Tests For Thyroid Cancer
Thyroid cancer may be diagnosed after a person goes to a doctor because of symptoms, or it might be found during a routine physical exam or other tests. If there is a reason to suspect you might have thyroid cancer, your doctor will use one or more tests to confirm the diagnosis. If cancer is found, other tests might be done to find out more about the cancer.
What Is The Thyroid
The thyroid is a small below the skin and muscles at the front of the neck, at the spot where a bow tie would rest. It makes two types of thyroid hormones: T3 and T4 . It helps the body do many things, such as get energy from food, grow, and go through .
The pituitary is a pea-sized gland at the bottom of the brain that makes thyroid stimulating hormone . TSH triggers the thyroid to make more thyroid hormone. The pituitary gland and the thyroid gland send messages back and forth to each other about how much hormone to make to keep the levels normal.
Diagnosis Of Thyroid Cancer
Usually, diagnosing thyroid cancer begins when a routine test suggests a problem with the thyroid. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for cancer or other health problems.
The process of diagnosis may seem long and frustrating. Its normal to worry, but try to remember that other health conditions can cause similar symptoms as thyroid cancer. Its important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of thyroid cancer.
The following tests are commonly used to rule out or diagnose thyroid cancer. Many of the same tests used to diagnose cancer are used to find out the stage, which is how far the cancer has progressed. Your doctor may also order other tests to check your general health and to help plan your treatment.
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What Are Thyroid Blood Tests
Doctors use blood tests to check for thyroid or pituitary problems. In kids already diagnosed with thyroid or pituitary problems, the tests are used to guide treatment.
Commonly ordered thyroid blood tests include:
- : This is done to measure the blood level of the hormone T4 . It might be done in one or both of the following ways:
- total T4, which measures the entire amount of thyroxine in the blood, including the amount attached to blood proteins that help carry the hormone through the bloodstream
- free T4, which measures only the thyroxine that’s not attached to proteins. This is the part of T4 in the blood that affects how the body’s cells work.The results of the T4 blood tests can help diagnose hyperthyroidism or hypothyroidism and guide treatment.
In some cases, abnormal thyroid test results can be due to a medicine, an ongoing medical condition, or pregnancy. In these cases, there may be nothing wrong with the thyroid or pituitary glands themselves.
What About Those Already On Thyroid Medications
If youre already on thyroid meds, but still have symptoms, it is possible you may need to up your dosage so that your labs fall within the optimal range, to help you feel better.
Please take a look at my article on TSH for a letter that you can take to your physician if he/she is not familiar with the current optimal reference range. As I mentioned earlier, I personally feel best with a TSH a bit under 1 IU/mL, but you may need some trial and error to find your personal best TSH.
Once you establish a dose of medication thats working for you and as long as your symptoms dont change you can test your thyroid hormones every six months.
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What Imaging Tests Do Doctors Use To Diagnose And Find The Cause Of Thyroid Disease
Your health care professional may order one or more imaging tests to diagnose and find the cause of thyroid disease. A trained technician usually does these tests in your doctors office, outpatient center, or hospital. A radiologist, a doctor who specializes in medical imaging, reviews the images and sends a report for your health care professional to discuss with you.
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 Are The Types Of Thyroid Disorders
Blood tests are used to diagnose hypothyroidism or hyperthyroidism. They do not point to a specific cause. In order to determine a cause of the thyroid abnormality, the doctor will consider the patient’s history, physical examination, and medical condition. Further testing might be used to isolate an underlying cause. These tests might include more blood testing for
- thyroid antibodies,
- ultrasound of the thyroid gland, or
If thyroid cancer is suspected and surgery may be required, your physician may ask for a blood test known as thyroglobulin.
- Thyroglobulin is a protein made only by thyroid cells.
- If the thyroglobulin level at baseline is detectable or elevated it can be used as a tumor marker.
- After a total thyroidectomy for cancer the level should fall to an undetectable range since the cells that make thyroglobulin have been removed.
- If the level remains detectable after surgery, there is a possibility of thyroid tissue elsewhere in the body, and metastatic disease should be considered.
- If the level is undetectable for a period of time after surgery and then starts to climb, a recurrence of the cancer – either at the primary site or elsewhere in the body should be considered.
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.
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Order your own lab tests online: its secure and easy.
- Step 2:
Select your lab tests and location or purchase an at-home kit.
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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.
Comparing High/low Tsh And T3/t4 Levels
- Normal TSH + normal T4 = normal thyroid function
- High TSH + normal T4 = you may have a higher risk of developing an underactive thyroid
- 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
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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, which may be referred to as a full thyroid panel, complete thyroid panel, extended thyroid panel or other thyroid lab tests, 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
Thyroid function tests are also used for treatment monitoring. Patients with known thyroid disorders will have periodic thyroid function testing to ensure their treatment is effective.
How Is Thyroid Disease Treated
Your healthcare providers goal is to return your thyroid hormone levels to normal. This can be done in a variety of ways and each specific treatment will depend on the cause of your thyroid condition.
