The Importance Of Thyroid Testing
Because thyroid problems can have serious health repercussions, its critical to recognize and treat them as soon as possible. When your thyroid generates insufficient or excessive levels of hormones, you may experience a medical disorder. For example, when your thyroid does not produce enough hormones, hypothyroidism develops. Hyperthyroidism, on the other hand, occurs when the thyroid gland produces too many hormones.
Do you have unexplained weight changes, emotional instability, or other warning signs of thyroid issues? We can perform thyroid testing to see whether you might have a problem with your thyroid. A timely test can help.
How Do I Interpret My Thyroid Test Results
The interpretation of thyroid blood tests can also be problematic. Reference ranges determine low, normal, or high levels of thyroid hormones. Many test reports will display your results next to a numerical representation of these ranges so you can see whether it falls safely within them. We particularly appreciate Everlywell here, as they show you a visual representation of the range with your measurement plotted on it.
That way, you can see how close to the high or low end of a typical range your results lie. That makes it a lot easier to visualize your thyroid health than a number like 3.3 pg/mL.
While these ranges are based on many studies, what is normal to the population is not necessarily typical to the individual. Each person has a different hormonal and chemical composition, and deviations from regular references may be normal for the individual.
Additionally, because these references arise from statistics and averages, the closer the test results are to either the lower or higher limit, the greater the uncertainty of whether the patient has thyroid disease. Likewise, if results are within the reference range but close to the limits, symptoms may still be present.
For these reasons, you should see blood tests as one portion of a diagnosis that includes symptoms, medical history, a physical examination, and imaging .
Are There Different Types Of Thyroid Removal Surgery
If your healthcare provider determines that your thyroid needs to be removed, there are a couple of ways that can be done. Your thyroid may need to be completely removed or just partially. This will depend on the severity of your condition. Also, if your thyroid is very big or has a lot of growths on it, that could prevent you from being eligible for some types of surgery.
The surgery to remove your thyroid is called a thyroidectomy. There are two main ways this surgery can be done:
- With an incision on the front of your neck.
- With an incision in your armpit.
The incision on the front of your neck is more of the traditional version of a thyroidectomy. It allows your surgeon to go straight in and remove the thyroid. In many cases, this might be your best option. You may need this approach if your thyroid is particularly big or has a lot of larger nodules.
Alternatively, there is a version of the thyroid removal surgery where your surgeon makes an incision in your armpit and then creates a tunnel to your thyroid. This tunnel is made with a special tool called an elevated retractor. It creates an opening that connects the incision in your armpit with your neck. The surgeon will use a robotic arm that will move through the tunnel to get to the thyroid. Once there, it can remove the thyroid back through the tunnel and out of the incision in your armpit.
- Are not at a healthy body weight.
- Have large thyroid nodules.
- Have a condition like thyroiditis or Gravess disease.
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What About Those Already On Thyroid Medications
If youre already on thyroid meds, but still have symptoms, you may need to up your dosage so that your labs fall within the optimal range, which in turn can 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 1IU/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.
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:
- T4 test: 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.
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When Abnormal Thyroid Function Tests Are Not Due To Thyroid Disease
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.
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.
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Complementary And Alternative Medicine
Some people try other therapies to cleanse the body, restore immune function, and balance the production and release of hormones. You should talk to your doctor if you’re interested in these other methods to make sure they won’t harm you or interfere with your treatment.
A naturopath may use homeopathic mixtures, herbs, preparations based on traditional Chinese medicine , and acupuncture to remove blocks to your ”life force energy.” Naturopaths are authorized to treat thyroid disease in some states, but in others, it’s illegal. While they may help with the stress associated with thyroid disease, there are no good studies showing that these therapies are effective for treating thyroid disorders.
Chiropractors use spinal manipulation to treat symptoms of thyroid disorders by easing muscle tension and improving blood circulation.
Should You Get A Thyroid Test
Getting your thyroid function tested is a good idea no matter who you are, but some populations are statistically at higher risk of developing thyroid conditions:
- Those with a family history of thyroid disorders
- People who have symptoms of hypothyroidism or hyperthyroidism
Women are around five to eight times more likely to have thyroid problems, with one in eight women developing thyroid disease during their lifetime.
