What You Can Do
If you have definite symptoms of hypothyroidism, you should talk to your clinician about being tested. If your LDL cholesterol has been advancing or your weight has been creeping up unexplainably, you’ll want to discuss getting a test. If you’re 60 or older and generally healthy, it’s still a good idea to check with your doctor to see whether your medical history suggests you might benefit from testing.
How Does The Thyroid Gland Function
The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 because it contains four iodine atoms. To exert its effects, T4 is converted to triiodothyronine by the removal of an iodine atom. This occurs mainly in the liver and in certain tissues where T3 acts, such as in the brain. The amount of T4 produced by the thyroid gland is controlled by another hormone, which is made in the pituitary gland located at the base of the brain, called thyroid stimulating hormone . The amount of TSH that the pituitary sends into the bloodstream depends on the amount of T4 that the pituitary sees. If the pituitary sees very little T4, then it produces more TSH to tell the thyroid gland to produce more T4. Once the T4 in the bloodstream goes above a certain level, the pituitarys production of TSH is shut off. In fact, the thyroid and pituitary act in many ways like a heater and a thermostat. When the heater is off and it becomes cold, the thermostat reads the temperature and turns on the heater. When the heat rises to an appropriate level, the thermostat senses this and turns off the heater. Thus, the thyroid and the pituitary, like a heater and thermostat, turn on and off. This is illustrated in the figure below.
Patterns Of Thyroid Tests Associated With Thyroid Disease
Primary Hypothyroidism A high TSH and low thyroid hormone level can indicate primary hypothyroidism. Primary hypothyroidism occurs when the thyroid gland makes too little thyroid hormone. Symptoms of hypothyroidism can include feeling cold, constipation, weight gain, slowed thinking, and decreased energy. Causes of primary hypothyroidism include:
- Autoimmune thyroid disease, including Hashimoto’s thyroiditis
- Thyroid gland dysfunction due to a medication
- Removal of all or part of the thyroid gland
- Radiation injury to the thyroid
- Excess treatment with anti-thyroid medications
Early or mild hypothyroidism may present as a persistently elevated TSH and a normal FT4 hormone level. This pattern is called subclinical hypothyroidism and your doctor may recommend treatment. Over time, untreated subclinical hypothyroidism can contribute to heart disease.
It is important to remember that normal TSH levels in older individuals are higher than the normal ranges for younger individuals.
Primary Hyperthyroidism A low TSH and a high thyroid hormone level can indicate primary hyperthyroidism. Primary hyperthyroidism occurs when the thyroid gland makes or releases too much thyroid hormone. Symptoms of hyperthyroidism can include tremors, palpitations, restlessness, feeling too warm, frequent bowel movements, disrupted sleep, and unintentional weight loss. Causes of primary hyperthyroidism include:
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What Is A Tsh Test
Thyroid tests Blood tests to measure thyroid hormones are readily available and widely used. Not all thyroid tests are useful in all situations.
TSH Test The best way to initially test thyroid function is to measure the TSH level in a blood sample. Changes in TSH can serve as an “early warning system” often occurring before the actual level of thyroid hormones in the body becomes too high or too low.
A high TSH level indicates that the thyroid gland is not making enough thyroid hormone . On the other hand, a low TSH level usually indicates that the thyroid is producing too much thyroid hormone . Occasionally, a low TSH may result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid . In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.
Thyroid Hormone And Body Temperature
Thyroid hormone plays a major role in the metabolism of every cell of the body. It helps to increase the metabolic activity of the vast majority of cells and helps to regulate the bodys temperature levels. When thyroid hormone expression is dysregulated, body temperature will be altered.
In addition, the individual may experience a number of other unwanted symptoms such as unexplained weight gain, menstrual or fertility problems, fatigue, dry skin and hair, high cholesterol and more. I go over these symptoms in detail in this article.
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How Big Is The Thyroid
Your thyroid is about 2 inches long. A healthy thyroid usually does not stick out from your throat and you cant see it by looking at your neck.
However, certain conditions can cause your thyroid to become enlarged. This is known as goiter. If you have a goiter, you may experience the following symptoms:
- Swelling in the front of your neck, just below the Adam’s apple.
- A feeling of tightness in your throat area.
- A change in your voice, such as hoarseness .
The Importance Of Basal Body Temperature
Low body temperature is not only an indication of a possible thyroid or adrenal dysfunction, but it can also create an environment for worsening problems. Our body temperature is critical for optimal immune function, circulation, enzyme activity and more .
A lower than normal body temperature creates an environment that is ripe for pathogens like bacteria and viruses. The reason we create a high temperature fever when we have a bacterial infection or a flu is that the high temperature is inhospitable for the bacteria and viruses and it activates powerful immune activities within the body.
