Thyroid Enlargement Referral Guidelines

Initial Evaluation

• Thyroid enlargement – swelling at the base of the neck, may be obvious
• Patient may complain of: tightness in the throat, coughing, hoarseness, difficulty swallowing or breathing

Initial Management

• Asymmetrical enlargement or suspect nodule – request a thyroid ultrasound
• TSH, Free T4, Thyroid Peroxidase antibody (TPO) – test requested

• If thyroid ultrasound shows a nodule, refer to the endocrinology thyroid nodule and thyroid cancer clinic. Expedited appointment will be given.
• If TSH >5 or <0.1, refer to endocrinologist
• If TSH >30 or Free T4>2, an urgent appointment is necessary
• If tests are free, no referral is needed. Check again in six months for consistent results.

Fax lab results to 202-476-4095 with contact information for the family. Our office will contact the family to set up the appointment.

If an expedited appointment is required, please call our doctor on call at 202-476-2121.

All patients with thyroid nodule evaluation will be given expedited appointment in the thyroid nodule and cancer clinic. A CD of the thyroid ultrasound must be provided at the time of the evaluation. For all inquiries regarding the thyroid nodule and thyroid cancer clinic, please call 202-476-2121.