Since thyroid issues are common, periodic testing is an excellent idea regardless of whether you are experiencing any symptoms of thyroid dysfunction.
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What Are Thyroid Function Tests Used For
People with some conditions have an increased risk of thyroid problems and so are often advised to have thyroid function tests undertaken each year. This conditions include:
Thyroid function tests can also be done to:
- Monitor treatment with thyroid replacement medicine for people who have hypothyroidism.
- Check thyroid gland function in people who are being treated for hyperthyroidism.
- Screen newborn babies for inherited problems with the thyroid gland.
Can I Live A Normal Life With A Thyroid Disease
A thyroid disease is often a life-long medical condition that you will need to manage constantly. This often involves a daily medication. Your healthcare provider will monitor your treatments and make adjustments over time. However, you can usually live a normal life with a thyroid disease. It may take some time to find the right treatment option for you and control your hormone levels, but then people with these types of conditions can usually live life without many restrictions.
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How Does A Blood Test For Hyperthyroidism Work
A TSH test for hyperthyroidism evaluates your levels of thyroid-stimulating hormone , and the thyroid hormones T3 and T4 may also be evaluated. Because TSH signals the thyroid gland to produce more thyroid hormones, unusually low levels of TSH can mean that your thyroid is making too many hormones. T3 and T4 measurements can also reveal just how high your thyroid hormone levels are, which can help your healthcare provider decide on a treatment strategy.
How The Thyroid Gland Hormones And Antibodies Work
To understand how blood tests help identify thyroid disorders, its important to know a bit about the thyroid and the specific substances these thyroid tests measure.
Shaped a bit like a butterfly and located in your neck, the thyroid is an endocrine gland that secretes hormones into the bloodstream. It serves several different functions, most notably regulating your metabolic rate.
When ordering a thyroid test, you will come across a lot of terminology that can be confusing. Here is a breakdown of the typical cast of characters in these tests, along with some explanation.
Thyroxine is the primary hormone produced by the thyroid gland. We call it T4 because it contains four iodine atoms. In our bodies, T4 plays vital roles in the health of our heart, digestive system, brain, bones, and metabolism.
In our bodies, blood carries T4 to various organs such as the liver, brain, and kidneys, to name a few where its actions cost it an iodine atom, converting T4 to T3 . The thyroid gland produces some of the bodys T3, but only a tiny fraction of the amount resulting from T4 conversion.
As its name suggests, thyroid-stimulating hormone signals the thyroid to produce additional T4. When T4 levels in the bloodstream are low, the hypothalamus produces thyrotropin-releasing hormone , which in turn causes the pituitary gland to secrete TSH. When that TSH hits the thyroid gland, it pumps out T4 in response.
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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.
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.
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Understanding Thyroid Stimulating Hormone
As mentioned above, the thyroid stimulating hormone is produced by the pituitary gland. It works sort of like the master of the hormones, and rules the production of T3 and T4 from its control center.If you have too much TSH, it might mean that your thyroid gland isnt making enough T3 or T4. Remember, the TSH is supposed to stimulate the thyroid gland but if the gland isnt responding, then youll have too much TSH in your system.If your TSH levels are too low, it may mean that your thyroid gland is making too much thyroid hormone. This excessive thyroid production could actually suppress the TSH.
A word of warning for pregnant women: Its incredibly important that your hormones are balanced in pregnancy, as thyroid stimulating hormone plays a role in the development of a healthy fetus.
Are Home Thyroid Tests Reliable
At-home thyroid tests are reliable and accurate. The top testing companies, including all of the companies we compare in this guide, partner only with certified labs of the caliber that health centers use for analysis. For thyroid testing, these companies rely on proven blood drop sample assays to deliver accurate results.
The instructions for this kind of test are straightforward, and your kit will include all of the information and materials youll need to administer it correctly.
As long as you follow the instructions in your at-home test kit, your lab tests should be as accurate as if you had a test administered in an office setting.
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Should I Exercise If I Have A Thyroid Disease
Regular exercise is an important part of a healthy lifestyle. You do not need to change your exercise routine if you have a thyroid disease. Exercise does not drain your bodys thyroid hormones and it shouldnt hurt you to exercise. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that its a good fit for you.
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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