Understanding TSH Lab Results: A Comprehensive Guide to Thyroid Function Tests
What are normal TSH levels. How does TSH testing help diagnose thyroid disorders. When should you get your TSH levels checked. What factors can affect TSH test results. How is TSH testing used to monitor thyroid treatment. What other thyroid tests are often done with TSH.
The Importance of TSH Testing in Thyroid Health Assessment
Thyroid-stimulating hormone (TSH) testing is a crucial tool in evaluating thyroid function and diagnosing thyroid disorders. As the primary regulator of thyroid gland activity, TSH levels provide valuable insights into the overall health of this important endocrine organ. But what exactly does a TSH test measure, and how can you interpret your results?
TSH is produced by the pituitary gland in response to signals from the hypothalamus. It stimulates the thyroid gland to produce and release thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3). These hormones play vital roles in regulating metabolism, growth, and development throughout the body.
How is TSH testing performed?
TSH testing is typically done through a simple blood test. A healthcare professional will draw a small amount of blood from a vein in your arm, which is then sent to a laboratory for analysis. The test itself is quick and relatively painless, with results usually available within a few days.
Interpreting TSH Lab Results: What Do the Numbers Mean?
Understanding your TSH lab results is essential for assessing thyroid function. Normal TSH levels generally fall between 0.4 and 4.0 milliunits per liter (mU/L), though this range can vary slightly depending on the laboratory and specific testing method used. Higher or lower TSH levels may indicate thyroid dysfunction:
- High TSH (above 4.0 mU/L): May indicate hypothyroidism (underactive thyroid)
- Low TSH (below 0.4 mU/L): May indicate hyperthyroidism (overactive thyroid)
However, it’s important to note that TSH levels alone don’t always tell the full story. Your healthcare provider will consider your TSH results in conjunction with other factors, including symptoms, physical examination findings, and additional thyroid hormone tests.
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Are TSH reference ranges the same for everyone?
While general reference ranges exist, TSH levels can vary based on factors such as age, pregnancy, and certain medical conditions. For example, during pregnancy, TSH levels may be lower due to hormonal changes. Some experts argue for narrower TSH reference ranges, particularly when screening for subclinical thyroid disorders.
Common Thyroid Disorders Detected by TSH Testing
TSH testing plays a crucial role in diagnosing and monitoring various thyroid disorders. Some of the most common conditions identified through TSH testing include:
- Hypothyroidism: An underactive thyroid gland, often characterized by elevated TSH levels
- Hyperthyroidism: An overactive thyroid gland, typically associated with low TSH levels
- Subclinical thyroid disorders: Mild thyroid dysfunction that may not present with obvious symptoms
- Thyroid nodules: Abnormal growths in the thyroid gland that may affect hormone production
- Thyroiditis: Inflammation of the thyroid gland, which can cause fluctuations in TSH levels
Can TSH levels fluctuate throughout the day?
TSH levels can indeed fluctuate throughout the day, with levels typically being highest in the early morning and lowest in the late afternoon. For this reason, TSH tests are often performed in the morning to ensure consistency in results. However, these fluctuations are generally minor and don’t significantly impact the interpretation of test results for most individuals.
Factors That Can Influence TSH Test Results
Several factors can affect TSH levels and potentially impact test results. Being aware of these factors can help you and your healthcare provider interpret your TSH results more accurately:
- Medications: Certain drugs, such as lithium, amiodarone, and glucocorticoids, can affect thyroid function and TSH levels
- Recent illness: Acute illnesses can temporarily alter TSH production
- Stress: Physical or emotional stress may influence TSH secretion
- Time of day: As mentioned earlier, TSH levels have a natural circadian rhythm
- Pregnancy: Hormonal changes during pregnancy can affect TSH levels
- Age: TSH levels tend to increase slightly with age
- Iodine intake: Excessive or deficient iodine consumption can impact thyroid function
Should you fast before a TSH test?
Fasting is generally not required for a TSH test. However, if your healthcare provider has ordered additional tests along with TSH, such as lipid profiles or glucose tests, you may be asked to fast for a certain period before the blood draw. Always follow your healthcare provider’s specific instructions regarding test preparation.
