Anxiety, palpitations and weight loss — often mistaken for a panic disorder.
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An overactive thyroid runs the body too fast. It is less common than an underactive one but tends to be more dramatic — and it is very frequently mistaken for anxiety, sometimes for years.
Graves' disease is the commonest cause and is autoimmune.
A suppressed TSH with raised free T4 and free T3 is the typical pattern. TSH falls first and is the most sensitive marker.
Subclinical hyperthyroidism — a low TSH with normal T4 and T3 — is common, often transient, and needs repeating before anyone acts on it.
TSH receptor antibodies confirm Graves' disease, the commonest cause.
A thyroid uptake scan distinguishes Graves' from a toxic nodule and from thyroiditis — and that distinction determines treatment entirely.
Thyroiditis is the important one to recognise: the thyroid is leaking stored hormone rather than overproducing it. It settles on its own, frequently passing through an underactive phase first, and antithyroid drugs do not help. Treating it as Graves' is a genuine error.
Biotin supplements distort thyroid assays and can produce a picture resembling hyperthyroidism where none exists. Stop biotin 48 hours beforehand.
Amiodarone and iodine-containing contrast both cause thyroid dysfunction and are worth declaring.
This is very frequently mistaken for anxiety or a panic disorder, sometimes for years — palpitations, restlessness, tremor and irritability describe both.
Anyone being assessed for new anxiety should have thyroid function checked, and it is a cheap test to omit.
A full thyroid panel with TSH receptor antibodies confirms both the overactivity and, usually, its cause.
Confirmed hyperthyroidism is a condition that warrants specialist endocrinology input — the treatment decision between antithyroid drugs, radioiodine and surgery is a specialist one. We arrange the testing, explain the results properly, and provide a private referral letter so you reach the right clinic without a delay.
Where the picture turns out to be anxiety rather than thyroid disease, that is a useful answer too.
Seek urgent care for a very fast or irregular heartbeat with fever, agitation or confusion — thyroid storm is rare but life-threatening.
Also urgent: sudden double vision or loss of vision with eye symptoms in Graves' disease.
Grittiness, bulging, double vision or eye pain in Graves' disease are not cosmetic. They need specialist ophthalmology input.
Artificial tears help the dryness, and stopping smoking is the single most effective thing you can do for the eyes.
Untreated overactivity thins bone and drives atrial fibrillation, which is why it is treated rather than tolerated even when symptoms feel manageable.
Most people who have radioiodine or surgery become underactive afterwards and need levothyroxine for life. That is an expected outcome rather than a complication, and it is worth knowing before choosing.
Lifelong thyroid monitoring follows whichever route is taken, including after antithyroid drugs, because relapse is common.
Diagnosis, specialist care and treatment are all free on the NHS, and thyroid disease requiring replacement qualifies for a medical exemption certificate covering all prescriptions.
This one belongs with the NHS, and we would say so plainly. An overactive thyroid needs endocrinology input, the treatments — carbimazole, radioiodine, surgery — all require specialist supervision, and NHS care is free and appropriate.
What a private consultation can genuinely do is arrange the blood tests quickly when symptoms suggest it, and get the referral moving — because an overactive thyroid is regularly mistaken for anxiety for months. Palpitations, tremor, weight loss, heat intolerance, irritability and poor sleep read as an anxiety disorder, and the thyroid test that would settle it is simple.
That misattribution is the most common harm here, and it is worth a blood test rather than a course of treatment for the wrong thing.
The safety point that matters most, and it is free to know: anyone taking carbimazole who develops a sore throat, mouth ulcers, fever or any sign of infection must stop it and get an urgent full blood count the same day. Carbimazole can rarely suppress the bone marrow, and this is the one warning nobody should be without.
Do not stop antithyroid medication without advice, and do not buy thyroid medication online — unsupervised treatment of an overactive thyroid is genuinely dangerous.
Chest pain, palpitations with breathlessness, fever with confusion, or severe agitation needs emergency assessment.
NICE NG145, Thyroid disease: assessment and management, is the governing guideline. It recommends referral to secondary care for adults with suspected or confirmed hyperthyroidism, and covers antithyroid drugs, radioactive iodine and surgery.
NG145 recommends carbimazole as first-line antithyroid drug, with propylthiouracil in specific circumstances including the first trimester of pregnancy.
NG145 and MHRA safety guidance require patients on carbimazole to be warned about agranulocytosis — to report sore throat, mouth ulcers, bruising, fever or malaise immediately and have an urgent full blood count. This is the basis for the warning above.
MHRA also advises on the risk of acute pancreatitis with carbimazole and on contraception requirements given teratogenicity.
British Thyroid Association guidance covers thyroid eye disease, which requires specialist ophthalmology input, and thyroid storm, a medical emergency.
It is very commonly mistaken for it — in both directions. Palpitations, restlessness, tremor, irritability and poor sleep fit both.
The features that point to thyroid: weight loss despite eating well, heat intolerance, and loose bowels.
Anyone being assessed for new anxiety should have thyroid function checked. It is inexpensive and it is missed regularly.
We can arrange the testing and explain it properly, but confirmed hyperthyroidism needs endocrinology.
The choice between antithyroid drugs, radioiodine and surgery is a specialist one, and we will refer rather than manage it remotely.
The thyroid leaking stored hormone rather than overproducing it — often after a viral illness or after pregnancy.
It settles by itself, usually passing through an underactive phase first, and antithyroid drugs do not help. Distinguishing it from Graves' is the reason a scan is done.
Because it substantially worsens Graves' eye disease and makes it harder to treat.
Of everything on this page, stopping smoking is the single most useful thing for the eyes — and free NHS support works far better than going it alone.
Not necessarily. Antithyroid drugs are usually tried first, often for 12 to 18 months.
Radioiodine or surgery follow where drugs do not achieve lasting control, or where a nodule is the cause.
Most people do after radioiodine or surgery, and it is common after long antithyroid treatment too.
That is an expected outcome rather than something going wrong — and an underactive thyroid on levothyroxine is considerably easier to live with than an overactive one.
Usually yes, once treatment takes effect, and some people regain more than they lost.
That is worth expecting rather than being surprised by, because weight regain after treatment causes real distress when nobody has mentioned it.
Not necessarily. Subclinical hyperthyroidism is often transient and frequently normalises on a repeat.
It matters more if you are over 65, have atrial fibrillation, or have osteoporosis, where even mild overactivity carries risk.
August 23, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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