When should a primary care physician refer a thyroid patient to an endocrinologist?
Most patients with thyroid disease can be handled very well by a primary care physician. If the PCP notices that the blood tests are atypical and don’t fit a regular pattern, or if a patient is refractory to treatment with thyroid function tests all over the board, or if the PCP finds an anatomic abnormality (like an enlarged or lumpy thyroid gland), they should refer the patient to an endocrinologist. Q: Is there anything that you wish PCPs would do before referring patients to you? A: It’s best to have a specific question for the endocrinologist. Also, if thyroid function tests are mildly abnormal, you may wish to repeat them after a short interval to make sure it’s not a lab error (or a variation due to illness) before referring the patient to an endocrinologist. If the patient has a couple of abnormal TSH levels and a family history of autoimmune thyroid disease, it’d be appropriate to order an anti-thyroid antibody panel (TPOAb) before referring the patient to the endocrinologist.
