ThyroidClinicPhase One
Consultation
What happens
Your first visit is 60 minutes — unhurried. We review every prior test, every prior diagnosis, every medication you've been prescribed and why. We listen to the timeline of your symptoms, not just the snapshot your GP captured in a 10-minute appointment.
Why it matters
Thyroid dysfunction is rarely a single data point. Fatigue, weight changes, hair loss, and mood shifts often predate abnormal TSH by years. The history is the diagnosis.
What you'll see
A written visit summary emailed within 24 hours — not a portal notification, a real document — outlining what we discussed, what we suspect, and what we're going to investigate next.
60-Minute New Patient Visit
Not the standard 15 minutes. We schedule time to understand your complete thyroid history.
Prior Records Review
Bring everything — we read it all, including the labs your previous doctor called "normal."
Symptom Timeline Mapping
We chart when symptoms began, not just current severity — patterns that pinpoint the underlying mechanism.
Phase Two
Diagnostics
What happens
We run a comprehensive panel — TSH, Free T4, Free T3, TPO antibodies, thyroglobulin antibodies, and Reverse T3. Where indicated, thyroid ultrasound with nodule characterization by TIRADS scoring.
Why it matters
TSH alone misses 40% of subclinical cases. A patient with normal TSH but suppressed Free T3 may have conversion dysfunction — their body produces thyroid hormone but can't activate it. Standard labs never catch this.
What you'll see
Your results, annotated in plain language, reviewed in a dedicated follow-up visit. Not a portal message. Not a nurse callback. A physician walks you through every value, what it means for your specific case, and what it changes about your treatment.
Standard ThyroidClinic Panel — What We Measure
Baseline screen — necessary but insufficient alone
Active hormone at tissue level
Missed by 40% of standard panels
Hashimoto's autoimmune marker
Graves' and post-thyroidectomy monitoring
Conversion blockade in stress states
Thyroid Ultrasound & Nodule Tracking
When indicated, high-resolution ultrasound with TIRADS scoring (a 5-point classification system for nodule risk). We measure nodules to the millimeter and compare across visits — not to alarm you, but to give you a precise, longitudinal picture of what's changing and what isn't.
Phase Three
Diagnosis
What happens
We synthesize your panel, your symptoms, your history, and your imaging into a precise diagnosis — named, explained, and written down. You leave knowing exactly what condition you have and why.
What you'll see
A diagnosis document — not a code on an insurance form. Plain language. What the condition is, what caused it, what it means for your life, and what we're going to do about it. Most of our patients say this is the first time they've felt genuinely understood.
Hashimoto's Thyroiditis
Most common in women 30–50
The most common cause of hypothyroidism in the US — an autoimmune attack on the thyroid gland. Often dismissed for years as anxiety or depression.
Hypothyroidism
Including post-thyroidectomy patients
Underactive thyroid requiring precise levothyroxine calibration. The difference between 88mcg and 100mcg can mean the difference between fog and clarity.
Subclinical Hypothyroidism
Often missed in standard panels
Frequently undertreated. Patients are symptomatic but told their labs are "borderline." We treat the patient, not the reference range.
Graves' Disease
Particularly in young women
Autoimmune hyperthyroidism causing heart palpitations, weight loss, and heat intolerance. Requires careful management of antithyroid medications.
Thyroid Nodules
Incidental findings and symptomatic
Most nodules are benign — but they require surveillance. We track size, echogenicity, and vascularity over time so you always know where you stand.
T3 Conversion Dysfunction
Frequently in chronic illness & stress
The diagnosis missed by TSH-only testing. Your thyroid may produce adequate T4, but peripheral conversion to active T3 is impaired — leaving you symptomatic on paper-normal labs.
Phase Four
Treatment Plan
What happens
Your treatment plan is built around you — your age, your antibody levels, your prior medication history, your symptom profile. Not the average patient. Not the reference range. You.
Why it matters
The difference between 88 mcg and 100 mcg of levothyroxine can mean the difference between cognitive fog and mental clarity. We calibrate in 12.5 mcg increments — the kind of precision that requires specialist training and time.
