What are thyroid tests and why are they important. How do blood tests like TSH, T3, and T4 help diagnose thyroid disorders. What imaging tests are used to evaluate thyroid function and structure. How do thyroid hormones impact various bodily functions.

The Crucial Role of the Thyroid Gland in Body Function

The thyroid gland, a small butterfly-shaped organ located in the front of the neck, plays a pivotal role in regulating numerous bodily functions. This unassuming gland produces hormones that influence nearly every organ system, controlling essential processes such as breathing, heart rate, metabolism, digestion, and even mood regulation.

Given its widespread impact on the body, maintaining optimal thyroid function is crucial for overall health and well-being. When the thyroid gland malfunctions, it can lead to a variety of disorders, including hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). These conditions can significantly affect a person’s quality of life, making accurate diagnosis and timely treatment essential.

Understanding Thyroid Tests: Types and Purposes

Thyroid tests are diagnostic tools used to assess the functionality of the thyroid gland and identify potential thyroid disorders. These tests can be broadly categorized into two main types: blood tests and imaging tests. Each type of test provides unique insights into thyroid health and function.

Blood Tests for Thyroid Function

Blood tests are the primary means of evaluating thyroid function. They measure the levels of various thyroid-related hormones and antibodies in the bloodstream. The most common blood tests for thyroid function include:

• TSH (Thyroid-Stimulating Hormone) Test
• T3 (Triiodothyronine) Test
• T4 (Thyroxine) Test
• Thyroid Antibodies Test

Imaging Tests for Thyroid Evaluation

Imaging tests provide visual information about the thyroid gland’s structure, size, and function. These tests can help identify physical abnormalities and assess the gland’s ability to absorb iodine. Common imaging tests for thyroid evaluation include:

• CT Scans
• Ultrasound
• Nuclear Medicine Tests (Thyroid Scan and Radioactive Iodine Uptake Test)

The TSH Test: A Primary Indicator of Thyroid Function

The Thyroid-Stimulating Hormone (TSH) test is often the first line of investigation when evaluating thyroid function. TSH is produced by the pituitary gland and stimulates the thyroid to produce and release its hormones. The TSH level in the blood provides valuable information about the thyroid’s overall function.

Why is the TSH test considered the most important initial thyroid test? TSH levels operate on a feedback loop with thyroid hormone levels. When thyroid hormone levels are low, TSH levels increase to stimulate the thyroid gland to produce more hormones. Conversely, when thyroid hormone levels are high, TSH levels decrease. This inverse relationship makes TSH a sensitive indicator of thyroid function.

Interpreting TSH Test Results

Interpreting TSH test results requires understanding the normal range and what deviations from this range might indicate:

• Normal TSH range: Generally between 0.4 and 4.0 mIU/L (milliunits per liter)
• High TSH levels (above 4.0 mIU/L): May indicate hypothyroidism
• Low TSH levels (below 0.4 mIU/L): May indicate hyperthyroidism

It’s important to note that these ranges can vary slightly between laboratories and may be adjusted for factors such as age and pregnancy.

T3 and T4 Tests: Measuring Thyroid Hormone Levels

While the TSH test provides an overall picture of thyroid function, T3 and T4 tests measure the actual levels of thyroid hormones in the blood. These tests are often performed in conjunction with the TSH test to provide a more comprehensive assessment of thyroid health.

T3 (Triiodothyronine) Test

T3 is the more potent form of thyroid hormone, playing a crucial role in regulating metabolism, body temperature, and heart rate. The T3 test measures both the bound and free forms of this hormone in the blood.

T4 (Thyroxine) Test

T4 is the primary hormone produced by the thyroid gland. Most T4 in the blood is bound to proteins, with only a small amount circulating in its free form. The T4 test can measure total T4 (both bound and free) or just the free T4, which is the active form of the hormone.

How do T3 and T4 levels correlate with thyroid function? In general, high levels of T3 and T4 may indicate hyperthyroidism, while low levels may suggest hypothyroidism. However, these results must always be interpreted in conjunction with TSH levels and clinical symptoms.

Thyroid Antibodies Test: Detecting Autoimmune Thyroid Disorders

The thyroid antibodies test is a specialized blood test that measures the presence and levels of specific antibodies that target thyroid tissues. This test is particularly useful in diagnosing autoimmune thyroid disorders, such as Hashimoto’s thyroiditis and Graves’ disease.

What antibodies does this test detect? The most commonly measured thyroid antibodies include:

• Thyroid Peroxidase Antibodies (TPOAb)
• Thyroglobulin Antibodies (TgAb)
• Thyroid Stimulating Hormone Receptor Antibodies (TRAb)

The presence of these antibodies can indicate an autoimmune attack on the thyroid gland, even before changes in thyroid hormone levels become apparent. This makes the thyroid antibodies test valuable for early detection and monitoring of autoimmune thyroid disorders.