The Role of TSH Testing in Thyroid Treatment Monitoring
For individuals diagnosed with thyroid disorders, TSH testing becomes an essential tool in monitoring treatment effectiveness. Regular TSH tests help healthcare providers adjust medication dosages and ensure that thyroid hormone levels remain within the optimal range.
How often should TSH levels be checked during treatment?
The frequency of TSH testing during thyroid treatment can vary depending on individual circumstances. Initially, tests may be performed every 4-8 weeks as medication doses are adjusted. Once a stable dose is achieved, testing may be reduced to every 6-12 months. However, more frequent testing may be necessary for pregnant women or individuals with complicated thyroid conditions.
Beyond TSH: Other Important Thyroid Function Tests
While TSH is often considered the most sensitive indicator of thyroid function, other tests can provide additional insights into thyroid health. These tests are frequently performed alongside TSH testing to provide a more comprehensive picture of thyroid function:
- Free T4 (FT4): Measures the amount of unbound thyroxine in the blood
- Free T3 (FT3): Assesses the level of unbound triiodothyronine
- Thyroid antibodies: Help identify autoimmune thyroid disorders
- Thyroglobulin: Used to monitor thyroid cancer treatment
When are additional thyroid tests necessary?
Additional thyroid tests may be ordered when TSH results are abnormal or when symptoms suggest thyroid dysfunction despite normal TSH levels. These tests can help differentiate between various thyroid disorders and guide treatment decisions. For instance, measuring thyroid antibodies can help diagnose autoimmune conditions like Hashimoto’s thyroiditis or Graves’ disease.
TSH Testing in Special Populations: Pregnancy and Neonatal Screening
TSH testing plays a crucial role in monitoring thyroid function during pregnancy and in newborn screening programs. Thyroid hormones are essential for fetal development, particularly brain development, making proper thyroid function critical during pregnancy.
How do TSH levels change during pregnancy?
During pregnancy, TSH levels typically decrease due to the influence of human chorionic gonadotropin (hCG), which can stimulate the thyroid gland. As a result, pregnancy-specific TSH reference ranges are often used, with lower upper limits compared to non-pregnant individuals. Regular TSH monitoring throughout pregnancy helps ensure optimal thyroid function for both mother and baby.
Neonatal TSH screening is a standard practice in many countries to detect congenital hypothyroidism, a condition that can lead to developmental delays if left untreated. This screening is typically performed within the first few days of life using a heel prick blood sample.
Emerging Trends and Future Directions in TSH Testing
As our understanding of thyroid function continues to evolve, so too does the field of TSH testing. Several emerging trends and areas of research are shaping the future of thyroid diagnostics:
- Narrower reference ranges: Some experts advocate for tighter TSH reference ranges to improve the detection of subclinical thyroid disorders
- Personalized reference ranges: Considering factors like age, ethnicity, and individual variation in establishing optimal TSH levels
- TSH bioassays: Development of more sensitive and specific TSH tests to enhance diagnostic accuracy
- Integration with genetic testing: Combining TSH testing with genetic analysis to identify individuals at risk for thyroid disorders
- Point-of-care testing: Advancements in rapid, on-site TSH testing for more immediate results
How might TSH testing evolve in the coming years?
As technology advances, we may see more widespread use of continuous thyroid hormone monitoring devices, similar to those used for glucose monitoring in diabetes management. These devices could provide real-time data on thyroid function, allowing for more precise and personalized treatment adjustments. Additionally, artificial intelligence and machine learning algorithms may be employed to analyze TSH patterns and predict thyroid dysfunction before it becomes clinically apparent.
Understanding TSH lab results is crucial for maintaining optimal thyroid health. By working closely with your healthcare provider and staying informed about your TSH levels, you can take an active role in managing your thyroid function and overall well-being. Remember that TSH testing is just one piece of the puzzle – a comprehensive approach to thyroid health involves considering symptoms, physical examination findings, and additional thyroid function tests when necessary.
Thyroid-stimulating Hormone (TSH) | Lab Tests Online
Sources Used in Current Review
(2017 May. Updated). Thyroid Tests. National Institute of Diabetes and Digestive and Kidney Diseases. Available online at https://www.niddk.nih.gov/health-information/diagnostic-tests/thyroid. Accessed on 6/02/18.
