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How To Read Thyroid Lab Results

Thyroglobulin Antibody Test Results

How to Interpret Your THYROID Lab Results

Following are sample results of the Thyroglobulin Antibody blood test. The reference intervals indicate the normal ranges and the flag indicates a result outside of those ranges. The Thyroglobulin Antibody test may be used as a tumor marker and to evaluate treatment of thyroid cancer. The test may also be ordered when an individual has symptoms of hyperthyroidism. The test is useful in monitoring the effectiveness of treatment in individuals with Graves Disease, before and after surgical thyroid removal, and other thyroid cancer treatments. This test is commonly ordered with a TSH test.

  • Elevated levels of the thyroglobulin antibodies may indicate Graves disease or thyroiditis.

LabCorp Example

Thyroglobulin Antibody reference range: 0.0 to 0.9 IU/mL.

Quest Diagnostics Example

Thyroglobulin Antibody reference range:< or = 1 IU/mL.

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.

What Should I Do With The Analysis

You should use the analysis to empower yourself and learn more about your results, but not to diagnose yourself with a thyroid-related condition, such as hyperthyroidism, hypothyroidism, Graves disease, or Hashimotos thyroiditis. Proper diagnosis and treatment require a holistic look at your previous medical history, symptoms, lifestyle, and more. Your doctor is the best person to do this.

You can use this information to inspire questions or use it as a starting point for a conversation with your doctor at your next appointment. Asking the right questions can help you know what to expect.

Also, consider bringing along a doctor discussion guide for even more guidanceit lists common vocabulary terms your doctor may use and important questions about symptoms, causes, diagnosis, treatment, and living well with thyroid disease.

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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.

When Abnormal Thyroid Function Tests Are Not Due To Thyroid Disease

How to Read Thyroid Test Results: 13 Steps (with Pictures)

While blood tests to measure thyroid hormones and thyroid stimulating hormone are widely available, it is important to remember that no all tests are useful in all circumstances and many factors including medications, supplements, and non-thyroid medical conditions can affect thyroid test results. An endocrinologist can help you make sense of thyroid test results when there is a discrepancy between your results and how you feel. A good first step is often to repeat the test and ensure there are no medications that might interfere with the test results. Below are some common reasons for mismatch between thyroid tests and thyroid disease.

Non-thyroidal illness Significant illness, such as an infection, cancer, heart failure, or kidney disease, or recent recovery from an illness can cause changes transient changes in the TSH. Fasting or starvation can also cause a low TSH. An endocrinologist can help to interpret changes in thyroid function tests in these circumstances to distinguish non-thyroid illness from true thyroid dysfunction.

Test interference Biotin, a common supplement for hair and nail growth, interferes with many thyroid function tests and can lead to inaccurate results. Endocrinologists recommend stopping biotin supplements for 3 days before having a blood test for thyroid function.

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What Do The Results Tell Us

An enlarged thyroid also called a goiter can be a sign of an iodine deficiency that hasnt yet affected the function of the thyroid. But it could also be a sign of an overactive thyroid or an underactive thyroid , where too many or too few hormones are made respectively.

Nodules that can be felt from the outside may also be a sign of a thyroid problem. But sometimes people have an enlarged thyroid gland or nodules without it affecting the function of their thyroid gland.

So this palpation examination can only tell us whether there might be a thyroid problem. Further tests and examinations are needed in order to be sure.

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.

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Parathyroid Hormone Test Results

Following is a sample of the results of the PTH blood test. The reference interval indicates the normal ranges and the flag indicates a result outside of those ranges. The Parathyroid helps regulate calcium levels. This test will provide valuable information as to how the Parathyroid is functioning.

  • High levels of PTH with low calcium levels may be an indicator that the Parathyroid glands are functioning properly.
    • Other tests such as Vitamin D, phosphorus and magnesium levels may be needed to determine if they are affecting your calcium levels.
  • High levels of PTH with high calcium levels may be an indicator of hyperparathyroidism.