Imaging Tests: Visualizing Thyroid Structure and Function

While blood tests provide crucial information about thyroid hormone levels, imaging tests offer insights into the gland’s physical structure and functional capacity. These tests are particularly useful in diagnosing thyroid nodules, assessing thyroid size, and evaluating the gland’s ability to absorb iodine.

CT Scans and Ultrasound

CT scans and ultrasound are non-invasive imaging techniques that provide detailed pictures of the thyroid gland. These tests can help identify structural abnormalities, such as nodules or enlargement of the gland (goiter). Ultrasound is often preferred for thyroid imaging due to its lack of radiation exposure and ability to guide fine-needle aspiration biopsies when necessary.

Nuclear Medicine Tests

Nuclear medicine tests, including thyroid scans and radioactive iodine uptake tests, use small amounts of radioactive material to assess thyroid function and structure. These tests are particularly useful in diagnosing hyperthyroidism and evaluating thyroid nodules.

How does a thyroid scan work? A small amount of radioactive iodine is administered orally or intravenously. The thyroid gland absorbs this iodine, and a special camera detects the radiation to create images of the gland. These images can reveal areas of increased or decreased function within the thyroid.

The Impact of Thyroid Hormones on Body Systems

Understanding the wide-ranging effects of thyroid hormones on various body systems underscores the importance of maintaining optimal thyroid function. Thyroid hormones influence numerous physiological processes, including:

• Metabolism and weight regulation
• Cardiovascular function
• Respiratory rate
• Digestive processes
• Muscle strength and function
• Brain development and cognitive function
• Mood and emotional well-being
• Reproductive health
• Bone density and calcium metabolism

Given this extensive influence, even slight imbalances in thyroid hormone levels can have significant effects on overall health and quality of life. This highlights the importance of regular thyroid function monitoring, especially for individuals with risk factors for thyroid disorders.

Factors Influencing Thyroid Test Results

While thyroid tests are generally reliable indicators of thyroid function, several factors can influence test results and should be considered when interpreting the outcomes. These factors include:

• Medications: Certain drugs, such as oral contraceptives, steroids, and lithium, can affect thyroid hormone levels.
• Pregnancy: Hormonal changes during pregnancy can alter thyroid function and test results.
• Time of day: TSH levels can fluctuate throughout the day, with levels typically highest in the early morning.
• Recent illness: Acute illnesses can temporarily affect thyroid hormone levels.
• Iodine intake: Excessive or deficient iodine intake can impact thyroid function and test results.
• Biotin supplements: High doses of biotin can interfere with some thyroid test methods.

Healthcare providers consider these factors when interpreting thyroid test results to ensure accurate diagnosis and appropriate treatment planning.

The Importance of Regular Thyroid Monitoring

Given the critical role of the thyroid in maintaining overall health, regular monitoring of thyroid function is essential, especially for individuals at higher risk of thyroid disorders. Risk factors that may warrant more frequent thyroid testing include:

• Family history of thyroid disorders
• Previous thyroid problems or surgery
• Autoimmune diseases such as type 1 diabetes or celiac disease
• History of radiation exposure to the neck area
• Age (risk increases with age, especially in women over 60)
• Pregnancy or recent childbirth

Regular thyroid function tests can help detect thyroid imbalances early, allowing for timely intervention and management of potential thyroid disorders.

Emerging Technologies in Thyroid Testing

As medical science advances, new technologies and approaches to thyroid testing are emerging. These innovations aim to improve the accuracy, convenience, and comprehensiveness of thyroid function assessment. Some promising developments include:

• Dried blood spot testing: Allows for at-home sample collection and may improve accessibility to thyroid testing.
• Genetic testing: Identifies genetic markers associated with increased risk of thyroid disorders.
• Advanced imaging techniques: Such as elastography, which can help differentiate between benign and malignant thyroid nodules.
• Artificial intelligence in image analysis: Enhances the accuracy of thyroid ultrasound interpretation.

These emerging technologies hold the potential to revolutionize thyroid testing, offering more personalized and efficient approaches to diagnosing and monitoring thyroid disorders.

The Role of Patient Education in Thyroid Health

Empowering patients with knowledge about thyroid function and the importance of regular testing is crucial for maintaining optimal thyroid health. Healthcare providers play a vital role in educating patients about:

• The signs and symptoms of thyroid disorders
• The importance of regular thyroid function tests
• Lifestyle factors that can impact thyroid health, such as diet and stress management
• The proper way to take thyroid medications, if prescribed
• The potential interactions between thyroid function and other health conditions

By fostering a collaborative approach between healthcare providers and patients, individuals can take a proactive role in managing their thyroid health and overall well-being.

Thyroid Tests: MedlinePlus

Also called: Thyroid panel

Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body’s most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods.

Thyroid tests check how well your thyroid is working. They are also used to diagnose and help find the cause of thyroid diseases such as hyperthyroidism and hypothyroidism. Thyroid tests include blood tests and imaging tests.