Additionally, enzymes are temperature dependent and wont function well at lower than optimal temperature ranges. A low-body temp will reduce overall enzyme activity which slows the bodies intracellular metabolism and causes an inability to buffer oxidative stress effectively. It also leads to poor digestion and sluggish gut and liver metabolism and an inability to deactivate and excrete toxins from the body.
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What Is The Thyroid
Your thyroid is a small, butterfly-shaped gland located at the front of your neck under your skin. Its a part of your endocrine system and controls many of your bodys important functions by producing and releasing certain hormones. Your thyroids main job is to control the speed of your metabolism , which is the process of how your body transforms the food you consume into energy. All of the cells in your body need energy to function.
When your thyroid isnt working properly, it can impact your entire body.
What Blood Tests Are Done To Test The Thyroid
Thyroid blood tests include:
These tests alone arent meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.
Additional blood tests might include:
- Thyroid antibodies: These tests help identify different types of autoimmune thyroid conditions. Common thyroid antibody tests include microsomal antibodies , thyroglobulin antibodies , and thyroid receptor antibodies .
- Calcitonin: This test is used to diagnose C-cell hyperplasia and medullary thyroid cancer, both of which are rare thyroid disorders.
- Thyroglobulin: This test is used to diagnose thyroiditis and to monitor treatment of thyroid cancer.
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Should I Exercise If I Have A Thyroid Disease
Regular exercise is an important part of a healthy lifestyle. You do not need to change your exercise routine if you have a thyroid disease. Exercise does not drain your bodys thyroid hormones and it shouldnt hurt you to exercise. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that its a good fit for you.
Are There Different Types Of Thyroid Removal Surgery
If your healthcare provider determines that your thyroid needs to be removed, there are a couple of ways that can be done. Your thyroid may need to be completely removed or just partially. This will depend on the severity of your condition. Also, if your thyroid is very big or has a lot of growths on it, that could prevent you from being eligible for some types of surgery.
The surgery to remove your thyroid is called a thyroidectomy. There are two main ways this surgery can be done:
- With an incision on the front of your neck.
- With an incision in your armpit.
The incision on the front of your neck is more of the traditional version of a thyroidectomy. It allows your surgeon to go straight in and remove the thyroid. In many cases, this might be your best option. You may need this approach if your thyroid is particularly big or has a lot of larger nodules.
Alternatively, there is a version of the thyroid removal surgery where your surgeon makes an incision in your armpit and then creates a tunnel to your thyroid. This tunnel is made with a special tool called an elevated retractor. It creates an opening that connects the incision in your armpit with your neck. The surgeon will use a robotic arm that will move through the tunnel to get to the thyroid. Once there, it can remove the thyroid back through the tunnel and out of the incision in your armpit.
- Are not at a healthy body weight.
- Have large thyroid nodules.
- Have a condition like thyroiditis or Gravess disease.
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Using Btt To Look At Adrenal Function
The adrenals work to increase blood flow throughout the body as cortisol works with its cousin aldosterone, which are both made in the adrenal cortex. Cortisol helps to maintain blood sugar, while aldosterone helps to retain sodium and maintain blood pressure. When we retain more sodium, we also retain more water, which increases blood volume and blood pressure. When we retain less sodium, we also retain less water, which decreases blood volume and blood pressure.
When people have hypertension or high blood pressure, they often take an angiotensin-converting enzyme inhibitor to lower aldosterone levels and therefore lower blood pressure. When the signaling process in the body, called the hypothalamic-pituitary-adrenal axis is dysregulated, we can end up with either high or low cortisol/aldosterone levels.
Low blood pressure is a common symptom for an individual with low cortisol, while high blood pressure is common for individuals with high cortisol. Other symptoms associated with HPA or adrenal dysfunction I discuss in detail in this article.
Who Should Get Thyroid Blood Tests
Individuals who experience symptoms of thyroid disease like neck enlargement, fatigue, trouble sleeping, muscle weakness, irregular menstruation, nervousness, and the like should take a test for thyroid function.
Additionally, those who are at risk for thyroid disorders should also get a thyroid test. This includes women above 60, those with a family history of thyroid disease, recently pregnant women, and individuals diagnosed with autoimmune disease.
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What Are Thyroid Blood Tests And Why Are They Taken
Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. They are done by withdrawing blood from a vein in your arm. These blood tests help to diagnose thyroid diseases.
The thyroid is a butterfly-shaped gland located in the front part of your neck. Its job is to produce thyroid hormones, which travel through your bloodstream and regulate many aspects of your bodys metabolism, including temperature, weight, and energy.
