Thyroid Specialist in Guatemala City
Your TSH is normal. So why do you still feel this way?
Fatigue, weight gain, hair loss, anxiety — symptoms attributed to a thousand different causes before anyone checks the thyroid. And when it is checked, it is not always interpreted correctly.
When should you see an endocrinologist for your thyroid?
You have persistent fatigue, excessive cold sensitivity, or unexplained weight gain
You were diagnosed with hypothyroidism but still have symptoms despite treatment
Thyroid nodules were found on an ultrasound and you are not sure what to do
You have unexplained palpitations, weight loss, or tremors
You have a family history of thyroid disease
Your TSH is abnormal and you do not have a clear follow-up plan
⚡ Consultations Monday through Saturday | By appointment only
1 in 8
women will develop a thyroid condition in her lifetime
60%
of people with thyroid disease do not know they have it
TSH
is not the only test needed to evaluate thyroid function
95%
of thyroid nodules are benign — but they still require evaluation
The thyroid is not just a TSH number. It is a system that regulates everything.
The thyroid gland produces hormones that regulate metabolism, body temperature, heart rate, weight, mood, and fertility. When it fails — in either direction — the impact is systemic.
The most common mistake in thyroid management is reducing the diagnosis to a single TSH value. A complete evaluation includes free T4, T3, thyroid antibodies, and in many cases an ultrasound. The right treatment depends on the underlying cause, not just the number.
“A normal TSH does not rule out thyroid disease. And an abnormal TSH does not always require medication. Clinical context is everything.”—Dra. Ma. Eugenia Penados
Thyroid symptoms that go unnoticed.
Thyroid diseases are masters of disguise. Their symptoms overlap with stress, depression, menopause, or simply aging. Recognizing them in context is part of the diagnosis.
Fatigue and drowsiness
Tiredness that does not improve with rest — a cardinal symptom of hypothyroidism.
Weight gain or loss
Hypothyroidism: weight gain without dietary changes. Hyperthyroidism: weight loss despite eating well.
Cold or heat intolerance
Constant feeling of cold (hypo) or excessive heat and sweating (hyper).
Hair and skin changes
Diffuse hair loss, dry and thick skin (hypo) or moist and thin skin (hyper).
Heart rhythm changes
Bradycardia in hypothyroidism. Tachycardia, palpitations, or atrial fibrillation in hyperthyroidism.
Mood changes
Depression and mental sluggishness (hypo) or anxiety, irritability, and insomnia (hyper).
Constipation or diarrhea
Intestinal transit slows with hypothyroidism and speeds up with hyperthyroidism.
Menstrual irregularities
Irregular, heavy, or absent cycles associated with untreated thyroid dysfunction.
Nodule or lump in the neck
May be asymptomatic. Requires ultrasound evaluation to determine its characteristics.
Do you identify with any of these symptoms?
A one-hour initial consultation is all it takes to begin your evaluation and, when needed, reach a clear diagnosis
The main thyroid conditions
Each thyroid disease has a different cause, presentation, and treatment. A correct evaluation starts by identifying the actual problem — not assuming that every TSH abnormality is the same.
Hypothyroidism
The thyroid produces fewer hormones than the body needs. Causes fatigue, weight gain, cold sensitivity, constipation, and depression. Treated with levothyroxine — but the right dose matters.
Hashimoto's Thyroiditis
The most common autoimmune cause of hypothyroidism. The immune system progressively attacks the thyroid. Requires monitoring even when TSH is normal.
Hyperthyroidism
Excess thyroid hormones. Causes weight loss, palpitations, tremor, insomnia, and anxiety. Can have multiple causes — the most common is Graves' disease.
Thyroid nodules
Growths within the thyroid gland. 95% are benign, but all require ultrasound evaluation and in some cases fine needle aspiration biopsy.
Many thyroid diseases coexist or evolve from one form to another. Hashimoto's thyroiditis, for example, can go through a transient hyperthyroid phase before progressing to permanent hypothyroidism. Ongoing follow-up allows these changes to be detected in time.