Blood tests for your thyroid include:

• TSH. It measures thyroid-stimulating hormone. This is usually the first test your healthcare provider will order.
• T3 and T4.They measure the level of the different thyroid hormones in your blood.
• Thyroid antibodies test. It measures certain thyroid antibodies (markers in the blood). This test may help diagnose autoimmune thyroid disorders.

Imaging tests include:

• CT scans
• Ultrasound
• Nuclear medicine tests, including:
  • Thyroid scan. It uses small amounts of radioactive material to create a picture of the thyroid, showing its size, shape, and position. It can help find the cause of hyperthyroidism and check for thyroid nodules (lumps in the thyroid).
  • Radioactive iodine uptake test, or thyroid uptake test. It checks how well your thyroid is working and can help find the cause of hyperthyroidism.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

• Calcitonin Test

  (National Library of Medicine)

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• Thyroid Antibodies

  (National Library of Medicine)

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• Thyroid Function Tests

  (American Thyroid Association)

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• Thyroid Scan and Uptake

  (American College of Radiology; Radiological Society of North America)

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• Thyroid Tests

  (Nemours Foundation)

• Thyroid Tests

  (National Institute of Diabetes and Digestive and Kidney Diseases)

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• Thyroxine (T4) Test

  (National Library of Medicine)

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• Triiodothyronine (T3) Tests

  (National Library of Medicine)

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• TSH (Thyroid-stimulating hormone) test

  (National Library of Medicine)

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• Ultrasound – Thyroid

  (American College of Radiology; Radiological Society of North America)

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• ClinicalTrials. gov: Thyroid Function Tests

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Normal Thyroid Hormone Levels – Endocrine Surgery

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 (T4) and triiodothyronine (T3). T4 is the primary form of thyroid hormone circulating in the blood (about 95%). 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 (protein bound and free) or free hormone levels.

Production of thyroid hormone by the thyroid gland is controlled by the pituitary, another endocrine gland in the brain. The pituitary releases Thyroid Stimulating Hormone (abbreviated TSH) into the blood to stimulate the thyroid to make more thyroid hormone. The amount of TSH that the pituitary sends into the bloodstream depends on the amount of thyroid hormone in the body. Like a thermostat, if the pituitary senses low thyroid hormone, then it produces more TSH to tell the thyroid gland to produce more. Once the T4 in the bloodstream goes above a certain level, the pituitary’s production of TSH is shut off. In this way, the pituitary senses and controls thyroid gland production of thyroid hormone. Endocrinologists use a combination of thyroid hormone and TSH testing to understand thyroid hormone levels in the body.

What is a TSH test?

Thyroid tests
Blood tests to measure low or high TSH levels are readily available and widely used. Not all thyroid tests are useful in all situations.

TSH Test
The best way to initially test thyroid function is to measure the TSH (Thyroid Stimulating Hormone) level in a blood sample. Changes in TSH can serve as an “early warning system” — often occurring before the actual level of thyroid hormones in the body becomes too high or too low.

A high TSH level indicates that the thyroid gland is not making enough thyroid hormone (primary hypothyroidism). On the other hand, a low TSH level usually indicates that the thyroid is producing too much thyroid hormone (hyperthyroidism). Occasionally, a low TSH may result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid (central hypothyroidism). In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.

What is a T4 test?

T4 Tests
A Total T4 test measures the bound and free thyroxine (T4) hormone in the blood. A Free T4 measures what is not bound and able to freely enter and affect the body tissues.

What does it mean if T4 levels are abnormal?
Importantly, Total T4 levels are affected by medications and medical conditions that change thyroid hormone binding proteins. Estrogen, oral contraceptive pills, pregnancy, liver disease, and hepatitis C virus infection are common causes of increased thyroid hormone binding proteins and will result in a high Total T4. Testosterone or androgens and anabolic steroids are common causes of decreased thyroid hormone binding proteins and will result in a low Total T4.

In some circumstances, like pregnancy, a person may have normal thyroid function but Total T4 levels outside of the normal reference range. Tests measuring free T4 – either a free T4 (FT4) or free T4 index (FTI) – may more accurately reflect how the thyroid gland is functioning in these circumstances. An endocrinologist can determine when thyroid disease is present in the context of abnormal thyroid binding proteins.

What is a T3 test?

T3 Tests
T3 tests measure triiodothyronine (T3) levels in the blood. A Total T3 test measures the bound and free fractions of triiodothyronine. Hyperthyroid patients typically have an elevated Total T3 level. T3 tests can be used to support a diagnosis of hyperthyroidism and can determine the severity.

In some thyroid diseases, the proportions of T3 and T4 in the blood change and can provide diagnostic information. A pattern of increased T3 vs T4 is characteristic of Graves’ disease. On the other hand, medications like steroids and amiodarone, and severe illness can decrease the amount of thyroid hormone the body converts from T4 to T3 (active form) resulting in a lower proportion of T3.

T3 levels fall late during hypothyroidism and therefore are not routinely used to evaluate patients with underactive or surgically absent thyroid glands.