Wisse, B. (2016 February 3, Updated). TSH Test. MedlinePlus Medical Encyclopedia. Available online at https://medlineplus.gov/ency/article/003684.htm. Accessed on 6/02/18.
Sofronescu, A. (2015 November 2, Updated). Thyroid Screen Interpretation. Medscape Protocols. Available online at https://emedicine.medscape.com/article/2172202-overview. Accessed on 6/02/18.
Erik, A. et. al. (2017 March 1). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. THYROID Volume 27, Number 3, 2017. Available online at https://www.liebertpub.com/doi/full/10.1089/thy.2016.
0457. Accessed on 6/02/18.
Straseski, J. (2018 June, Updated). Thyroid Disease. ARUP Consult. Available online at https://arupconsult.com/content/thyroid-disease. Accessed on 6/02/18.
(© 2018). Thyroid Function Tests. American Thyroid Association. Available online at https://www.thyroid.org/thyroid-function-tests/. Accessed on 6/02/18.
Schneider, C. (2018 April 30). Initial evaluation of thyroid dysfunction – Are simultaneous TSH and fT4 tests necessary? PLoS One. 2018; 13(4): e0196631. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927436/. Accessed on 6/02/18.
Ross, D. et. al. (2016 October). 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid Volume 26, Issue 10. Available online at https://www.liebertpub.com/doi/full/10.1089/thy.2016.0229. Accessed on 6/02/18.
2015 American Thyroid Association guidelines for evaluation of thyroid nodules recommends TSH measurement in initial evaluation of all individuals with a thyroid nodule.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
U.S. Preventive Services Task Force (2004 May 15). Screening for Thyroid Disease: Recommendation Statement. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20040515/us.html.
MedlinePlus Medical Encyclopedia. TSH. (Updated 10/24/07). [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm.
(© 2005). Thyroid Stimulating Hormone (TSH). ARUP’s Guide to Clinical Laboratory Testing [On-line information]. Available online at http://www.aruplab.com/guides/clt/tests/clt_239b.jsp#1149154 .
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition.
Saunders Elsevier, St. Louis, Missouri. Pp. 1038-1041.
Ladenson,PW et al, for the American Thyroid Association. American Thyroid Association guidelines for detection of thyroid dysfunction. 12 Jun 2000. Arch Intern Med 60:1573-1575.
American Association of Clinical Endocrinologists. Women’s endocrine health. Available online at http://www.powerofprevention.com/w_endocrine.php.
Eckman, A. (Updated 2010 April 19). TSH test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm. Accessed February 2011.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby’s Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 949-950.
Meikle, A. and Roberts, W. (Updated 2010 October). Thyroid Disease. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/ThyroidDz.html. Accessed February 2011.
(© 2008).
Thyroid Function Tests. American Thyroid Association [On-line information]. Available online at http://www.thyroid.org/patients/patient_brochures/function_tests.html. Accessed February 2011.
Bissell, M. Editor (2010 August). Lower thyroid-stimulating hormone thresholds in neonatal screening. CAP Today. Clinical Abstracts [On-line information]. Available online through http://www.cap.org. Accessed February 2011.
(Updated 2014 May 14). Thyroid Tests. National Endocrine and Metabolic Diseases Information Service [On-line information]. Available online at http://endocrine.niddk.nih.gov/pubs/thyroidtests/index.aspx. Accessed June 2014.
Topiwala, S. (Updated 2012 June 26). TSH test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm. Accessed June 2014.
(© 1995–2014). Thyroid-Stimulating Hormone-Sensitive (s-TSH), Serum. Mayo Clinic Mayo Medical Laboratories [On-line information].
Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8939. Accessed June 2014.
Lin, J. (Updated 2012 February 17). Thyroid-Stimulating Hormone. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/2074091-overview. Accessed June 2014.
Meikle, A. W. and Straseski, J. (Updated 2014 April). Thyroid Disease. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/ThyroidDz.html?client_ID=LTD. Accessed June 2014.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby’s Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 949-950.
McPherson, R. and Pincus, M. (© 2011). Henry’s Clinical Diagnosis and Management by Laboratory Methods 22nd Edition: Elsevier Saunders, Philadelphia, PA. Pg 376.