How the thyroid is evaluated during your consultation
A complete thyroid evaluation integrates clinical assessment, lab work, and imaging. Dr. Penados has a portable in-office ultrasound for initial thyroid evaluation and nodule follow-up during the same appointment.
Thyroid medical history
Current symptoms, duration, family history, prior medications, radiation exposure, and pregnancies.
Thyroid physical examination
Gland palpation, size and consistency assessment, palpable nodules, and clinical signs of hyper or hypothyroidism.
Thyroid lab work
TSH, free T4, and free T3 as the base panel. Anti-TPO, anti-thyroglobulin, and TSI antibodies are ordered when symptoms justify it — not routinely in every case.
In-office thyroid ultrasound
Assessment of size, echostructure, and characteristics of thyroid nodules.
Fine needle aspiration biopsy (if indicated)
For nodules with suspicious features according to TIRADS classification. Performed under local anesthesia in the office. Includes pathology report and follow-up appointment — Q1,500.
Thyroid scintigraphy (if applicable)
Ordered when hyperthyroidism is present and functioning nodules or toxic multinodular goiter need to be identified. Performed at an external center.
Why see Dr. Penados for your thyroid?
Thyroid ultrasound during the same visit
Dr. Penados has a portable in-office ultrasound to evaluate thyroid nodules on the same day as your consultation.
Thyroid biopsy available in-office
For nodules requiring histological study, fine needle aspiration biopsy is performed in the same office under local anesthesia. The cost includes the pathology report and a follow-up appointment to review results.
Complete evaluation for hyperthyroidism
In hyperthyroidism, TSH alone is not enough. The evaluation includes free T4, T3, and antibodies to identify the cause and define the right treatment.
Rigorous differential diagnosis
Hashimoto's, Graves', subacute thyroiditis, multinodular goiter — each condition requires a different approach. Dr. Penados works with up-to-date diagnostic criteria rather than assuming every thyroid abnormality is the same.
Thyroid ultrasound during the same visit
Dr. Penados has a portable in-office ultrasound to evaluate thyroid nodules on the same day as your consultation.
Thyroid biopsy available in-office
For nodules requiring histological study, fine needle aspiration biopsy is performed in the same office under local anesthesia. The cost includes the pathology report and a follow-up appointment to review results.
Complete evaluation for hyperthyroidism
In hyperthyroidism, TSH alone is not enough. The evaluation includes free T4, T3, and antibodies to identify the cause and define the right treatment.
Rigorous differential diagnosis
Hashimoto's, Graves', subacute thyroiditis, multinodular goiter — each condition requires a different approach. Dr. Penados works with up-to-date diagnostic criteria rather than assuming every thyroid abnormality is the same.
Ready to receive specialized endocrinological care?
Experience the difference of comprehensive, personalized, evidence-based treatment
Specialized Endocrinology in Guatemala
Clínica de Endocrinología, Metabolismo y Medicina Interna, Dra. Ma. Eugenia Penados Ovalle
6a avenida 4-01 zona 10, Edificio Medika 10, Nivel 3 (N3) Clínica 307Modern practice in the heart of Guatemala City
Office Hours
Monday, Tuesday, Thursday from 9:00 AM to 4:00 PM Friday from 9:00 AM to 1:00 PM Saturday from 8:00 AM to 12:00 PM
Emergency Care
Dr. Penados does not treat emergencies. For medical urgencies, please go to the emergency department of a hospital.
Coverage Areas
Guatemala City
- • Zone 10, 14, 15
- • Zone 9, 13, 16
- • Highway to El Salvador
Metropolitan Area
- • Mixco
- • Villa Nueva
- • Santa Catarina Pinula
- • San Cristóbal
Nationwide Coverage
- • All departments of Guatemala
- • Patients traveling from across the country
- • Periodic visits to Petén (approx. every 6 weeks)
Common questions, clear answers
Still have questions? Let's talk directly on WhatsApp for personalized answers.