Measurement of Free T3 is possible but is often not reliable and therefore may not be helpful.

What is a normal thyroid (hormone) level?

To assess thyroid hormone status for low or high TSH levels we use TSH and FT4 tests. The normal value for a laboratory test is determined by measuring the hormone in a large population of healthy individuals and finding the normal reference range. Normal ranges for thyroid tests may vary slightly among different laboratories, and typical ranges for common tests are given below.

TSH normal values are 0.5 to 5.0 mIU/L. Pregnancy, a history of thyroid cancer, history of pituitary gland disease, and older age are some situations when TSH is optimally maintained in a different range as guided by an endocrinologist.

FT4 normal values are 0.7 to 1.9ng/dL. Individuals taking medications that modify thyroid hormone metabolism and those with a history of thyroid cancer or pituitary disease may be optimally managed with a different normal FT4 range.

Total T4 and Total T3 levels measure bound and free thyroid hormone in the blood. These levels are influenced by many factors that affect protein levels in the body, including medications, sex hormones, and liver disease.
A normal Total T4 level in adults ranges from 5.0 to 12.0μg/dL.
A normal Total T3 level in adults ranges from 80-220 ng/dL.

Free T3 assays are often unreliable and not routinely used to assess thyroid function.

What does it mean if my thyroid levels are abnormal?

Patterns of thyroid tests associated with thyroid disease

Primary Hypothyroidism
A high TSH and low thyroid hormone level (e. g. low FT4) 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 (e.g. amiodarone, tyrosine kinase inhibitors, or cancer immunotherapy)
• Removal of all or part of the thyroid gland
• Radiation injury to the thyroid (e.g. external beam radiation, radioactive iodine ablation treatment)
• Excess treatment with anti-thyroid medications (e.g. methimazole, propylthiouracil)

Early or mild hypothyroidism may present as a persistently high 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 (ages 70 and above) are higher than the normal ranges for younger individuals.

Primary Hyperthyroidism
A low TSH and a high thyroid hormone level (e.g. high FT4) 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:

• Graves’ disease
• Toxic or autonomously functioning thyroid nodule
• Multinodular goiter
• Thyroid inflammation (called thyroiditis) early in the course of disease
• Thyroid gland dysfunction due to a medication (e.g. amiodarone or cancer immunotherapy)
• Excess thyroid hormone therapy

Early or mild hyperthyroidism may present as a persistently low TSH and a normal FT4 hormone level. This pattern is called subclinical hyperthyroidism and your doctor may recommend treatment. Over time, untreated subclinical hyperthyroidism can worsen osteoporosis and contribute to abnormal heart rhythms.

Thyroiditis
Thyroid inflammation, also called thyroiditis, causes injury to the thyroid gland and release of thyroid hormone. Individuals with thyroiditis usually have a brief period of hyperthyroidism (low TSH and high FT4 or Total T4) followed by development of hypothyroidism (high TSH and low FT4 or Total T4) or resolution.

Some forms of thyroiditis are transient, like post-partum thyroiditis or thyroiditis following an infection, and often resolve on their own without need for medication.

Other forms of thyroiditis, like thyroiditis resulting from cancer immunotherapy, interferon alpha, or tyrosine kinase inhibitors, usually result in permanent hypothyroidism and require long term treatment with thyroid hormone replacement.

Your endocrinologist will monitor your thyroid tests during thyroiditis and can help determine if you need short- and long-term medications to balance your thyroid function and control any symptoms.

Central Hypothyroidism
A low TSH and a low FT4 may indicate pituitary disease. Detection of central hypothyroidism should prompt your doctor to check for problems in other pituitary hormones, an underlying cause, and you may need imaging tests to look at the pituitary gland.

Central hypothyroidism is treated with thyroid hormone replacement. Importantly, adequacy of thyroid replacement in central hyperthyroidism is assessed with FT4 and Total T4 tests not TSH as in primary hyperthyroidism, and deficiency in stress hormone cortisol should be assessed before starting thyroid treatment to prevent an adrenal crisis. 

Causes of central hypothyroidism include pituitary gland disease, such as a pituitary mass or tumor, history of pituitary surgery or radiation, pituitary inflammation (called hypophysitis) resulting from autoimmune disease or cancer immunotherapy, and infiltrative diseases.

Rare causes of abnormal thyroid function
Thyroid hormone resistance
Iodine induced hyperthyroidism
TSH-secreting tumor (TSH-oma)
Germ cell tumors
Trophoblastic disease
Infiltrative diseases, such as systemic scleroderma, hemochromatosis, or amyloidosis.

When abnormal thyroid function tests are not due to thyroid disease

While blood tests to measure thyroid hormones and thyroid stimulating hormone (TSH) are widely available, it is important to remember that not 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 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.

Individuals who have exposure to mice, like laboratory researchers and veterinarians, may develop antibodies against mouse proteins in their blood. These antibodies cross react with reagents in multiple thyroid function tests and cause unpredictable results. A specialized assay can accurately measure thyroid hormone levels and TSH in this circumstance.