©2014 American Thyroid Association. Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.
If antithyroid drugs are chosen as initial management of GD, how should the therapy be managed? Available online at http://www.thyroid.org/thyroid-guidelines/hyperthyroidism/resultse/. Accessed September 2014.
(April 4, 2014) Aytug S. Euthyroid Sick Syndrome. Medscape. Available online at http://emedicine.medscape.com/article/118651-overview. Accessed September 2014.
Thyroid Tests | NIDDK
Health care professionals use thyroid tests to check how well your thyroid is working and to find the cause of problems such as hyperthyroidism or hypothyroidism. The thyroid is a small, butterfly-shaped gland in the front of your neck that makes two thyroid hormones: thyroxine (T4) and triiodothyronine (T3). Thyroid hormones control how the body uses energy, so they affect nearly every organ in your body, even your heart.
The thyroid is a small, butterfly-shaped gland in your neck.
Thyroid tests help health care professionals diagnose thyroid diseases such as
Your doctor will start with blood tests and may also order imaging tests.
What blood tests do doctors use to check thyroid function?
Doctors may order one or more blood tests to check your thyroid function. Tests may include thyroid stimulating hormone (TSH), T4, T3, and thyroid antibody tests.
Thyroid blood tests check your thyroid function.
For these tests, a health care professional will draw blood from your arm and send it to a lab for testing. Your doctor will talk to you about your test results.
TSH test
Health care professionals usually check the amount of TSH in your blood first. TSH is a hormone made in the pituitary gland that tells the thyroid how much T4 and T3 to make.
A high TSH level most often means you have hypothyroidism, or an underactive thyroid. This means that your thyroid isn’t making enough hormone. As a result, the pituitary keeps making and releasing TSH into your blood.
A low TSH level usually means you have hyperthyroidism, or an overactive thyroid.
This means that your thyroid is making too much hormone, so the pituitary stops making and releasing TSH into your blood.
If the TSH test results are not normal, you will need at least one other test to help find the cause of the problem.
T
4 tests
A high blood level of T4 may mean you have hyperthyroidism. A low level of T4 may mean you have hypothyroidism.
In some cases, high or low T4 levels may not mean you have thyroid problems. If you are pregnant or are taking oral contraceptives, your thyroid hormone levels will be higher. Severe illness or using corticosteroids—medicines to treat asthma, arthritis, skin conditions, and other health problems—can lower T4 levels. These conditions and medicines change the amount of proteins in your blood that “bind,” or attach, to T4. Bound T4 is kept in reserve in the blood until it’s needed. “Free” T4 is not bound to these proteins and is available to enter body tissues.
Because changes in binding protein levels don’t affect free T4 levels, many healthcare professionals prefer to measure free T4.
T
3 test
If your health care professional thinks you may have hyperthyroidism even though your T4 level is normal, you may have a T3 test to confirm the diagnosis. Sometimes T4 is normal yet T3 is high, so measuring both T4 and T3 levels can be useful in diagnosing hyperthyroidism.
Thyroid antibody tests
Measuring levels of thyroid antibodies may help diagnose an autoimmune thyroid disorder such as Graves’ disease—the most common cause of hyperthyroidism—and Hashimoto’s disease—the most common cause of hypothyroidism. Thyroid antibodies are made when your immune system attacks the thyroid gland by mistake. Your health care professional may order thyroid antibody tests if the results of other blood tests suggest thyroid disease.
What imaging tests do doctors use to diagnose and find the cause of thyroid disease?
Your health care professional may order one or more imaging tests to diagnose and find the cause of thyroid disease.
A trained technician usually does these tests in your doctor’s office, outpatient center, or hospital. A radiologist, a doctor who specializes in medical imaging, reviews the images and sends a report for your health care professional to discuss with you.
Ultrasound
Ultrasound of the thyroid is most often used to look for, or more closely at, thyroid nodules. Thyroid nodules are lumps in your neck. Ultrasound can help your doctor tell if the nodules are more likely to be cancerous.
For an ultrasound, you will lie on an exam table and a technician will run a device called a transducer over your neck. The transducer bounces safe, painless sound waves off your neck to make pictures of your thyroid. The ultrasound usually takes around 30 minutes.