If you have high levels of thyroid hormones , treatment options can include:
- Anti-thyroid drugs : These are medications that stop your thyroid from making hormones.
- Radioactive iodine: This treatment damages the cells of your thyroid, preventing it from making high levels of thyroid hormones.
- Beta blockers: These medications dont change the amount of hormones in your body, but they help manage your symptoms.
- Surgery: A more permanent form of treatment, your healthcare provider may surgically remove your thyroid . This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.
If you have low levels of thyroid hormones , the main treatment option is:
- Thyroid replacement medication: This drug is a synthetic way to add thyroid hormones back into your body. One drug thats commonly used is called levothyroxine. By using a medication, you can manage thyroid disease and live a normal life.
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What Are Thyroid Function Tests
Thyroid function tests are a series of blood tests used to measure how well your thyroid gland is working. Available tests include the T3, T3RU, T4, and TSH.
The thyroid is a small gland located in the lower-front part of your neck. Its responsible for helping regulate many bodily processes, such as metabolism, energy generation, and mood.
The thyroid produces two major hormones: triiodothyronine and thyroxine . If your thyroid gland doesnt produce enough of these hormones, you may experience symptoms such as weight gain, lack of energy, and depression. This condition is called hypothyroidism.
If your thyroid gland produces too many hormones, you may experience weight loss, high levels of anxiety, tremors, and a sense of being on a high. This is called hyperthyroidism.
Typically, a doctor who is concerned about your thyroid hormone levels will order broad screening tests, such as the T4 or the thyroid-stimulating hormone test. If those results come back abnormal, your doctor will order further tests to pinpoint the reason for the problem.
If youre concerned about your thyroid function and dont already have a primary care doctor, you can view doctors in your area through the Healthline FindCare tool.
There are also at-home thyroid function tests available from LetsGetChecked and Everlywell. Healthline has also created a list of best at-home thyroid tests here.
Why It Is Done
Thyroid hormone tests are done to:
- Find out what is causing an abnormal thyroid-stimulating hormone test. For more information, see the topic Thyroid-Stimulating Hormone . This is the most common reason for thyroid hormone tests.
- Check how well treatment of thyroid disease is working. The free thyroxine value is often used to keep track of treatment for hyperthyroidism or hypothyroidism, if TSH is abnormal or if TSH is normal and a patient has pituitary disease.
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Thyroid Testing: How It Works
Thyroid tests use a blood sample to measure various hormone levels. Thyroid-stimulating hormone , for example, is often measured to indirectly check if your thyroid gland is producing enough thyroid hormones. TSH levels are usually higher than normal if you have an underactive thyroid .
Thyroid function tests can also measure thyroid hormones like thyroxine to provide a better understanding of how low â or how high â your thyroid hormone levels are.
How The Thyroid Works
Just as the thyroid gland communicates with other organs through the hormone it produces, the pituitary gland in the brain communicates with the thyroid through a hormone it makesthyroid-stimulating hormone, or TSH. When the pituitary senses that thyroid hormone levels are too low, it releases more TSH to coax the thyroid into action. When the thyroid is nudged by TSH, it produces thyroid hormonea large proportion of which is thyroxine and a smaller proportion triiodothyronine . The T4 is eventually converted into T3, the “active” form that is taken up by receptors in body cells.
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Why Consider This Test
Specific Thyroid Concerns
Tests that measure both TSH and T4 can be used together to screen for and help diagnose thyroid conditions, including hypothyroidism and hyperthyroidism .2
Female Health and Fertility
Women are five to eight times more likely than men to have thyroid problems. Hypothyroidism is a leading cause of difficulty in achieving and maintaining pregnancy.2
Proactive Prevention
Undiagnosed thyroid disease may put patients at risk for certain serious conditions such as cardiovascular diseases, osteoporosis, and infertility. Most thyroid conditions can be managed with medication.2
References
Knowing When To Check Your Thyroid
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Drawing Blood For Thyroid Function Tests
Before you get a blood draw to check your thyroid levels, talk with your doctor about any medications youre taking. Also let them know if youre pregnant. Certain medications and being pregnant may influence your test results.
A blood draw, also known as venipuncture, is a procedure performed at a lab or a doctors office. When you arrive for the test, youll be asked to sit in a comfortable chair or lie down on a cot or gurney. If youre wearing long sleeves, youll be asked to roll up one sleeve or to remove your arm from the sleeve.
A healthcare professional, like a technician or nurse, will tie a band of rubber tightly around your upper arm to make the veins swell with blood. Once the healthcare professional has found an appropriate vein, theyll insert a needle under the skin and into the vein.
You may feel a sharp prick when the needle punctures your skin. The healthcare professional will collect your blood in test tubes and send it to a laboratory for analysis.
When the healthcare professional has gathered the amount of blood needed for the tests, theyll withdraw the needle and place pressure on the puncture wound until the bleeding stops. They will then place a small bandage over the wound.
You should be able to return to your typical daily activities immediately.