I don’t feel well, but my thyroid tests are normal

Thyroid blood tests are generally accurate and reliable. If you do not have low or high TSH levels and your thyroid tests are normal, your symptoms may not be related to thyroid disease, and you may want to seek additional evaluation with your primary care physician.

How is hypothyroidism treated?

What is thyroid medication?

Thyroid Hormone Treatment
Levothyroxine is the standard of care in thyroid hormone replacement therapy and treatment of hypothyroidism. Levothyroxine (also called LT4) 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 (autoimmune disease against gluten) 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 (triiodothyronine) 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.

Other formulations of thyroid hormone replacement include natural or desiccated thyroid hormone extracts from animal sources. Natural or desiccated thyroid extract preparations have greater variability in the dose of thyroid hormone between batches and imbalanced ratios if T4 vs T3. Natural or animal sources of thyroid hormone typically contain 75% T4 and 25% T3, compared to the normal human balance of 95% T4 and 5% T3. Treatment with a correct balance of T4 and T3 is important to replicate normal thyroid function and prevent adverse effects of excess T3, including osteoporosis, heart problems, and mood and sleep disturbance. An endocrinologist can evaluate symptoms and thyroid tests to help balance thyroid hormone medications.

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 perform a physical exam.

Women who are pregnant and women who may become pregnant should only be treated with levothyroxine (T4). 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.

Individuals with a history of thyroid cancer, even if only a portion of the thyroid was removed, also have different target ranges for TSH and FT4 tests. Thyroid hormone replacement in these individuals is closely tied to ongoing thyroid cancer surveillance, monitoring of thyroid cancer tumor markers, and dynamic assessment of recurrence risk. These patients are optimally managed by a multidisciplinary team including an endocrinologist and endocrine surgeon.

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what it is, how to define the target audience and what it is for

The target audience is a group of people who may be interested in the goods or services of the company and buy them. People in the target group are united by the same characteristics – place of residence, age, social status, interests, needs, purchasing behavior and much more.

Why does business study the target audience

It is important for business to study the target audience in order to sell the product not to all people, but to those who are more interested in it. If a company knows what people look for when buying, it can:

• create advertisements that consumers will definitely notice;
• offer promotions that will interest them and bring sales;
• improve the properties of goods in order to outperform competitors;
• create new products that are interesting to specific people.

Consider examples of how brands use knowledge about the target audience.

Children’s goods store “Detki” knows that parents start looking for New Year’s gifts for children not at the end of December, but much earlier. And they offer a profitable promotion already in November:

Promotion of children’s goods store “Detki”

Another example is CDEK. The company is aware that some of their customers buy items from the Asos online store. But often clothes that cannot be tried on do not fit in size or style, and customers have to return the order back to the store at their own expense. To make returns easier, CDEK is offering a free return to Asos to the target audience from any CDEK outlet:

A CDEK offer aimed at target customers who shop at Asos

What is the target audience

The target audience can be classified according to different criteria.

By type of product purchase

This group is divided into main and indirect audiences.

Main

These are the people who make the decision to buy the product themselves. For example, dog owners decide what food to buy for their pets.

Indirect

This is an audience that uses goods and services, but does not decide on their purchases. An example of an indirect audience for a toy store is children. They choose toys, but the decision to buy is made by the parents.

By interests

Broad

Broad target audience is a group of people who are interested in a store, brand or company.

For example, a wide audience of the Lamoda online store is people who prefer to choose clothes and accessories online.

Narrow

Among all the people who buy clothes in the Lamoda online store, there can be men, women, teenagers, mothers of children, office workers, stylists, and so on. All these are different groups that pay attention to different details when buying.

For example, it is important for women to be able to order several sizes of the same dress and choose the one that fits best. And for teenagers – save on purchases, for example, buy two goods for the price of one.

To meet the needs of each group, the store creates offers for each of them.

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How storytelling works

By type of target group

B2B

The B2B segment includes companies that sell goods to other companies, for example, metal structures for the construction of apartment buildings , or offer services for them, for example , legal advice.

The target audience of the B2B segment pays attention to who makes the decision to buy or sell, taxation and tax reporting, annual income.

B2C

The B2C segment includes companies that sell goods or services to ordinary people. For example, clothes, cars, apartments, dental or beauty services.

For the B2C segment, it is important to consider how people choose goods, whether they pay attention to delivery conditions, at what price they prefer to buy, which may affect their choice of goods, and so on.

Ready to buy

Cold

Cold audience are people who are not yet familiar with the company and do not feel the need to buy something from it. For a cold audience to want to buy, you need to find its problems and offer their solution through the purchase of a product or service.

If the cold audience becomes interested and responds to the offer, it will become “warm”. But it may be that the audience will not see the solution to their problems through the product and will remain in the cold group.