During an ultrasound, a transducer bounces sound waves off the neck to make images of the thyroid.
Thyroid scan
Health care professionals use a thyroid scan to look at the size, shape, and position of the thyroid gland.
This test uses a small amount of radioactive iodine to help find the cause of hyperthyroidism and check for thyroid nodules. Your health care professional may ask you to avoid foods high in iodine, such as kelp, or medicines containing iodine for a week before the test.
For the scan, a technician injects a small amount of radioactive iodine or a similar substance into your vein. You also may swallow the substance in liquid or capsule form. The scan takes place 30 minutes after an injection, or up to 24 hours after you swallow the substance, so your thyroid has enough time to absorb it.
During the scan, you will lie on an exam table while a special camera takes pictures of your thyroid. The scan usually takes 30 minutes or less.
Thyroid nodules that make too much thyroid hormone show up clearly in the pictures. Radioactive iodine that shows up over the whole thyroid could mean you have Graves’ disease.
Even though only a small amount of radiation is needed for a thyroid scan and it is thought to be safe, you should not have this test if you are pregnant or breastfeeding.
Radioactive iodine uptake test
A radioactive iodine uptake test, also called a thyroid uptake test, can help check thyroid function and find the cause of hyperthyroidism. The thyroid “takes up” iodine from the blood to make thyroid hormones, which is why this is called an uptake test. Your health care professional may ask you to avoid foods high in iodine, such as kelp, or medicines containing iodine for a week before the test.
For this test, you will swallow a small amount of radioactive iodine in liquid or capsule form. During the test, you will sit in a chair while a technician places a device called a gamma probe in front of your neck, near your thyroid gland. The probe measures how much radioactive iodine your thyroid takes up from your blood. Measurements are often taken 4 to 6 hours after you swallow the radioactive iodine and again at 24 hours. The test takes only a few minutes.
If your thyroid collects a large amount of radioactive iodine, you may have Graves’ disease, or one or more nodules that make too much thyroid hormone.
You may have this test at the same time as a thyroid scan.
Even though the test uses a small amount of radiation and is thought to be safe, you should not have this test if you are pregnant or breastfeeding.
What tests do doctors use if I have a thyroid nodule?
If your health care professional finds a nodule or lump in your neck during a physical exam or on thyroid imaging tests, you may have a fine needle aspiration biopsy to see if the lump is cancerous or noncancerous.
For this test, you will lie on an exam table and slightly bend your neck backward. A technician will clean your neck with an antiseptic and may use medicine to numb the area. An endocrinologist who treats people with endocrine gland problems like thyroid disease, or a specially trained radiologist, will place a needle through the skin and use ultrasound to guide the needle to the nodule. Small samples of tissue from the nodule will be sent to a lab for testing. This procedure usually takes less than 30 minutes.
Your health care professional will talk with you about the test result when it is available.
Thyroid-stimulating Hormone (TSH) Blood Test
Categories
The Thyroid-stimulating Hormone (TSH) Blood Test checks thyroid gland function.
Test Code: 004259
Also Known As: Third Generation TSH; Thyrotropin; hTSH; TSH Test
Methodology: Electrochemiluminescence immunoassay (ECLIA)
Preparation: No fasting required. Stop biotin consumption at least 72 hours prior to the collection.
Test Results: 1-2 days. May take longer based on weather, holiday or lab delays.
Test Code: 899
Also Known As: Third Generation TSH; Thyrotropin; hTSH; TSH Test
Methodology: Immunoassay (IA)
Preparation: No fasting required.
Stop biotin consumption at least 72 hours prior to the collection.
Test Results: 1-2 days. May take longer based on weather, holiday or lab delays.
Description
TSH is a hormone that is produced by the pituitary gland. This gland is responsible for making sure that the thyroid hormones are released into the blood. TSH test is a thyroid function test used to assist in the diagnosis of thyroid disorders, monitor thyroid replacement therapy in patients with hypothyroidism, diagnose and/or monitor female infertility problems, and occasionally the test is used to help evaluate pituitary gland function. While the test is most often used to help diagnose thyroid disorders in adults, expert opinions vary on the benefits of screening, and at what age to begin testing.
