What is thyroid disorders?
The thyroid gland in the neck produces hormones that set the pace of the body's metabolism. An underactive thyroid (hypothyroidism) slows things down, causing fatigue, weight gain, low mood and feeling cold; an overactive thyroid (hyperthyroidism) speeds things up, causing anxiety, palpitations, heat intolerance and weight loss. Thyroid nodules and goitre — swellings of the gland — are common and usually benign but sometimes need assessment.
Thyroid problems affect around 1 in 20 people, are much more common in women, and often run in families, with autoimmune disease (Hashimoto's and Graves') the leading cause. Diagnosis starts with simple blood tests measuring TSH and thyroid hormones, sometimes with antibody tests; ultrasound and occasionally a fine-needle biopsy are used to evaluate nodules.
Common symptoms
- Persistent tiredness or sluggishness
- Unexplained weight gain or loss
- Feeling unusually cold or heat-intolerant
- Palpitations or racing heart
- Anxiety, low mood or irritability
- Hair thinning and dry skin
- Swelling in the neck
How long will you wait?
GPs diagnose and manage most thyroid disease promptly, but routine NHS endocrinology referrals for complex cases, nodules or persistent symptoms typically take three to six months in many areas.
Privately, you can typically see a consultant endocrinologist within 3–7 days, with blood tests and neck ultrasound usually completed within the same week.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Levothyroxine. Daily hormone replacement for an underactive thyroid, adjusted using blood tests until levels are right.
- Antithyroid drugs. Carbimazole or propylthiouracil to control an overactive thyroid, often for 12–18 months.
- Radioactive iodine. A definitive one-off treatment for persistent overactivity.
- Thyroid surgery. Removal of part or all of the gland for large goitres, suspicious nodules or when other treatments are unsuitable.
What does private treatment cost?
As a guide, a private endocrinology consultation costs around £200–£300, a full thyroid blood panel £80–£200, and a neck ultrasound around £200–£350.
Does health insurance cover thyroid disorders?
Private medical insurance generally covers investigating new thyroid symptoms and assessing nodules, including scans and biopsies, and covers surgery where clinically needed. Long-term management of an established underactive or overactive thyroid — repeat prescriptions and routine monitoring — is usually treated as a chronic condition and excluded. A thyroid condition diagnosed before you took out the policy will normally be excluded as pre-existing.
Frequently asked questions
My blood tests are 'borderline' — what does that mean?
Subclinical thyroid disease means your TSH is outside the normal range but your thyroid hormone levels are still normal. It often causes no symptoms and sometimes normalises on its own, so guidelines usually recommend repeating tests after a few months before treating. Treatment may be considered if TSH is markedly raised, antibodies are positive, you have symptoms, or you are planning pregnancy.
Should I worry about a lump in my thyroid?
Thyroid nodules are very common — detectable in a large proportion of adults if you look — and around 95% are benign. They still deserve proper assessment: an ultrasound grades the nodule's appearance, and only those with suspicious features need a fine-needle biopsy. See your GP promptly if a neck lump is growing quickly, feels hard, or is accompanied by voice change or swallowing difficulty.
I'm on levothyroxine but still feel tired — why?
First, check your dose is right: TSH should be within range, and absorption can be affected by taking tablets with food, coffee, calcium or iron. If levels are optimal yet symptoms persist, it is worth looking for other causes — anaemia, low vitamin D or B12, sleep problems, menopause or low mood. An endocrinology review can help fine-tune treatment and investigate systematically.