How Is Thyroid Disease Diagnosed
Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:
- Physical exams.
One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm. Thyroid blood tests are used to see if you have:
The specific blood tests that will be done to test your thyroid can 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:
Talk to your healthcare provider about the ranges for these thyroid blood tests. Your ranges might not be the same as someone elses. Thats often alright. If you have any concerns or worries about your blood test results, talk to your provider.
An ultrasound typically takes about 20 to 30 minutes.
Comparing High/low Tsh And T3/t4 Levels
- Normal TSH + normal T4 = normal thyroid function
- Low TSH + high T4 = overactive thyroid
- High TSH + low T4 = underactive thyroid
- Low TSH + low T4 = low thyroid function due to another problem, such as pituitary gland dysfunction
Looking at TSH alongside T3 test results can also help with diagnosis:
- Low T3 + high TSH = low thyroid function
- High T3 + low TSH = overactive thyroid
Who Should Get Testing
Thyroid function testing is often ordered when patients have symptoms of a thyroid disorder. Testing can assist with diagnosing or ruling out thyroid problems as a cause of your symptoms.
Many of the symptoms of common thyroid problems are nonspecific there is a wide range of diseases and disorders which may cause them. Thyroid function testing may be included with other tests to evaluate if you are having trouble with a non-specific symptom like fatigue, depression, or difficulty becoming or staying pregnant.
In addition to being used for diagnosis, thyroid function tests may be performed to screen for thyroid disease in patients who have no symptoms. Newborn infants are routinely screened for hypothyroidism shortly after birth.
Screening for thyroid disease in adults is controversial. Some experts recommend screening certain groups who are at higher risk of having an underactive thyroid. These risk factors may include:
- Family history of thyroid disease
- Personal history of type I diabetes
- Personal history of autoimmune disease
- Personal history of radiation to the head and neck
Other experts do not recommend routine screening for thyroid disorders in adults. The U.S. Preventive Services Task Force, which issues screening recommendations, has concluded that there is currently not enough evidence to assess the benefits and drawbacks of screening for thyroid disorders.
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Thyroid Disorders And Symptoms
If you don’t produce enough thyroid hormones, your bodily processes start to “slow down”. Signs of an underactive thyroid include:
Overactive thyroid If you produce too many thyroid hormones, it over-stimulates your metabolic functions. Signs of an overactive thyroid include:
- difficulty sleeping
Autoimmune thyroid diseasesAn autoimmune disease is when your immune system mistakenly attacks your body in this case, thyroid antibodies attack your thyroid. This can lead to a thyroid disorder.
What Are Thyroid Function Tests Used For
People with some conditions have an increased risk of thyroid problems and so are often advised to have thyroid function tests undertaken each year. This conditions include:
Thyroid function tests can also be done to:
- Monitor treatment with thyroid replacement medicine for people who have hypothyroidism.
- Check thyroid gland function in people who are being treated for hyperthyroidism.
- Screen newborn babies for inherited problems with the thyroid gland.
Your Thyroid Does Change As You Age
As with any organ, your thyroid may start to function differently as you get older.
Thyroid dysfunction generally occurs in either early adulthood or between the ages of 40 to 50, Lee said. As we get into our 70s, TSH naturally increases, meaning that your thyroid hormone levels may shift to be a little lower. This seems to happen to protect our bodies as we age, with less stress on our heart and metabolic system.
This is important to note, Lee said, because it gives physicians a greater threshold to treat someone who is older who may have higher TSH levels. Alternatively, low TSH levels can be more harmful the older we get.
This isnt to say that if youre young, you dont need to think about your thyroid at all. Thyroid disorders can happen at many different ages, as can lumps.
We do know that the younger population, those in their 20s, 30s and 40s, can develop thyroid nodules, Rao said. The vast majority of these nodules, especially if theyre below one centimeter, are 95% of the time completely benign. But its still important to be aware that they are there, and periodically monitor them.
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Why Do I Need A Thyroid Function Test
You may need this test if you have symptoms of hyperthyroidism or hypothyroidism. Hyperthyroidism is a condition that is caused by thyroid hormone levels that are too high. Hyperthyroidism can lead to weight loss, sweating, a fast heartbeat, trouble sleeping, and other symptoms. Hypothyroidism is a condition that develops when your thyroid hormone levels are too low. Hypothyroidism may cause weight gain, fatigue, sensitivity to cold, thinning hair, depression, and other symptoms. This test may instead be done to check how well your thyroid medicine is working.