LabCorp Example

PTH reference range: 15-65 pg/mL.

Quest Diagnostics Example

PTH reference range: 14-64 pg/mL. The chart below the result may be used as a guideline for interpretation of the PTH result.

What Does The Test Result Mean

How To Read Your Thyroid Panel Results

If the feedback system involving the thyroid gland is not functioning properly due to one of a variety of disorders, then increased or decreased amounts of thyroid hormones may result.

  • When TSH levels are increased, the thyroid will make and release inappropriate amounts of T4 and T3 and you may experience symptoms associated with hyperthyroidism.
  • If there is decreased production of thyroid hormones, you may have symptoms of hypothyroidism.

The test results alone are not diagnostic but will prompt your healthcare practitioner to perform additional testing to investigate the cause of the excess or deficiency and thyroid disorder. As examples, the most common cause of hyperthyroidism is Graves disease and the most common cause of hypothyroidism is Hashimoto thyroiditis.

The following table summarizes some examples of typical test results and their potential meaning.

Note: Laboratory results must always be correlated with the clinical findings of the patient.
TSH
Hypothyroidism resulting from a problem with the hypothalamus or pituitary signals that govern the thyroid gland

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What Is Thyroid Hormone

Thyroid hormone is made by the thyroid gland, a butterfly-shaped endocrine gland normally located in the lower front of the neck. Thyroid hormone is released into the blood where it is carried to all the tissues in the body. It helps the body use energy, stay warm and keeps the brain, heart, muscles, and other organs working as they should.

Thyroid hormone exists in two main forms: thyroxine and triiodothyronine . T4 is the primary form of thyroid hormone circulating in the blood . To exert its effects, T4 is converted to T3 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. T3 normally accounts for about 5% of thyroid hormone circulating in the blood.

Most thyroid hormone in the blood is bound by protein, while only a small fraction is “free” to enter tissues and have a biologic effect. Thyroid tests may measure total or free hormone levels.

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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Thyroid Function Test Results Explained

The thyroid usually changes slowly. It hardly ever quickly changes to being overactive or underactive: it usually takes a few weeks at least, or even a few months. If you have a thyroid function test that shows something is wrong, it’s usually worth repeating it in 3-6 weeks. That is because there’s always the chance that your thyroid gland could have gone back to normal by itself.

The second thing to bear in mind about thyroid function tests is that medications, and even herbal remedies or vitamin supplements, can affect the accuracy of thyroid results.

For these two reasons it’s always recommended to have a thyroid function test if it is recommended to you by a doctor, rather than having it done privately or without a doctor suggesting it.

Signs You Should Do A Thyroid Function Test

Hypothyroidism Undetected: Why It Is Often Missed

If any of these hormones are out of balance it can lead to a thyroid disorder and cause a wide range of symptoms. If youre experiencing any of these symptoms its really important to check your thyroid function. Its also common for thyroid disorders to run in families so its particularly important to test your thyroid function if you think you might be at risk. You can test your thyroid function as part of our womens hormones blood test.

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High Tsh And Normal Ft4

This pattern of results can signify so-called subclinical hypothyroidism. Measurement of antithyroid peroxidase antibody titres is a useful adjunct to help guide decision-making because positivity predicts a higher risk of subsequent progression to overt hypothyroidism. Again, confirmation that the TSH is persistently raised is generally advised, although in certain circumstances T4 replacement can be instituted without delay. LT4 therapy should be particularly considered in: younger patients women who wish to become or who are pregnant patients with positive TPO antibodies or a rising trend in serial TSH levels and the presence of marked hypercholesterolaemia. Raised TSH with normal TH levels is also seen with assay interference and in patients taking exogenous T4, where it might reflect malabsorption, altered metabolism or poor compliance .

Basic Thyroid Package Test Results

Following is a sample of the results of the Basic Thyroid Package blood test. The reference interval indicates the normal ranges and the flag indicates a result outside of those ranges. Both LabCorp and Quest Diagnostics measure T4 levels using micrograms per Liter for their reference ranges.