One type of thyroid disorder is Hypothyroidism which means that the thyroid gland is underactive. Some symptoms that can be related to this disorder are:
- weight gain
- dry skin
- constipation
- a feeling of being too cold
- tiredness
Another type of thyroid disorder is Hyperthyroidism which means that the thyroid gland is overactive.
Symptoms associated with this disorder may include:
- weight loss
- rapid heart rate
- nervousness
- diarrhea
- a feeling of being too hot
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TSH Blood Test
Thyroid-Stimulating Hormone, Third-generation TSH
Test Code: 004259
Specimen Type: Blood
Description:
TSH Blood Test
A TSH (Thyroid Stimulating Hormone) test is commonly ordered to help evaluate a person’s thyroid function and aid in the diagnosis of thyroid disorders such as hyperthyroidism or hypothyroidism.
It may also be used in some cases to evaluate pituitary gland function. TSH is produced by the pituitary gland and aids the thyroid gland in producing Triiodothronine (T3) and Thyroxine (T4). These 2 hormones help control the body’s metabolism, temperature, and heart rate.
Common symptoms of thyroid disorders include but are not limited to anxiety, irregular weight gain or loss, insomnia, diarrhea, constipation, irritation or sensitivity in the eyes, increased heart rate, dry skin, hair loss, and menstrual irregularity in women.
A TSH test is a common general health screening. It can also be ordered when someone is experiencing symptoms associated with thyroid disorders or to monitor treatment for a thyroid disorder. Women experiencing fertility issues often have their TSH tested. TSH can be ordered along with other thyroid tests for a more comprehensive analysis and is most commonly paired with a T4 test.
This test has a sensitivity of 0.004 μIU/mL and meets all criteria as a third-generation TSH assay.
Turnaround time for the TSH test is typically 1 business day.
Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.
Requirements:
It is recommended that someone taking Biotin (also known as vitamin B7 or B8, vitamin H, or coenzyme R) stop consumption at least 72 hours prior to the collection of a sample.
Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For people on hemodialysis, specimen collection should be delayed for 2 weeks.
Categories:
TSH Blood Test
Thyroid-Stimulating Hormone, Third-generation TSH
Test Code: 899
Specimen Type: Blood
Description:
TSH Blood Test
A TSH (Thyroid Stimulating Hormone) test is commonly ordered to help evaluate a person’s thyroid function and aid in the diagnosis of thyroid disorders such as hyperthyroidism or hypothyroidism.
It may also be used in some cases to evaluate pituitary gland function. TSH is produced by the pituitary gland and aids the thyroid gland in producing Triiodothronine (T3) and Thyroxine (T4). These 2 hormones help control the body’s metabolism, temperature, and heart rate.
Common symptoms of thyroid disorders include but are not limited to anxiety, irregular weight gain or loss, insomnia, diarrhea, constipation, irritation or sensitivity in the eyes, increased heart rate, dry skin, hair loss, and menstrual irregularity in women.
A TSH test is a common general health screening. It can also be ordered when someone is experiencing symptoms associated with thyroid disorders or to monitor treatment for a thyroid disorder. Women experiencing fertility issues often have their TSH tested. TSH can be ordered along with other thyroid tests for a more comprehensive analysis and is most commonly paired with a T4 test.
This test has a sensitivity of 0.004 μIU/mL and meets all criteria as a third-generation TSH assay.
Turnaround time for the TSH test is typically 1 business day.
Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.
Requirements:
Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For people on hemodialysis, specimen collection should be delayed for 2 weeks.
Categories:
Thyroid-Stimulating Hormone, Third-generation TSH
Test Code: 004259
Specimen Type: Blood
Description:
TSH Blood Test
A TSH (Thyroid Stimulating Hormone) test is commonly ordered to help evaluate a person’s thyroid function and aid in the diagnosis of thyroid disorders such as hyperthyroidism or hypothyroidism.
It may also be used in some cases to evaluate pituitary gland function. TSH is produced by the pituitary gland and aids the thyroid gland in producing Triiodothronine (T3) and Thyroxine (T4). These 2 hormones help control the body’s metabolism, temperature, and heart rate.
