of standard fatigue investigation.
Are thyroid medications safe in pregnancy?
Yes, thyroxine is safe and necessary during pregnancy for women with hypothyroidism. In fact, thyroid hormone requirements increase during pregnancy, and untreated thyroid disease can cause serious complications. See your GP early in pregnancy for thyroid review.
Is iodine deficiency really an issue in Australia?
It can be, particularly in pregnancy and breastfeeding when needs are highest. Iodised salt and dairy products provide most of the iodine in the average Australian diet. Pregnant and breastfeeding women are advised to take a supplement containing 150 micrograms of iodine daily.
My TSH is “slightly high” but I feel fine. Do I need treatment?
Subclinical hypothyroidism (mildly elevated TSH with normal T4) is common and the decision to treat depends on your TSH level, symptoms, age, pregnancy plans, and antibody status. Discuss with your GP — sometimes monitoring is appropriate; other times treatment is recommended.
Get Your Thyroid Checked at Your Family Doctor Clinic
If you have any symptoms suggesting a thyroid problem — fatigue, weight changes, mood disturbance, hair loss, or temperature intolerance — book an appointment with your GP. A simple blood test can give you answers, and treatment is usually straightforward and effective.