What you'll see
A written treatment protocol — your starting dose, your titration schedule, the target lab values we're aiming for, and exactly when we'll reassess. No guessing. No waiting by the phone.
Levothyroxine Calibration
We start at 1.6 mcg/kg/day and titrate in 12.5–25 mcg increments, checking Free T4 and Free T3 — not just TSH — every 6–8 weeks until you feel well, not just "in range."
Combination T4/T3 Therapy
For patients who remain symptomatic on levothyroxine alone, we consider combination therapy with liothyronine (T3) — an approach supported by evidence but rarely offered in general practice.
Autoimmune Protocol
For Hashimoto's and Graves' disease, treatment addresses the immune mechanism — not just the hormone level. Selenium supplementation, dietary evaluation, and antibody monitoring are part of the plan.
Post-Thyroidectomy Optimization
After thyroid removal, TSH suppression targets vary by cancer history, age, and cardiovascular risk. We individualize — a 34-year-old post-papillary thyroid cancer patient needs a different target than a 62-year-old post-benign nodule patient.
Phase Five
Ongoing Monitoring
What happens
Thyroid management is not a set-and-forget prescription. Hormone needs shift with age, stress, pregnancy, and season. We track your trajectory — not just your most recent snapshot.
Why it matters
Most patients who feel unwell on thyroid medication haven't had a dose adjustment in years. Their labs are "normal" but their life isn't. Regular, structured monitoring catches the drift before it becomes a crisis.
What you'll see
A longitudinal lab record — your values across every visit, graphed over time, so you can see your own trend. When you ask "am I getting better?" we can show you the answer.
Your Monitoring Schedule
First Follow-Up Panel
Full panel recheck after initial dose. Free T4, Free T3, TSH. Dose adjusted if Free T3 remains suboptimal even with normal TSH.
Symptom & Lab Reconciliation
We compare how you feel against where your labs landed. If the numbers look good but you don't, the numbers aren't the whole story.
Antibody Monitoring
TPO and thyroglobulin antibody trends. For Hashimoto's patients, declining antibody levels confirm the autoimmune process is being addressed.
Comprehensive Annual Review
Full panel plus ultrasound for nodule patients. Year-over-year comparison document — so you can see your own trajectory, not just today's snapshot.
Symptom-Triggered Reassessment
Life changes — stress, pregnancy, menopause, illness. Thyroid function shifts with it. You have direct access to reassessment without waiting for your annual.
First Follow-Up Panel
Full panel recheck after initial dose. Free T4, Free T3, TSH. Dose adjusted if Free T3 remains suboptimal even with normal TSH.
Symptom & Lab Reconciliation
We compare how you feel against where your labs landed. If the numbers look good but you don't, the numbers aren't the whole story.
Antibody Monitoring
TPO and thyroglobulin antibody trends. For Hashimoto's patients, declining antibody levels confirm the autoimmune process is being addressed.
Comprehensive Annual Review
Full panel plus ultrasound for nodule patients. Year-over-year comparison document — so you can see your own trajectory, not just today's snapshot.
Symptom-Triggered Reassessment
Life changes — stress, pregnancy, menopause, illness. Thyroid function shifts with it. You have direct access to reassessment without waiting for your annual.
94%
of patients reach optimal Free T3 within 6 months
40%
of subclinical cases missed by TSH-only testing
60min
average new patient consultation time
24h
written visit summary turnaround
You've read every phase of your care.
Now let's begin it.
New patient consultations are available within 2 weeks. Pre-filtered for thyroid evaluations — no referral required in most cases.
Ready to understand
what's actually happening?
New patient thyroid consultations available within 2 weeks. No referral required in most cases. Insurance accepted.
Available within
2 weeks
Visit length
60 minutes
Appointment type
New Patient
Pre-filtered for new patient thyroid consultations. You'll select your preferred physician and time.
Free Thyroid Lab Guide
Not ready to book? Download our guide to reading your own thyroid panel — what TSH, Free T4, Free T3, and antibody values actually mean, explained without jargon.
Download the Thyroid Lab Guide (PDF) →