Thyroid Disorders Specialist | Naas Endocrinology
Thyroid · Naas, Co. Kildare

Thyroid Disorders Specialist

Expert management of underactive and overactive thyroid, Graves' disease, thyroid nodules, and thyroid cancer follow-up. Consultant-led care at our Naas, Co. Kildare clinic.

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About Thyroid Conditions

Understanding Thyroid Disease

The thyroid gland is a butterfly-shaped gland in the neck that produces hormones — primarily thyroxine (T4) and triiodothyronine (T3) — which regulate metabolism, energy levels, heart rate, mood, and many other bodily functions.

Thyroid disorders are among the most common endocrine conditions. Hypothyroidism (underactive thyroid) results in insufficient hormone production, slowing body processes. Hyperthyroidism (overactive thyroid) produces excess hormones, accelerating metabolism. Structural abnormalities such as nodules and goitre require careful assessment and surveillance.

This page is for educational purposes only. It does not constitute medical advice. Always consult a qualified healthcare professional for assessment and management of thyroid conditions.
Symptoms

Signs of Thyroid Imbalance

Hypothyroidism symptoms:

  • Fatigue and low energy
  • Weight gain
  • Cold intolerance
  • Depression and low mood
  • Dry skin and hair thinning
  • Constipation
  • Brain fog
  • Slow heart rate

Hyperthyroidism symptoms include weight loss, heat intolerance, palpitations, tremor, anxiety, diarrhoea, and eye changes in Graves' disease.

Specialist Services

Thyroid Conditions We Manage

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Hypothyroidism

Assessment and management of underactive thyroid, including levothyroxine optimisation, T4/T3 combination therapy considerations, and Hashimoto's thyroiditis management.

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Hyperthyroidism

Diagnosis and treatment of overactive thyroid, including antithyroid medications (carbimazole), assessment for radioiodine therapy, and liaison with endocrine surgery where needed.

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Graves' Disease

Specialist management of Graves' disease, an autoimmune cause of hyperthyroidism, including assessment for thyroid eye disease (Graves' orbitopathy) and long-term treatment planning.

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Thyroid Nodules

Evaluation of thyroid nodules using clinical assessment and blood tests. Guidance on indications for ultrasound and fine-needle aspiration biopsy. Risk stratification using established guidelines.

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Thyroid Cancer Follow-up

Post-treatment surveillance for patients with a history of differentiated thyroid cancer, including TSH suppression monitoring, thyroglobulin tracking, and long-term risk assessment.

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Levothyroxine Optimisation

Review of patients who remain symptomatic on levothyroxine, including assessment of absorption issues, T3 conversion, optimal TSH targets, and consideration of combination T4/T3 therapy.

Investigations

Thyroid Blood Tests & Investigations

Assessment of thyroid function typically begins with a TSH (thyroid-stimulating hormone) measurement — the most sensitive initial test. Depending on results, this may be supplemented with Free T4, Free T3, and thyroid antibody levels (TPO antibodies in autoimmune thyroid disease; TSH receptor antibodies in Graves' disease).

Structural assessment with thyroid ultrasound is used to evaluate goitre, nodules, or suspected malignancy. Fine-needle aspiration (FNA) cytology may be recommended based on nodule size, sonographic features, and clinical context. All investigations are guided by current evidence-based guidelines.

Consultations are led by Dr Syed Kashif Hussain Kazmi, Consultant Endocrinologist (IMC: 213626), with extensive experience in thyroid disease management.

Patient Questions

Frequently Asked Questions

Hypothyroidism commonly causes fatigue, weight gain, feeling cold, constipation, dry skin, hair thinning, depression, low mood, brain fog, and a slowed heart rate. Many of these symptoms are non-specific and can be attributed to other causes, which is why a blood test measuring TSH is essential for diagnosis. Some people have subtle or subclinical hypothyroidism with minimal symptoms. The severity of symptoms does not always correlate directly with TSH levels.
Graves' disease is an autoimmune condition in which the immune system produces antibodies (TSH receptor antibodies) that stimulate the thyroid gland to overproduce hormones, causing hyperthyroidism. It is the most common cause of hyperthyroidism. In addition to symptoms of an overactive thyroid, some patients develop Graves' orbitopathy — inflammation and swelling of the tissues around the eyes, causing protrusion, double vision, or discomfort. Treatment options include antithyroid medications, radioiodine ablation, or surgery, depending on the clinical picture and patient preference.
A thyroid nodule is a discrete lump within the thyroid gland. They are extremely common — detectable by ultrasound in up to 50% of adults — and the vast majority are benign. However, a small percentage can be malignant. Features that may warrant further investigation include rapid growth, a hard or irregular texture, associated lymph node enlargement, hoarseness, dysphagia, family history of thyroid cancer, previous neck irradiation, or certain ultrasound characteristics. Risk stratification using established classification systems (such as TIRADS or BTA guidelines) guides the decision to perform fine-needle aspiration or monitor with surveillance ultrasound.
This is a common and important question. Some patients with hypothyroidism continue to experience symptoms despite a TSH within the reference range on levothyroxine. Possible reasons include inadequate dose, absorption issues (interactions with food, calcium, or other medications), inadequate T4-to-T3 conversion due to deiodinase polymorphisms, an optimal TSH target that differs from the standard range, or coexisting conditions such as iron deficiency, depression, or sleep disorders. A specialist review can assess these factors comprehensively and consider whether combination T4/T3 therapy might be appropriate in selected patients.
The primary screening test for thyroid dysfunction is TSH (thyroid-stimulating hormone), produced by the pituitary gland. An elevated TSH suggests hypothyroidism; a suppressed TSH suggests hyperthyroidism. Free T4 and Free T3 provide information on the actual hormone levels being produced. TPO (thyroid peroxidase) antibodies are elevated in Hashimoto's thyroiditis and Graves' disease. TSH receptor antibodies confirm Graves' disease. Thyroglobulin is used in post-thyroid cancer surveillance. A specialist will interpret results in the context of symptoms, examination findings, and clinical history.

Expert Care for Your Thyroid

Book a private thyroid consultation with Dr Kazmi, Consultant Endocrinologist, at our Naas clinic. Prompt appointments available.

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