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What Does High Thyroid Blood Test Mean

Why Do I Need A Tsh Test


You may need a TSH test if you have symptoms of too much thyroid hormone in your blood , or too little thyroid hormone .

Symptoms of hyperthyroidism, also known as overactive thyroid, include:

Symptoms of hypothyroidism, also known as underactive thyroid, include:

  • Weight gain
  • Low tolerance for cold temperatures
  • Irregular menstrual periods
  • Constipation

Cysts Or Nodules In The Thyroid Gland

Nodules or cysts in the thyroid gland can affect its function and cause too little T4 and T3 to be produced. This has the effect of increased secretion of TSH which can cause levels to increase above 4.0 mIU/L.

The journal Medical Clinics of North America reports that testing for high levels of TSH is essential in monitoring thyroid nodules. Blood serum tests for TSH are usually combined with ultrasound scans to check for cancerous cells in the thyroid. Doctors say that constant monitoring is essential because low T4 in the blood along with normal or high TSH can increase the risk that nodules become malignant.16

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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.

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Should People With Thyroid Problems Avoid These Foods

Soy: If you have hypothyroidism, yes. Eating too much soy causes problems only for those with hypothyroidism, which occurs when your thyroid gland does not make enough thyroid hormones, Dr. Nasr says.

The main problem is that soy may hinder absorption of the hormones that such patients take.

Some studies show that if you eat a lot of soy, or drink a big glass of soy milk, within one hour of taking a thyroid hormone, it might affect absorption, Dr. Nasr says. Many individuals depend on a consistent absorption of those hormones to achieve a steady state.

Generally, expertsrecommend that people who have a borderline thyroid one thats a littleunderactive but youre still trying to preserve thyroid function do not toconsume large amounts of soy every day, he adds.

Turnips and rootvegetables: No. These vegetables aresometimes thought to cause thyroid problems, but thats not the case, Dr. Nasrsays. They are good for your diet, regardless of any thyroid issues.

One root vegetable that is the exception is cassava, a common staple in certain parts of Africa. This plant is known to produce toxins that can slow an already underactive thyroid, especially in the presence of an iodine deficiency, Dr. Nasr says. But thats not relevant here in the United States, unless you cook cassava and you eat it every day.

What Your T4 Blood Test Results Mean

What a High TSH Really Means for your Thyroid + What ...

You should get the results of your test within a day or so. Results can vary based on your age, gender, and the method your lab uses to read the result.

Normal Range

The normal range for free T4 in adults is 4.6 to 11.2 micrograms per deciliter .

A normal T4 test result means your thyroid gland works like it should.

High or Low T4

A high T4 result could mean you have hyperthyroidism. A low T4 test result is a sign of hypothyroidism.

Your hypothalamus and pituitary glands control the release of T4. An abnormal result on the T4 test could also be a sign of a problem with one of these glands.

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Is The Thyroglobulin Test Suggested For Pregnant Women

Generally, there is a steady increase in the thyroglobulin level during pregnancy. The mothers who had been a thyroid cancer survivor are always recommended to undergo the thyroglobulin test. The test helps in constant monitoring and assessment of the condition of the thyroid cancer by measuring the thyroglobulin levels in the blood.

What Are The Treatments For Hyperthyroidism

The main aim of treatment of an overactive thyroid gland is to reduce your level of thyroxine to normal. Other problems, such as a large thyroid swelling or associated eye problems, may also need treatment. Factors such as the underlying cause of the problem, your age and the size of any goitre are taken into account to decide on the best treatment plan.

Treatment options include the following:

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Potential Complications Of Hypothyroidism

Left untreated, the symptoms of hypothyroidism will usually progress. That can lead to complications including birth defects, infertility, elevated bad cholesterol, and mental health problems. Rarely, complications from untreated hypothyroidism can result in severe life-threatening depression, heart failure, or a type of coma called myxedema coma.

Additionally, because the body is expecting a certain amount of thyroid hormone, the pituitary will make additional thyroid stimulating hormone as a way to prompt the thyroid to produce more hormone . This extra work at signaling the thyroid gland to keep producing T4 may cause the thyroid gland to become enlarged, leading to the formation of a goiter .

What Is Free T4 And Bound T4

TSH test explained | Thyroid stimulating hormone test | Thyroid function test | Blood TSH test

T4 stands for thyroxine, one of two hormones your thyroid gland makes. The thyroid is a butterfly-shaped gland in your neck that helps control your body’s growth and energy use. The T4 test measures the amount of T4 in your blood to show whether your thyroid works as well as it should.

You have two kinds of T4 hormone:

  • Free T4 travels around your bloodstream on its own and goes wherever you need it.
  • Bound T4 attaches to proteins to travel through your blood.