Warm

These are users who have already interacted with a brand or company or simply know about the existence of such a company and / or its product. They could not buy the product, but, for example, save it in their favorites or put it in the shopping cart.

Hot

These are users who have bought at least once. They are the target customers of the company.

Read also

How to immerse the author in the project so that his text is useful for the brand

Characteristics of the target audience

Geographic

The target audience by geographical features can be united by a country, city, region, region, district, or even one building. For example, a children’s room in a shopping center may be of interest only to those parents who come to the center for shopping, and not to everyone in the city.

Geographic characteristics allow you to customize the display of ads in certain cities and regions in different advertising accounts.

And also plan logistics and open new offline points of sale. For example, if the target audience is not in some city, it makes no sense to open a store there.

Socio-demographic

The audience can be divided by gender, age, education, marital status, income, and so on. Characteristics are used to set up detailed targeting in advertising accounts to show ads to those who are more likely to be interested in them.

Psychographic

According to psychographic features, the audience can be segmented by habits, values, interests, decision-making speed, hobbies, lifestyle, personal qualities.

If, after studying these parameters, “pressure” on the problems of the audience, you can strengthen advertisements – offer to solve problems with the help of goods or services.

For example, a company is engaged in property insurance. The problem of its target audience is the fear that trouble will happen to housing: a fire, neighbors will flood or robbers will enter when everyone is at work. A company can show an ad with a family in which all fears happen at the same time, but since the family has previously taken out insurance, it is in order and does not incur any losses.

Behavioral

These characteristics describe how consumers behave when buying:

• what they pay attention to when choosing a product or service: quality of service, reviews, price, delivery, bonuses, and so on;
• how to choose a product: consult with relatives, study information and reviews on the Internet, look at reviews, consult with managers;
• why people buy goods, why they use services;
• how they behave on the site: which pages are viewed, which links are clicked, which product cards are saved to favorites.

This information is needed to build the sales process. For example, if you know that users look at reviews before making a purchase, you can create a page with the opinion of those who have already bought, and introduce “cold” customers to it through advertising.

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Dividing customers by loyalty using RFM analysis

What is target audience segmentation

Segmentation is the division of the general target audience into small groups that are united by certain interests.

Segmentation is needed, for example, to fine-tune the display of advertisements or create a promotion that will fall into the needs of certain people.

For example, a flower shop can sell flowers to all people. Or divide them into several groups:

1. Men who periodically buy flowers as gifts for their wives and girls.
2. Young men and women who give flowers to friends or relatives on certain holidays. For example, on Mother’s Day. The Semitsvetik store offers separate bouquets to those who want to congratulate their mother on
3. Parents of schoolchildren who periodically give flowers to teachers.
4. Event decorators who decorate rooms with flowers.

The store creates its own assortment for each group. For example, it offers discreet bouquets for Teacher’s Day, and for March 8 – bouquets of expensive flowers.

How to segment the target audience

Customers can be segmented by purchasing behavior, average bill, place of purchase – offline or on the Internet, product of interest, and so on.

Here is one example of segmentation based on purchase frequency:

Active shoppers

This is an audience segment that buys frequently and spends a lot. The segment stands out among the entire audience so that the company can continue to increase its loyalty and not let itself be forgotten.

Interested in buying but not yet buying

This segment of the audience is interested in products but has not yet made a decision to buy. The search for a segment is necessary so that the company can figure out how to “squeeze” users and transfer them to the segment of active buyers.

Rare Buyers

This segment of the audience has already partnered with the company and trusts it, so the goal is to reactivate it. To do this, the company creates a separate series of letters, profitable promotional codes and a loyalty system that should encourage consumers to buy from it again.

For example, the re.Store store sends reminder emails if the subscriber has not visited their website for a long time:

When the email is opened, the brand tells the latest news:

An example of a reactivation email from re.Store

Never bought, but may be interested in goods

This is a cold audience segment. He needs to be involved in the buying process with advertisements and mailing lists, persuaded to the first purchase.

How to determine the target audience

Let’s consider some popular methods in marketing.

The 5W method

In this method, you need to answer five questions and fill out a questionnaire to fully describe one or more segments of the target audience.

The questionnaire template looks like this.

Three-level method

This method divides audience characteristics into three levels:

1. General level.
2. Product category level.
3. Brand level.

General level

At this level, you must specify the main characteristics of the target audience: age, gender, location, as well as psychographic ones – personality type, life position, values, beliefs, etc.

Product category level

Here you should define how the audience makes a purchase decision, how they choose from the assortment, and also:

• how often the product is used: daily, once a month, once a year or less;
• how often he buys from the brand;
• whether he buys all the time from one brand or periodically “leaves” to competitors;
• where he makes purchases: on the Internet, in a store, in a market;
• plans to buy or decides to buy a product spontaneously.

Brand level

Describes how the audience feels about the brand:

• whether they know about the brand and how they feel about it;
• how loyal to the brand;
• what he thinks about the brand, whether he considers it better than competitors.

After that, all characteristics are collected in one file to describe the target audience.