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What Is Thyroid Function Testing
A number of blood tests may be used to learn if your thyroid gland is working normally. These function tests reveal if your thyroid is producing the right amount of thyroid hormones. Thyroid blood tests may be ordered:
- To check for thyroid disease before it causes symptoms, especially in newborns
- To diagnose an underactive or overactive thyroid
- To determine if an underlying disorder, such as Hashimotos thyroiditis, Graves disease, thyrotoxicosis, or thyroid inflammation, may be causing an underactive or overactive thyroid
- To evaluate a lump on the thyroid gland, called a thyroid nodule
- To evaluate an enlargement of the thyroid gland, called a goiter
- To monitor treatment for thyroid disorders
Understanding how your thyroid is functioning enables your doctor to treat a thyroid disorder if one is present.
Order your own lab tests online: its secure and easy.
- Step 2:
Select your lab tests and location or purchase an at-home kit.
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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Thyroid Binding Globulin And T3 Uptake
TBG is a binding protein that binds free thyroid hormones T4 and T3. When TBG increases it reduces free hormone levels including free T3 levels, which may cause a functional hypothyroidism.
TBG levels can increase during pregnancy, high estrogen levels and liver disease. TBG levels can decrease during hyperthyroidism, Cushing Syndrome, malnutrition, renal disease and medications .
The way we measure TBG levels is through T3 uptake because it is easier to measure. The optimal T3 uptake level is 28-38%. The higher percentage the more binding sites are available. This happens with high estrogen which increases TBG and lowers T3 uptake levels. High estrogen can occur with birth control pills, sluggish liver, insulin resistance and estrogen dominance. This results in lower free T4 and T3 levels.
Elevated testosterone will reduce binding sites, which will increase T3 uptake and result in higher levels of free T3. In many cases, the TSH will be normal or low, the T4 levels will be normal or low but the free T3 levels will be high with elevated testosterone. High testosterone is associated with testosterone replacement and with insulin resistance in some women which can also lead to PCOS.
What Causes Thyroid Disease
The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works.
Conditions that can cause hypothyroidism include:
- Thyroiditis: This condition is an inflammation of the thyroid gland. Thyroiditis can lower the amount of hormones your thyroid produces.
- Hashimotos thyroiditis: A painless disease, Hashimotos thyroiditis is an autoimmune condition where the bodys cells attack and damage the thyroid. This is an inherited condition.
- Postpartum thyroiditis: This condition occurs in 5% to 9% of women after childbirth. Its usually a temporary condition.
- Iodine deficiency: Iodine is used by the thyroid to produce hormones. An iodine deficiency is an issue that affects several million people around the world..
- A non-functioning thyroid gland: Sometimes, the thyroid gland doesnt work correctly from birth. This affects about 1 in 4,000 newborns. If left untreated, the child could have both physical and mental issues in the future. All newborns are given a screening blood test in the hospital to check their thyroid function.
Conditions that can cause hyperthyroidism include:
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Where Is The Thyroid Located
Your thyroid gland is located in the front of your neck, straddling your windpipe . Its shaped like a butterfly smaller in the middle with two wide wings that extend around the side of your throat. A healthy thyroid gland is not usually visible from the outside , and you cant feel it when you press your finger to the front of your neck.
How Are Thyroid Nodules Treated
Treatment depends on the type of thyroid nodule. Treatment options include:
- No treatment/watch and wait: If the nodules arent cancerous, you and your healthcare provider may decide that you dont need to be treated at this time. Youll see your provider regularly so they can check for any changes in the nodules.
- Radioactive iodine: Your provider may use radioactive iodine to treat hyperfunctioning thyroid nodules and goiters with several nodules. Your thyroid gland absorbs the radioactive iodine, causing the nodules to shrink.
- Surgery: Surgery to take out the nodules is the best treatment for nodules that are cancerous, cause obstructive symptoms like breathing or swallowing issues and are suspicious (they cant be diagnosed without being surgically removed and examined.
