Benefits And Limitations Of The Self
You can perform a simple at-home neck check to help with early detection. This self-exam can help you find lumps or enlargements that may indicate a thyroid condition Note that a neck check is not the most reliable way to identify thyroid disease. Even if your neck looks normal on the surface, something more serious could be lurking. If you have risk factors for thyroid diseases , it is a good idea to check your neck periodically. Any growth is a sign that you should seek professional help.
What To Consider When Searching For An At
In your search for an at-home thyroid test, decide what is most important for your needs. Most tests measure TSH and T4 levels. You may need further tests that measure levels such as T3, T7, TSI, and antibodies. Find out what types of recommendations for additional testing or treatment plans each company offers.
At-home tests can be considered if you have symptoms that cause you to suspect a thyroid disorder. You may also want to test your thyroid levels after implementing lifestyle changes, starting a new medication, or beginning a treatment plan. Its also a good idea to do a home test if you are at risk of developing a thyroid disorder.
At-home thyroid tests offer plenty of advantages and drawbacks to consider.
Signs Of Thyroid Trouble
The American Association of Clinical Endocrinologists estimates that 30 million Americans have some kind of thyroid disorder. Thats a surprising number but even more startling is that up to 50% of people with thyroid disease arent even aware that they have it.
Its common for people to chalk up some thyroid symptoms fatigue, irritability, sleep problems to general life stress, says Tiffany Hor, MD, an endocrinologist at Rush.
Such nonspecific symptoms are often easy to ignore, but the consequences of postponing diagnosis and treatment can be serious: Over the long term, untreated thyroid issues can lead to health complications ranging from an increased risk of osteoporosis to cardiovascular issues.
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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.
Top 10 Thyroid Tests And How To Interpret Them
Medically reviewed and written by Izabella Wentz, PharmD, FASCP
In my clinical experience, Ive seen many cases of thyroid problems go undiagnosed because most doctors dont perform a comprehensive test panel.
I spent almost a decade undiagnosed because I only had one marker tested. My thyroid condition was missed completely, leading me to deal with needless mystery symptoms like chronic fatigue, depression, anxiety, and many others, for far too long!
I still have a copy of my lab results from 2008, before I was diagnosed with Hashimotos. At that time, I was desperately searching for a reason behind my exhaustion, hair loss, anxiety, and digestive issues. According to this lab report, my TSH was at 4.5 IU/mL, yet there was a note written from the doctor declaring: Your thyroid function is normal, no need to do anything. Perhaps a TSH of 4.5 IU/mL would have been normal for a 95-year-old woman, but I was 25 and sleeping 12+ hours a night to feel rested!
Of course, even as a pharmacist, I didnt think to question the doctor and most people dont. If you suspect that you may have a thyroid condition, or know someone who does, this article will go over all of the most helpful tests that can help you identify a thyroid condition.
This article will also teach you how to understand your labs so that you can advocate for proper treatment for yourself.
In this article, Ill go over:
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The Thyroid Screening Test
The thyroid stimulating hormone, or TSH test, is used as a screening test for thyroid disease, as well as a test for monitoring the correct dose of medication needed for an individual.
This is an important test that I recommend getting every time you check your thyroid function.
TSH is a pituitary hormone that responds to low/high amounts of circulating thyroid hormone. If youre new to thyroid lab testing, it may seem counterintuitive, but an elevated TSH means that you do not have enough thyroid hormone on board and that you are hypothyroid. This is because the TSH hormone senses low thyroid levels and is released when there is a lack of it, in an effort to signal the body to make more.
In advanced cases of Hashimotos and primary hypothyroidism, this lab test will be elevated. In the case of Graves disease and hyperthyroidism, TSH levels will be low. People with Hashimotos and mild or central hypothyroidism may have a normal reading on this test.
If youve been a thyroid patient for a while, youre probably thinking to yourself, Well, of course, doesnt everyone know that? and I have to warn you Ive unfortunately seen physicians who have mistakenly thought that a low TSH meant one had an underactive thyroid, and a high TSH, an overactive thyroid putting their patients in really dangerous situations by under- or overmedicating them!