Persona method

The method is used to create a detailed, generalized image of a potential client – a character. The persona method is not suitable for primary research of the target audience. It should be used when information has already been collected and needs to be systematized.

Here are some tips for creating target characters:

1. First, give a general description: describe gender, age, geographic location, education, income, and so on.
2. After indicate what the character values ​​in life: comfort, status, functionality, or something else.
3. At the next stage, describe where he spends time more often: offline or online. If online – in which social networks he is registered, on which domain he uses a mailbox, what applications he installs on his smartphone.
4. And finally, determine why the character needs the product, how he needs to buy, what characteristics he pays attention to in the first place.

All answers should be collected in one document. Add a character name and photo. As a result, several characters will be created – representatives of different segments of the target audience. It is important to make them realistic, you can even come up with a biography.

The main thing about the target audience

The target audience is a group of people united by common characteristics who may be interested in the product or services of the company and buy them. The unifying characteristics include gender, age, interests, hobbies, experiences, way of choosing a product, brand awareness, frequency of purchase, and much more.

All characteristics can be divided into the following:

• socio-demographic;
• geographical;
• psychographic;
• behavioral.

The target audience can also be divided into groups:

• according to their readiness to buy: cold, warm and hot audience;
• by interests: wide and narrow;
• by type of target group: for the audience for B2B and B2C segments;
• by type of acquisition: main and indirect.

Dividing an audience into groups is called segmentation. You need to segment the audience in order to fine-tune advertisements, create products that will be of interest to specific people, launch promotions, a loyalty system, and much more.

Various methods can be used to describe the target company. For example, the 5W method, the three-level method, or the person method.

The first two methods are suitable for the initial collection of information about the audience. The last one is if there is already primary information about the audience and it is necessary to describe it more accurately. To do this, hypothetical characters are described who are interested in the brand’s product.

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Target audience: how to define and categorize

Target audience is a collection of consumers with the same desires that an organization can satisfy with its products. People are formed into groups according to the following criteria: gender, age, geographical location, solvency, interests, and others.

The success of a brand depends on a well-designed offer for potential buyers. For example, companies that sell children’s toys are aimed at parents, while a healthy food store is aimed at people who prefer a healthy lifestyle.

It is necessary to pay attention to any aspects: the desires of the client, his preferences, place of residence and others. Each product has its own specific group of consumers, because this is how an advertising campaign will bring results.

Why it is important to correctly define the target audience

Organizations need to understand the portrait of their target audience in order to offer products only to interested customers. If a company knows what consumers focus on when buying, it will:

• create advertising campaigns that attract consumers;
• launch promotions that will lead to good sales;
• optimize your products to stand out from the competition;
• release new products that are interesting to customers.

Consider the example of MTS. The organization knows that customers have families. For this target audience, the company offers a special discount to all family members.

Target audience classification

By type of purchase

Main target audience

Priority group for companies. They themselves decide on the need to purchase goods and are the initiators when making a purchase. For example, office workers independently determine what clothes to buy for working days.

Indirect TA

This audience plays a passive role. As an example, a person who is given a gift certificate to a particular store.

By interest

Wide target audience

These are consumers who are interested in your store as a whole. So, the wide target audience of the VkusVill store is people who prefer healthy food products.

Narrow target audience

A more specialized circle of people, segmented according to a certain attribute. For example, women, men, parents, students, schoolchildren, athletes and others. Such groups differ from each other: when buying, they focus on different details. Alternatively, savings are important for students (a two-in-one promotion is being launched), and for athletes, the choice of healthy products to keep fit (for example, an increase in the range of protein).

By type of target group

B2B (business to business)

This segment includes organizations that provide their products to other organizations. For example, agencies developing online services for business, or companies supplying raw materials and other materials for work.

B2C (business to consumer)

B2C is a company that sells products to ordinary consumers. This category includes clothing and food stores, pet products, beauty salons, various courses and more.

Ready to buy

Cold TA

These are customers who do not know about your brand and are not interested in purchasing products. In order to transfer such an audience into the “warm” category, you need to identify its problems and offer products as a means of satisfying needs.

Warm TA

This type of TA is already familiar with the company and has an idea about its products. It is not necessary for consumers to purchase something from you, they can simply add the item to their shopping cart.

Hot target

These are regular customers and those who are interested in your brand. They are also called target customers.

Characteristics of the target audience

Many factors are important to consider when determining your target group. To maximize profits and increase brand success, focus on the following:

• Demographics. This is the basic information about the buyers: gender, age, religion, education, solvency and more. This information is quite easy to collect due to its availability and simple analysis.
• Geographic data. Knowing the customer’s location is important for companies, especially for local businesses. Geographic targeting adjusts the display of ads for people living in a specific location. For example, for a cafe located in St. Petersburg, it would be logical to create a local geotargeting.
• Psychographic data. Includes information about the personal characteristics of the consumer, his principles, interests, hobbies and hobbies. To obtain such data, create a survey/questionnaire or make a special subscription form.
• Behavioral data. Collected by tracking the actions taken by the client on the site (what products were viewed, what was added to the basket or favorites). Then an advertising campaign is formed.