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What Are The Risk Factors For Developing A Thyroid Condition
Thyroid conditions are common and can affect anyone at any age. However, some factors put you at a higher risk of developing a thyroid condition, including:
- Having a family history of thyroid disease.
- Having an autoimmune condition, such as Type 1 diabetes, rheumatoid arthritis or lupus.
- Taking a medication thats high in iodine.
Being older than 60, especially if youre a woman or a person who was assigned female at birth .
How To Test For Thyroid Problems At Home
How to check your thyroid hormones at home?
The Everlywell at-home thyroid test can tell you if your thyroid hormone levels suggest hypothyroidism. This thyroid function test requires only a few drops of blood as a sample. After getting your online test results, you can easily see your levels of thyroid-stimulating hormone , free T3 and T4, and TPO antibodies. High TSH and/or low T3 and T4 can indicate hypothyroidism.
You can also take our thyroid test at home to check your hormones for indications of hyperthyroidism. Hyperthyroidism means your thyroid gland is overactive: itâs producing too many hormones. Low levels of TSH and/or high T3 and T4 can suggest hyperthyroidism.
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What Are The Types Of Goiter
Goiter can be classified in a few different ways, including the way by which it grows and if your thyroid hormone levels are irregular or not.
Classifications for goiter based on how it enlarges include:
- Simple goiter: This type of goiter happens when your entire thyroid gland swells and feels smooth to the touch.
- Nodular goiter: This type of goiter happens when a solid or fluid-filled lump called a nodule develops within your thyroid and makes it feel lumpy.
- Multinodular goiter: This type of goiter happens when there are many lumps within your thyroid. The nodules may be visible or only discovered through examination or scans.
Classifications of goiter based on thyroid hormone levels include:
- Toxic goiter: This goiter happens when your thyroid is enlarged and produces too much thyroid hormone.
- Nontoxic goiter: If you have an enlarged thyroid but normal thyroid levels , its a nontoxic goiter. In other words, you dont have hyperthyroidism or hypothyroidism .
Healthcare providers combine these descriptors to classify certain types of goiter when diagnosing them. For example, a toxic multinodular goiter happens when theres more than one nodule on your thyroid usually several producing an extra amount of thyroid hormone.
What Should I Take Care Of After Getting Tested For Thyroid Hormones
Once the blood sample for thyroid test is drawn, you can return to normal activities, including driving. A simple thing that you can follow is to avoid strenuous activity with the arm from where the sample was taken for a few hours after the tsh test. If you experience any pain or bleeding, apply ice packs
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Take A Small Sip Of Water Extend Your Neck Back And Swallow
Once you feel comfortable with what you are looking at you can proceed to the next step.
The most important part of this step is making sure that you are positioned in such a way that you can see the base of your neck when you swallow your water.
This can sometimes be tricky because it requires you to have your neck extended while you swallow a sip of water while you monitor the base of your neck with your eyes.
Neck extension here is very important because it pulls your skin tight.
And the tightening of the skin is necessary to see the bumps and inconsistencies that I mentioned previously as your thyroid glides underneath the skin.
As a precaution, if you tend to get dizzy with moving your head around, make sure you grab something tight before you extend your neck.
Who Does Goiter Affect
Anyone can have a goiter, but its about four times more likely to develop in people assigned female at birth compared to people assigned male at birth. Your risk of developing goiter also increases as you age. Theyre more common after age 40.
People who have any of the following conditions may also be more likely to develop goiter:
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What Is The Thyroid Gland
The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroids job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.
What Should I Do To Prepare For A Thyroid Function Test
Thyroid function tests usually require very little preparation.
You don’t need to fast before the blood test. And it doesn’t matter if you have taken your thyroid medicine just before the blood test.
Tell your doctor if you are taking any medication, as some medicines can alter the test results and how they are interpreted.
It is also important to mention if you have had any X-ray tests that have used a special contrast dye, as this may contain iodine which can affect the results. Levels of thyroid chemicals also change in pregnancy, so tell your doctor if you are pregnant when the test is taken.
Note: all newborn children have their thyroid function tested as part of the heel prick test which is offered to all babies and undertaken when they are 5 days old. See the separate leaflet called Newborn Baby Screening Tests for more information.
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