Most conventional practitioners will stop further thyroid testing when they determine the TSH is normal .
Recommended test: TSH
Recognizing Symptoms Of Thyroid Disease
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What Are Thyroid Hormones
The thyroid is a small gland that sits at the front of your neck. Itâs responsible for controlling many of the bodyâs key activities â such as metabolism. It does this by releasing specific hormones into the bloodstream.
A hormone is small chemical messenger that allows different parts of your body to âtalkâ with each other. The thyroid makes two kinds of hormones: thyroxine and triiodothyronine . These hormones circulate in your blood, allowing the thyroid gland to regulate many of the bodyâs important functions, such as:
- Metabolism â Thyroid hormones tell the body when to burn fat, which gives you more energy. Thyroid hormones can also trigger the production of glucose â a sugar formed from carbohydrates â to provide your body with more energy.
- Heart rate â Thyroid hormones can affect your resting heart rate .
- Internal body temperature â Thyroid hormones are involved in regulating your bodyâs internal temperature â so the thyroid gland acts a bit like a thermostat that helps make sure your body doesnât get too cool or too hot.
Whatâs more, thyroid hormones can contribute to more wakefulness and alertness because of how they affect the nervous system.
In short, your body requires the right balance of thyroid hormone levels in order to effectively carry out many of its functions.
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.
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Understanding Thyroid Labs For Medication Prescriptions And Adjustments
Thyroid labs, especially TSH, free T3, and free T4, are critical for determining if you need to start, increase, or reduce the dose of your thyroid hormone medications, as well as if youre on the right thyroid medications.
Some physicians who prescribe thyroid medications will not prescribe a medication unless the TSH is above 10 IU/mL, and will be satisfied when a person who is taking thyroid meds has a TSH under 10 IU/mL. I think this is the reason why many people continue to have fatigue, cold intolerance, difficulty with weight loss, and hair loss despite taking thyroid medications.
When the TSH is between 2.5 IU/mL and 10 IU/mL, and/or when T3 and T4 are within normal limits, this is known as subclinical hypothyroidism. This means that the thyroid is still able to make enough thyroid hormone, but not without sacrifice. At this point, our thyroid is working overtime, leading to many of the common symptoms of hypothyroidism.
What Do The Results Mean
Your TSH test results can tell you if your thyroid is making too much or too little thyroid. But the test can’t explain why your TSH levels may be too high or too low.
If your test results aren’t normal, your provider will probably order other thyroid blood tests to find out what’s causing your thyroid problem. These blood tests may include:
- Thyroid antibodies test to help diagnose an autoimmune thyroid disorder, such as:
- Graves’ disease, the most common cause of hyperthyroidism
- Hashimoto’s disease, that the most common cause of hypothyroidism
In certain cases, an abnormal TSH result may be a sign of a pituitary gland problem, but this doesn’t happen often.
Learn more about laboratory tests, reference ranges, and understanding results.
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What Do My Thyroid Test Results Mean
The two most common types of thyroid function tests are the T4 and TSH test. Typically, these two tests are ordered together.
The T4 testmore commonly known as the thyroxine test is used to determine if your thyroid is overactive. If this is the case, you will be diagnosed with hyperthyroidism.
Symptoms of hyperthyroidism include unplanned weight loss, tremors, diarrhea and anxiety.
The TSH test will reveal how much thyroid-stimulating hormone is in your blood. Normal levels range from 0.4 to 4.0 milli-international units of hormone per liter of blood.
If youve been diagnosed with hyperthyroidism and your TSH levels are above 2.0 mIU/L, you are at a heightened risk of developing hypothyroidism, which can result in weight gain, fatigue, depression and weak hair and nails.
If your provider believes you have hyperthyroidism, he or she may order a T3 test to check for levels of the hormone triiodothyronine.
This hormone level should be within 100-200 nanograms of hormone per deciliter of blood. If your levels are abnormally high, it is possible that you are suffering from an autoimmune disorder called Graves disease.