A total T4 test measures both free and bound T4. A free T4 test measures only thyroxine that’s not bound to proteins. Many doctors today use the free T4 test because it’s more accurate than the test for bound T4.

The T4 test can also detect problems with your pituitary gland. This gland releases TSH that directs the thyroid to release its hormones.

The information that follows will help you understand why your doctor has asked for a T4 test. It will also help you know what the results might mean in terms of your own health.

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How Do I Know If My Thyroid Dose Is Correct

Monitoring thyroid levels on medication Correct dosing of thyroid hormone is usually assessed using the same tests for diagnosis of thyroid disease, including TSH and FT4. Thyroid tests are typically checked every 4-6 weeks initially and then every 6 to 12 months once stable. In special circumstances, such as pregnancy, a history of thyroid cancer, central hypothyroidism, amiodarone therapy, or use of combination T4 and T3 thyroid hormone replacement, your endocrinologist may check different thyroid tests. Additionally, your endocrinologist will evaluate for symptoms of hyperthyroidism and hypothyroidism and peform a physicial exam.

Women who are pregnant and women who may become pregnant should only be treated with levothyroxine . Only T4 efficiently crosses the placenta to provide thyroid hormone to the developing fetus. Thyroid hormone is critical in early pregnancy for brain development. Normal ranges for thyroid tests in pregnancy are different and change by trimester. Women with thyroid disease in pregnancy or who are considering pregnancy should be under the care of an endocrinologist to guide therapy.

Got Questions About Normal Thyroid Hormone Levels?

Thyroid Removal Or Thyroid Deactivation

If you have had surgery to remove your thyroid or radioiodine therapy to deactivate your thyroid, you will receive regular T4 replacement therapy. This usually affects TSH levels secreted by your pituitary gland as your medication is monitored and adjusted.

The journal Rambam Maimonides says that low levels of T3 and T4 exert a negative feedback on TSH and signals to your body to increase TSH levels. When receiving levothyroxine therapy, your TSH levels and T4 levels will be closely monitored to make sure that T4 levels dont drop dangerously low.14

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T3 And T4 Interpretations

  • A normal TSH and normal T4 show a normal thyroid
  • A low TSH and high T4 generally means an overactive thyroid
  • A high TSH and low T4 means an underactive thyroid
  • A low TSH and low T4 mean low thyroid function because of another problem, such as with the pituitary gland or hypothalamus of the brain

A low T3 value with a high TSH value is diagnostic evidence of low thyroid function. By contrast, a low TSH value with a high T3 value is the opposite, and means an overactive thyroid.

Definition Of A High Tsh

Weight Loss And Tsh Level

So what defines a high TSH?

If your TSH is higher than 5.0 then the lab will flag you as high and you may experience the symptoms listed above.

You can see a clear example of this below:

The reference range in this example is 0.3 to 5.00 uIU/ml and the result is 7.024.

Having said all of this, theres actually a good case to make that you can still have a high TSH but still be inside of the reference range.

So how do we get there?

Well, newer studies have shed light on the fact that some of the original tests that helped determine our standard normal TSH values may not have have been full of healthy people.

When you are being compared to some standard you want to make sure that the standard you are being compared to is actually healthy!

It doesnt make sense to compare your TSH as a 25-year-old to that of an 86-year-old .

Using this logic some newer studies have suggested that a more normal TSH reference range is somewhere between 1.0 and 2.5 uIU/ml and anything higher than 2.5 is considered high .

With this logic you can have a high TSH anywhere between 2.5 and 5.5, even though it technically falls within the normal range:

In addition, other studies have suggested we use the African American population as the standard for TSH testing because they have one of the lowest rates of autoimmune disease compared to other populations and their TSH is somewhere around 1.0.

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Milder Forms Of Hypothyroidism Are Harder To Diagnose

Although the majority of cases of hypothyroidism will be easy to diagnose with these simple blood tests, many millions of people will have this disease in mild to moderate forms which are more difficult to diagnose. The solution for these patients is more complex and this is due to several factors.

First, we must realize that not all people with hypothyroidism are the same. There are many degrees of this disorder from very severe to very mild. Additionally, and very importantly, we cannot always predict just how bad an individual patient will feel just by examining his or her thyroid hormone levels. Blood levels have normal ranges, but other factors need to be taken into account as well, such as the presence or absence of symptoms.

In other words, some patients with what would be considered mild deviations in their thyroid laboratory test results will feel just fine while others will be quite symptomatic. The degree of thyroid hormone abnormalities often, but NOT ALWAYS, will correlate with the degree of symptoms.

It is important for both you and your physician to keep this in mind since the goal is not necessarily to make the lab tests go into the normal range, but to make you feel better as well! We must also keep in mind that even the normal thyroid hormone levels in the blood have a fairly large range, so even if a patient is in the normal range for the general population, it may not be the normal level for them.