Segmentation of the target audience

Segmentation is the division of a wide target audience into different groups that are similar in certain respects.

segmentation is used to fine-tune advertising campaigns or create an offer to meet the needs of some customers.

Let’s take an example: an interior door store sells its products to everyone. However, it is better to segment customers into certain categories.

1. Family men who repair the apartment. Most often they have children.
2. Wealthy people who frequently update their interiors and prefer a unique and luxurious design.
3. Young families who have recently moved and do not have large finances.
4. Designers who need doors for their projects. They are interested in custom design.

Each group needs to be given attention and proposals developed specifically for it. For example, discounts and promotions for young families and exclusive materials for making doors for wealthy people.

Offer of interior doors for children’s room

How to segment the target audience

As we have already found out, buyers can be divided into different groups. Here is an example of such a division, which is based on the frequency of purchases:

• Active consumers
  These are customers who constantly purchase products from the brand. Strengthen the loyalty of this audience and constantly remind you of yourself.

• Interested in purchasing item
  This segment is looking at your product, but has not yet decided whether to buy it or not. Think of a way to convince these customers to make a purchase in order to move them into the active consumer segment.

• Buyers rarely
  People who have already purchased the product, but did so irregularly. Here the goal of the company is to reactivate their . Use separate emails, discounts, and a loyalty system to attract customers back to purchase.

• Non-purchasers
  This segment refers to cold clients. Introduce them to your brand and showcase the value of your products with promotional offers and mailing lists.

How to determine the target audience

Before developing a marketing strategy, it is important to study the target audience and only then create an advertisement. We offer ways to determine the core of your target audience:

• Method of forecasts. First, an approximate portrait of the target audience is drawn up and its features and characteristics are described. After that, a campaign is created for this segment. Then the advertisement starts, and it depends on the results whether you made the portrait correctly or not.
• Research method. This method involves ordering an analysis of the target audience in an agency or collecting information based on research from popular sources: VTsIOM surveys, various sites with a research bias, demographic data.
• 5W method. Based on a simple rule: every product has its own buyer. It includes five points that will help highlight individual segments of the target audience.

• Survey method. Surveys are being compiled to determine the target audience. Some representatives of the target audience participate through social networks, by phone or in person.
• Interview method. There are two types of interview: detailed and regular. The first involves a long dialogue of about an hour, perhaps for recording. The main goal is to identify the main doubts and desires of the consumer. This method is more typical for large businesses. Regular interviews often take place online or at an event and do not take much time.
• Three-level method. Divides audience characteristics into the following levels:

General. Specifies the basic characteristics of the target audience.

Product category level. The frequency of use of the product, the frequency of purchases, consumer loyalty, the place of order (online or in the store) are determined.

Brand level. How people perceive the company. For example, what do they know about the brand, how loyal to it, how, in their opinion, the organization differs from others.

After three levels, general information is collected to describe the portrait of the target audience.

• Statistical method. One of the most accessible data sources is the analysis of checks (how many goods are in it, when and at what time the goods were purchased, what was the purchase amount, etc.).

You can also analyze the behavior of consumers on the site. For this, analytics tools are used (the most popular are Google Analytics and Yandex.Metrika).

Analysis of offline consumer behavior is carried out using surveillance cameras or through the number of people connected to free Wi-Fi.

Based on these data, a portrait of the target audience is formed.

• Person method Used to create a detailed and generalized image of a potential client.

There are steps to create a character that will be your customer:

1. General description of a person: gender, age, religion, education, and more.
2. Character values ​​and priorities: uniqueness, status, practicality, etc.
3. Where the consumer most often spends time: online (what social networks he uses) or offline.
4. You need to determine why the character needs your product and what the emphasis is on when buying.

At the end, come up with a name and add a photo of the character. Thus, you will get portraits of the target audience that you need to focus on.

Target Audience Analysis

• CJM ( Customer Journey Map ). This is a buyer interaction map, which is based on an analysis of the desires and interests of the target audience. For clarity, use various Mind Map services (Mindjet, Сoggle).

• CustDev (Customer Development) – testing ideas on potential customers through interviews. Google forms, social media surveys, and more are used.
• Study of seasonality and demand (Google Trends, WordStat).
• Analysis of the target audience of site (Yandex.Metrica is used for your company, SimilarWeb for competitors).
• Social media analysis — generated from social media reports and various research sites (mediascope.net, Target Hunter).
• Analytical services from advertising platforms, analyzing the interaction of the target audience on different sources (YouTube Analytics, Attribution 360).

Conclusion

The target audience is a group of consumers who are united by similar characteristics and are interested in the organization’s products. Common features include age, gender, location, ability to pay, interests, hobbies, purchase frequency, brand familiarity.

Determining the target audience is important at the initial stages of a business.