The final thyroid function test your provider may order is the T3 resin uptake test. Also known as a T3RU, this blood test will measure the binding capacity of a hormone called thyroxin-binding globulin.
Your providers office should reach out to you within a matter of days to walk you through the results of your thyroid test.
How Long After My Thyroid Is Removed Will My Tiredness Go Away
Typically, you will be given medication to help with your symptoms right after surgery. Your body actually has thyroid hormone still circulating throughout it, even after the thyroid has been removed. The hormones can still be in your body for two to three weeks. Medication will reintroduce new hormones into your body after the thyroid has been removed. If you are still feeling tired after surgery, remember that this can be a normal part of recovering from any type of surgery. It takes time for your body to heal. Talk to your healthcare provider if you are still experiencing fatigue and other symptoms of thyroid disease after surgery.
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What Is Thyroid Disease
Thyroid disease is a general term for a medical condition that keeps your thyroid from making the right amount of hormones. Your thyroid typically makes hormones that keep your body functioning normally. When the thyroid makes too much thyroid hormone, your body uses energy too quickly. This is called hyperthyroidism. Using energy too quickly will do more than make you tired it can make your heart beat faster, cause you to lose weight without trying and even make you feel nervous. On the flip-side of this, your thyroid can make too little thyroid hormone. This is called hypothyroidism. When you have too little thyroid hormone in your body, it can make you feel tired, you might gain weight and you may even be unable to tolerate cold temperatures.
These two main disorders can be caused by a variety of conditions. They can also be passed down through families .
What Is Reverse T3
Reverse T3 is a biologically inactive form of T3. Normally, when T4 is converted to T3 in the body, a certain percentage of the T3 is in the form of RT3. When the body is under stress, such as during a serious illness, thyroid hormone levels may be outside of normal ranges even though there is no thyroid disease present. RT3 may be elevated in non-thyroidal conditions, particularly the stress of illness. It is generally recommended that thyroid testing be avoided in hospitalized patients or deferred until after a person has recovered from an acute illness. Use of the RT3 test remains controversial, and it is not widely requested.
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What Other Tests May Be Ordered In Addition To A Thyroid Panel
Blood tests that may be performed in addition to a thyroid panel may include:
- Thyroid antibodies – to help diagnose autoimmune thyroid disease and distinguish it from other thyroid conditions
- Calcitonin – to help diagnose C-cell hyperplasia and medullary thyroid cancer
- Thyroglobulin – primarily to monitor treatment and recurrence of thyroid cancer
- Thyroxine-binding globulin – to evaluate patients with abnormal T4 and T3 levels
What To Consider In Your Personal And Family Medical Histories
Its important to give your physician as many details as possible about your personal medical history, as well as family history . Be sure to discuss:
Your general state of healthparticularly any changes you have noticed in your general overall health.
Your familys health historyespecially if a close relative has been diagnosed with hypothyroidism .
Whether youve ever had , or radiation to your neck to treat cancer.
Any medicines you may be taking that could cause hypothyroidism .
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Magnetic Resonance Imaging Scan
MRI scans use magnets instead of radiation to create detailed cross-sectional images of your body. MRI can be used to look for cancer in the thyroid, or cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the thyroid. MRI can provide very detailed images of soft tissues such as the thyroid gland. MRI scans are also very helpful in looking at the brain and spinal cord.
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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What Does Your Thyroid Gland Do
Your thyroid gland is a gland found at the front of your neck, just below your Adam’s apple. Your thyroid gland produces hormones that play a key role in regulating your metabolism and affects things like your heart rate, body temperature, and breathing. These hormones are:
These hormones are controlled by thyrotropin-releasing hormone and thyroid-stimulating hormone .
Preparing For The Tests
You dont need to do anything special to prepare for the thyroid function tests. If a healthcare professional has ordered other blood tests to be taken at the same time, you may need to fast for several hours before the test. They will let you know of any special instructions to follow.
Otherwise, you will not need to follow any specific directions before the test.
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