Common symptoms of thyroid disorders include but are not limited to anxiety, irregular weight gain or loss, insomnia, diarrhea, constipation, irritation or sensitivity in the eyes, increased heart rate, dry skin, hair loss, and menstrual irregularity in women.
A TSH test is a common general health screening. It can also be ordered when someone is experiencing symptoms associated with thyroid disorders or to monitor treatment for a thyroid disorder. Women experiencing fertility issues often have their TSH tested. TSH can be ordered along with other thyroid tests for a more comprehensive analysis and is most commonly paired with a T4 test.
This test has a sensitivity of 0.004 μIU/mL and meets all criteria as a third-generation TSH assay.
Turnaround time for the TSH test is typically 1 business day.
Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.
Requirements:
It is recommended that someone taking Biotin (also known as vitamin B7 or B8, vitamin H, or coenzyme R) stop consumption at least 72 hours prior to the collection of a sample.
Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For people on hemodialysis, specimen collection should be delayed for 2 weeks.
Categories:
TSH Blood Test
Thyroid-Stimulating Hormone, Third-generation TSH
Test Code: 899
Specimen Type: Blood
Description:
TSH Blood Test
A TSH (Thyroid Stimulating Hormone) test is commonly ordered to help evaluate a person’s thyroid function and aid in the diagnosis of thyroid disorders such as hyperthyroidism or hypothyroidism.
It may also be used in some cases to evaluate pituitary gland function. TSH is produced by the pituitary gland and aids the thyroid gland in producing Triiodothronine (T3) and Thyroxine (T4). These 2 hormones help control the body’s metabolism, temperature, and heart rate.
Common symptoms of thyroid disorders include but are not limited to anxiety, irregular weight gain or loss, insomnia, diarrhea, constipation, irritation or sensitivity in the eyes, increased heart rate, dry skin, hair loss, and menstrual irregularity in women.
A TSH test is a common general health screening. It can also be ordered when someone is experiencing symptoms associated with thyroid disorders or to monitor treatment for a thyroid disorder. Women experiencing fertility issues often have their TSH tested. TSH can be ordered along with other thyroid tests for a more comprehensive analysis and is most commonly paired with a T4 test.
This test has a sensitivity of 0.004 μIU/mL and meets all criteria as a third-generation TSH assay.
Turnaround time for the TSH test is typically 1 business day.
Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.
Requirements:
Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For people on hemodialysis, specimen collection should be delayed for 2 weeks.
Categories:
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Thyroid-Stimulating Hormone (TSH) – Lab Results explained
Optimal Result:
0.45 – 4.5 mIU/L,
or
0.45 – 4.50 IU/L.
The table below provides estimates of TSH levels that are normal, low (indicating hyperthyroidism) and high (indicating hypothyroidism):
| hyperthyroidism | normal | mild hypothyroidism | hypothyroidism |
| 0 – 0.4 | 0.4 – 4 | 4 – 10 | 10 |
Most labs use these reference values.
———————
TSH stands for thyroid stimulating hormone, though it is sometimes called thyrotropin or thyrotropic hormone. TSH stimulates the thyroid gland to produce thyroid hormone, which is is critical for the proper function of virtually every cell in the body. TSH is released by the pituitary gland after the gland has been stimulated by thyroid releasing hormone (TRH), which is secreted by the hypothalamus. Thyroid hormone provides negative feedback on the hypothalamus and/or the pituitary to reduce thyroid hormone production and release. TSH measurements are important for diagnosing hypothyroidism and hyperthyroidism. TSH may be measured in conjunction with total thyroxine (T4), total triiodothyronine (T3), free T4, free T3, and reverse T3 concentrations in the serum.
Normal Ranges for TSH:
Children:
– 1-2 Days — 3.20-34.60 mIU/L
– 3-4 Days — 0.70-15.40 mIU/L
– 5 Days-4 Weeks — 1.70-9.10 mIU/L
– 1-11 Months — 0.80-8.20 mIU/L
– 1-19 Years — 0.50-4.30 mIU/L
Adult (non-pregnant):
0.40-4.50 mIU/L
Pregnancy
– First Trimester — 0.26-2.66 mIU/L
– Second Trimester — 0.55-2.73 mIU/L
– Third Trimester — 0.43-2.91 mIU/L
Factors That May Affect Your TSH Results:
There are a number of variations and factors that can affect TSH levels. It’s important to be aware of these, as treatment that is dictated solely by lab values (as opposed to also considering an individual’s symptoms) can result in an ineffective plan.