Thyroid blood tests show if you have:
- Hyperthyroidism: Overactive thyroid producing more thyroid hormones than your body needs. Hyperthyroidism speeds up your metabolism, which can cause weight loss, rapid heartbeat, insomnia, puffiness around the eyes, anxiety and other symptoms. The most common cause of hyperthyroidism is Graves disease.
- Hypothyroidism: Underactive thyroid producing too few thyroid hormones. Hypothyroidism slows down your metabolism, which can cause weight gain, menstrual irregularity, dry and puffy skin, fatigue and other symptoms. The most common cause of hypothyroidism is Hashimotos disease.
Thyroid blood tests are used to diagnose thyroid disorders associated with hyper- or hypothyroidism. These include:
When Is A Thyroid Function Test Done
A thyroid function test is requested in a variety of situations, including if you:
- have signs or symptoms of an underactive thyroid gland or an overactive thyroid gland
- have signs of problems with your pituitary gland
- are taking medicines that can affect your thyroid function, such as amiodarone and lithium
- are a woman with infertility problems
- are taking thyroid medicine, such as thyroxine, to monitor how you are responding to it.
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What Is Being Tested
Thyroid function tests are used to check for a number of thyroid problems. The tests measure the amount of different hormones including thyroid stimulating hormone , thyroxine , and triiodothyronine . Other tests on the thyroid include various antibodies related to thyroid tissue.
TSH is produced by the pituitary gland in the brain. TSH is carried in the blood to the thyroid gland, which sits at the front of the neck. From there, TSH influences how much T4 and T3 are released into the blood.
TSH, T3 and T4 levels can all be tested in the blood. Your doctor will probably test TSH first, then T3 and T4 if TSH is abnormal. Tests can also be used to measure antibodies to diagnose autoimmune thyroid disease.
How To Measure Tsh Levels
The TSH test involves a healthcare professional drawing blood from a vein in the inner arm. They then send the blood sample for laboratory testing.
Usually, people do not need to prepare for a TSH test. However, if the doctor is checking the blood for more than one issue, a person may need to fast or prepare in another way. The doctor will provide this information beforehand.
A TSH test is often the best way to monitor thyroid function. However, if a person has abnormally high or low TSH levels, the doctor may need to perform at least one other diagnostic test to identify the underlying cause. These tests look at levels of specific thyroid hormones and antibodies.
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Treating Abnormal Tsh Levels
A doctor will diagnose a thyroid disorder by reviewing your medical history, conducting a physical examination, and doing multiple tests, including a blood test. In some, but not all, instances, you may need a thyroid ultrasound or thyroid scan.
Treatments for hypothyroidism and hyperthyroidism can change over time, based on the severity of the condition and your response to medication.
Knowing When To Check Your Thyroid
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What Type Of Results Do You Get For A T3 Test
Blood test reports, including T3 test reports, usually provide the following information:
- The name of the blood test or what was measured in your blood.
- The number or measurement of your blood test result.
- The normal measurement range for that test.
- Information that indicates if your result is normal or abnormal or high or low.
Why Would I Need These Tests
The thyroid gland‘s hormones help control some of your body’s metabolic processes, such as heart rate, blood pressure, body temperature and weight. Too much or too little of these hormones can make you ill.
You might need thyroid tests if:
- you have symptoms of hyperthyroidism or hypothyroidism
- you are taking some form of thyroid hormone replacement treatment
- you are female and being investigated for infertility
Very rarely, babies are born without a working thyroid gland. For this reason, all Australian newborns are screened for hypothyroidism with a TSH test using a drop of blood taken from a heel prick.
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Medications That Interfere With Thyroid Level Testing
Be sure to let your doctor know if you are taking birth control or another form of estrogen, or if you are pregnant, as it can cause high levels of T3 and T4.
Also, supplements that include biotin can cause thyroid function test measurements to appear abnormal. Biotin is also known as vitamin B-7.
Which Medications Are Available To Treat Hypothyroidism
Hypothyroidism is a lifelong condition. For many people, medication reduces or alleviates symptoms.
Hypothyroidism is best treated by using levothyroxine . This synthetic version of the T4 hormone copies the action of the thyroid hormone your body would normally produce.
The medication is designed to return adequate levels of thyroid hormone to your blood. Once hormone levels are restored, symptoms of the condition are likely to disappear or at least become much more manageable.
Once you start treatment, it will take several weeks before youll begin feeling relief. Youll require follow-up blood tests to monitor your progress. You and your doctor will work together to find a dose and a treatment plan that best addresses your symptoms. This can take some time.
In most cases, people with hypothyroidism must remain on this medication their entire lives. However, the amount you take may need to be adjusted, especially if you have Hashimotos thyroiditis. To make sure your medication is still working properly, your doctor will likely test your TSH levels yearly.
If blood levels indicate the medication isnt working as well as it should, your doctor will adjust the dose until a balance is achieved.
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