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Thyroid Problems (cont.)

Thyroid Problems Diagnosis

The medical history and physical exam are important parts of the evaluation for thyroid problems. The health care practitioner will focus on eye, skin, cardiac (heart), and neurologic findings.

Blood tests

  • Thyroid-stimulating hormone (TSH): In most cases, this is the single most useful lab test in diagnosing thyroid disease. When there is an excess of thyroid hormone in the blood, as in hyperthyroidism, the TSH is low. When there is too little thyroid hormone, as in hypothyroidism, the TSH is high.
  • Free (T4): T4 is one of the thyroid hormones. High T4 may indicate hyperthyroidism. Low T4 may indicate hypothyroidism.
  • Triiodothyronine (T3): T3 is another one of the thyroid hormones. High T3 may indicate hyperthyroidism. Low T3 may indicate hypothyroidism.
  • TSH receptor antibody (TSI): This antibody is present in Graves' disease.
  • Antithyroid antibody (thyroperoxidase antibody): This antibody is present in Hashimoto's and Graves' disease.

Nuclear thyroid scan: During this scan a small amount of radioactive iodine is swallowed or a similar material, 99m-technetium, is injected into the blood, and then an imaging study of the thyroid is taken that reveals localization of the radioactivity. Increased uptake of the radioactive material in the thyroid gland indicates hyperthyroidism, while decreased uptake is present in hypothyroidism. This test should not be performed on women who are pregnant.

Thyroid ultrasound: Thyroid ultrasound helps to determine the size and number as well as the different types of nodules in the thyroid gland. This exam can also detect if there are enlarged parathyroid glands or lymph nodes near the thyroid gland.

Fine-needle aspiration: During this procedure, a thin needle is inserted into the thyroid gland in order to get a sample of thyroid tissue, usually from a nodule. This test can be done in a health care practitioner's office without special preparations. It is recommended that the biopsy be performed with ultrasound guidance. The tissue is then observed under a microscope by a pathologist to look for any signs of cancer.

Computerized axial tomography (CT) scan: A CT scan is occasionally used to look for the extent of a large goiter into the upper chest or to look for narrowing or displacement of the trachea (breathing tube) from the goiter. However, this is not a routine test for thyroid nodules or goiter.

Medically Reviewed by a Doctor on 11/10/2014
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