The health problems of Sen. John P. East (R-N.C.) have led to speculation here that he may not seek reelection next year, and the early jockeying for his seat raises the specter of a bitter primary battle between rival wings of the state GOP.

East, 54, was hospitalized for a month this spring with hypothyroidism, a condition unrelated to the polio that has confined him to a wheelchair for the past 30 years.

Aides say he has recovered from the thyroid disorder and that they expect him to seek a second term. But the gossip mill here counts that as a far less than certain prospect.

If he doesn't make the race, a showdown looms between two camps of the state party that have been clashing for a decade: the moderate Republicans of the Piedmont, and the New Right of Sen. Jesse Helms (R-N.C.).

The first moves came last month, when East missed the GOP state convention, on doctors' orders. Associates of 12-term Rep. James T. Broyhill (R-N.C.), a pillar of the party's moderate wing, used the occasion to spread the word that if East isn't a candidate, then their man is.

That did not sit well with Thomas Ellis, a Raleigh lawyer who chairs the National Congressional Club, the muscular, New Right fund-raising and political machine first organized to promote Helms, and which plucked East out of the obscurity of a college professorship to elect him in 1980.

Suggesting that Broyhill would have trouble passing a conservative "litmus test," Ellis quickly floated another name that caught everyone by surprise -- his own.

"If East does not run, either I will run, or we will find a candidate who will go up there and vote like Jesse Helms," said Ellis, who has been Helms' closest political adviser.

The prospect of a contested primary troubles many Republicans.

"You could really wind up with some bad scars, and the problem would be that forces that lined up for the Senate fight would then be in place to go right into the next war, which would be between New York Rep. Jack Kemp and Vice President Bush for the presidency," said a top adviser to Gov. James G. Martin (R), who asked not to be identified. "It would divert everyone's attention from what we should be about, which is party-building."

Others look upon a primary in the opposite light, not as a peril, but as a potential boost to the freshly won Republican dominance in the state.

"Primary battles help," said R.E. Carter Wrenn, executive director of the National Congressional Club. "After we had the big split in 1976 between the Ford and Reagan forces in this state, it brought a pile of new people in."

It was the Reagan primary victory over Ford here in 1976 that enabled Helms' forces to to wrestle control of the state party away from then-Gov. Jim Holshouser (R). Helms and the club have held the upper hand ever since, although Martin comes out of the more moderate Holshouser-Broyhill wing.

Though Wrenn sees little danger of self-inflicted primary wounds, he made it clear that a fight would have a sharp ideological edge.

Citing Broyhill's vote for making Martin Luther King Jr.'s birthday a federal holiday, his vote against supplying aid to the Nicaraguan counterrevolutionaries, or "contras," and his support of the House budget resolution, Wrenn said, "In the South, if a moderate Republican runs, the Democrats win. You need a conservative to give Democrats a reason to switch over."

Wrenn said East will not make his decision about seeking reelection until January. If East chooses not to be a candidate, not everyone is sure Ellis would be the conservative stand-in. Many here say Ellis was caught off guard by the Broyhill bubble, and circulated his own name simply to keep Broyhill from building early momentum.

Ellis got some brief, unpleasant public exposure two years ago. He had to withdraw his nomination for the Board for International Broadcasting, which oversees U.S. government foreign broadcasting operations, after several senators during confirmation hearings questioned the segregationist views he espoused in the 1950s.

If East and Ellis don't run, the other conservative most often mentioned is Campbell University President Norman A. Wiggans, who is also president of the Baptist State Convention.

While the focus has been on GOP infighting, no Republican, not even East, would have a lock on the seat.

Former governor James B. Hunt (D) has kept politically active since Helms defeated him last November and has said he will decide about the 1986 race by this fall.

There are at least two arguments pushing Hunt toward another try at the Senate. He has a $600,000 surplus from the 1984 campaign, and he has The Charlotte Observer's poll taken last month showing him leading East by 51 to 38 percent in a trial heat for 1986