How Is Hyperthyroidism Diagnosed

A blood test can diagnose having an overactive thyroid gland . A normal blood test will also rule it out if symptoms suggest that it may be a possible diagnosis. One or both of the following may be measured in a blood sample:

  • Thyroid-stimulating hormone . This chemical is made in the pituitary gland in the brain. It is released into the bloodstream. It stimulates the thyroid gland to make thyroxine. If the level of thyroxine in the blood is high then the pituitary gland releases less TSH. Therefore, a low level of TSH means that your thyroid gland is overactive and is making too much thyroxine.
  • Thyroxine . A high level of T4 confirms hyperthyroidism.

Sometimes the results of the tests are borderline. For example, a normal T4 but with a low TSH. Other tests are sometimes done to clarify the situation and the cause. For example, another blood test that measures T3 is sometimes helpful and an ultrasound scan of the thyroid gland or a thyroid scan may be done if you have a nodular goitre.

Also, if tests are borderline, one option is to repeat the tests a few weeks later, as sometimes borderline tests are due to another illness. Other tests may be done if a rare cause of hyperthyroidism is suspected.

In people with Gravesâ disease a blood test may detect specific autoantibodies which are commonly raised. However, these can also be raised in some people without Gravesâ disease so this is not a specific test for Gravesâ disease.

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What Is Thyroid Medication

Thyroid Hormone Treatment Levothyroxine is thestandard of care in thyroid hormone replacement therapy and treatment of hypothyroidism. Levothyroxine is equivalent to the T4 form of naturally occurring thyroid hormone and is available in generic and brand name forms.

How do I take levothyroxine? To optimize absorption of your thyroid medication, it should be taken with water at a regular time each day. Multiple medications and supplements decrease absorption of thyroid hormone and should be taken 3-4 hours apart, including calcium and iron supplements, proton pump inhibitors, soy, and multivitamins with minerals. Because of the way levothyroxine is metabolized by the body, your doctor may ask you to take an extra pill or skip a pill on some days of the week. This helps us to fine tune your medication dose for your body and should be guided by an endocrinologist.

For patients with celiac disease or gluten sensitivity, a gluten free formulation of levothyroxine is available.

Some individuals may have genetic variant that affects how the body converts T4 to T3 and these individuals may benefit from the addition of a small dose of triiodothyronine.

Liothyronine is replacement T3 thyroid hormone. This medication has a short half-life and is taken twice per day or in combination with levothyroxine. Liothyronine alone is not used for treatment of hypothyroidism long term.

Guidelines On Early Detection And Treatment

Thyroid TSH Levels High – What it means and what to do!

A review of the history of guidelines for subclinical thyroid dysfunction provides insight into the reason for practice variation . In 1990 and again in 1998, the American College of Physicians found it is reasonable to screen women older than 50 years of age for unsuspected but symptomatic thyroid disease. The guideline specified that the goal of routine testing was to find overt, but overlooked, thyroid dysfunction, not subclinical hypothyroidism. Because the clinical significance of mildly elevated TSH test results was uncertain, the guideline recommended obtaining a free T4 test only when the TSH level was undetectable or 10 mIU/L or more. The ACP guideline panel used a systematic review of the literature to arrive at its recommendations.These guidelines expired in 2003.

In 1999, the American Association of Clinical Endocrinologists recommended screening asymptomatic women over the age of 60.In 2000, the American Thyroid Association recommended screening all patients over 35 years of age every 5 years . These organizations used a consensus process to develop guidelines and did not use systematic reviews in arriving at their recommendations.

Evidence for the association of subclinical hypothyroidism and adverse health outcomes and quality of evidence for risks and benefits of treatment: Findings of the American Association of Clinical Endocrinologists, the American Thyroid

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Lab Tests Of Biopsy Samples

In some cases, doctors might use molecular tests to look for specific gene changes in the cancer cells. This might be done for different reasons:

  • If FNA biopsy results arent clear, the doctor might order lab tests on the samples to see if there are changes in the BRAF or RET/PTC genes. Finding one of these changes makes thyroid cancer much more likely.
  • For some types of thyroid cancer, molecular tests might be done to see if the cancer cells have changes in certain genes , which could mean that certain targeted drugs might be helpful in treating the cancer.

These tests can be done on tissue taken during a biopsy or surgery for thyroid cancer. If the biopsy sample is too small and all the molecular tests cant be done, the testing may also be done on blood that is taken from a vein, just like a regular blood draw.

How The Ft3 Thyroid Test Is Done :

If your doctor wants FT3 thyroid test on you, you may need a FT3 thyroid blood test. During the FT3 thyroid blood test, a pathologist will put a needle into your veins and take out a small quantity of blood. A pathologist is a physician in the medical field who thoroughly studies the causes and effects of disease. Within a few hours you will get your FT3 thyroid Test report by your pathologist.

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