  • The thyroid stimulating hormone or TSH signals the thyroid to perform its job and burn calories.
    • Low TSH results may indicate hyperthyroidism.
    • Elevated TSH results may indicate hypothyroidism.
  • T3 uptake is used to estimate the amount of TBG in the blood and how much T3 and T4 is available for the body to use.
  • T3 uptake directly affects the T3 and T4 levels.
  • T4 circulates in the blood and influences how other organs and the heart function in the body.
  • Elevated levels of T4 may indicate hyperthyroidism or thyroiditis. Abnormal elevated results may also be caused by too much iodine, high levels of protein in the blood, or too much thyroid medication.
  • Low levels of T4 may indicate hypothyroidism, iodine deficiency, or possible pituitary gland disorder.
  • T7 is a calculated measure of T4 x T3U
  • LabCorp Example

    TSH reference range: 0.450 to 4.500 uIU/mL. Thyroid Panel: Thyroxine : reference range 4.5 to 12.0 ug/dL T3 Uptake: 24-39% Free Thyroxine Index : 1.2 to 4.9.

    Quest Diagnostics Example

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    Drawing Blood For Thyroid Function Tests

    Talk to your doctor about any medications youre taking, and tell your doctor 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 technician or nurse will tie a band of rubber tightly around your upper arm to make the veins swell with blood. Once the technician 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 technician will collect your blood in test tubes and send it to a laboratory for analysis.

    When the technician 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. The technician will then place a small bandage over the wound.

    You should be able to return to your normal daily activities immediately.

    The Thyroid Screening Test

    Thyroid tests explained: How to read your own labs!

    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.

    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 get 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 over or under medicating them!

    Thus, many physicians may miss the patients who are showing an elevated TSH. This is one reason why patients should always ask their physicians for a copy of any lab results.

    Recommended test: TSH

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    How To Keep Hypothyroidism Under Control

    Because youll need to take thyroid medication every day for the rest of your life, even after the right dose is found, your hormone levels will be monitored regularly to be sure that your treatment is working properly. Eventually, most people with hypothyroidism can just be seen yearly by their doctor, Doria-Medina says.

    The American Thyroid Association recommends that you keep your TSH within a narrow range of 0.5 to 2.5 mU/L, but dont be alarmed if your test results vary a little. Some variation is normal because your pituitary gland sends out TSH in pulses, not a steady stream. Also, factors like the time of day youre tested can make a difference. TSH levels are likely to be higher at night and lower during the day. Some people, including those who are pregnant or those with a history of thyroid cancer, have different TSH goals. Talk to your doctor about the target TSH range thats right for you.

    If you have new or worsening symptoms or your health status changes such as if you become pregnant, go through menopause, or are given another medicine that can interfere with the absorption of your thyroid hormones, such as anticonvulsants, certain antacids, or iron or calcium supplements you should see your doctor and have your blood tested again, even if its ahead of schedule.

    Common Tests To Examine

    Some information on this page is a little more advanced. If you have trouble understanding the process of normal thyroid function, please go to our page describing this process first.

    As we have seen from our overview of normal thyroid physiology, the thyroid gland produces T4 and T3. But this production is not possible without stimulation from the pituitary gland which in turn is also regulated by the hypothalamus’s TSH Releasing Hormone. Now, with radioimmunoassay techniques it is possible to measure circulating hormones in the blood very accurately. Knowledge of this thyroid physiology is important in knowing what thyroid test or tests are needed to diagnose different diseases. No one single laboratory test is 100% accurate in diagnosing all types of thyroid disease however, a combination of two or more tests can usually detect even the slightest abnormality of thyroid function.

    For example, a low T4 level could mean a diseased thyroid gland ~ OR ~ a non-functioning pituitary gland which is not stimulating the thyroid to produce T4. Since the pituitary gland would normally release TSH if the T4 is low, a high TSH level would confirm that the thyroid gland is responsible for the hypothyroidism.

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