– Laboratory Error: If a TSH level is surprising, sometimes simply repeating the test is the best course. Errors can occur during the blood draw, in transcribing the results, or due to mix-ups in the lab. Statistically, there is always a risk of lab error, and results should always be interpreted along with clinical symptoms and findings.
– Antibodies: Antibodies are thought to interfere with accurate thyroid testing in roughly 1 percent of people. In a 2018 review, it was estimated that in people who have these antibodies, the interference with TSH testing caused either misdiagnosis or inappropriate treatment in more than 50 percent of cases:
Heterophile antibodies: Heterophile antibodies are antibodies that may occur when a person is exposed to animal-derived pharmaceuticals and antibody therapies. Their presence is more common in people who have had certain vaccinations, blood transfusions, or have been exposed to some animals (not household pets). The estimated incidence of these antibodies varies widely, but when present, they can interfere with TSH levels. There is no easy way to know if you have these antibodies, but a discrepancy between TSH levels and free T4 (the hallmark of heterophile antibodies), or between TSH levels and how you feel, should raise the question.
Thyroid antibodies: Thyroid autoantibodies, present in some people with or without a thyroid condition, may also affect TSH levels. Again, a discrepancy between lab values and how you feel should raise the question of whether or not the test is accurate.
Other antibodies: Other antibodies important in TSH testing interference include anti-ruthenium antibodies and anti-streptavidin antibodies.
– Other Factors: A number of other factors can affect TSH test results either through having an effect on actual levels of thyroid hormones or interacting with testing measures.
Some of these include:
– The time of day that the test is done: TSH levels are higher if you’re tested after fasting (for example, in the morning after not having eaten since the night before) as compared to after eating later in the day.
– Illness
– Pregnancy
– Some medications that are used for heart disease and in cancer treatment
– Foods or supplements rich in/derived from iodine or kelp
– Biotin supplements
– Non-steroidal anti-inflammatory medications such as Advil (ibuprofen)
– Changes in sleep habits
In order to get the most accurate results, it’s important to be consistent. For example, always having your test done at the same time of day.
Sources:
http://www.uptodate.com/contents/thyroid-hormone-synthesis-and-physiology
http://www.ncbi.nlm.nih.gov/pubmed/2194786
http://www.uptodate.com/contents/laboratory-assessment-of-thyroid-function
http://www.questdiagnostics.com/testcenter/TestDetail.action?ntc=899
http://www.uptodate.com/contents/disorders-that-cause-hypothyroidism
http://www.uptodate.com/contents/disorders-that-cause-hyperthyroidism
http://www.ncbi.nlm.nih.gov/pubmed/21048053
http://www.nejm.org/doi/full/10.1056/NEJMcp0801880
http://www.uptodate.com/contents/disorders-that-cause-hyperthyroidism
Understanding High TSH, Low TSH, T3 & T4 Test Results
Thyroid-stimulating hormone or TSH is a hormone produced by the pituitary gland. It is one of the primary hormones of the body that aids in the conduction of a plethora of vital bodily activities including regulation of metabolism, release of hormones by the thyroid gland and much more. A TSH test aids in the measurement of the amount of TSH present in the bloodstream. For an excessively low or high quantity of this element is known to cause the onset of a number of chronic diseases and conditions in the body.
Thyroid is a small butterfly shaped gland that sits atop the neck. It’s one of the main glands of the body that typically produces three hormones – triiodothyronine (T3), thyroxine (T4), and calcitonin. Each of these hormones is linked with the production of TSH. To clear the air, the thyroid produces hormones when the pituitary gland releases TSH in the blood. This means that, two glands work together and ensure the right amount of hormones are made. However, in the event one of these glands dysfunctions, the working of the other one is affected too.
Physicians usually recommend a TSH blood test to check for the existence of any underlying causes of atypical production of hormones in these two glands. In addition to this, it’s also suggested for screening an overactive or underactive thyroid gland.
Why It Is Done
There are a number of reasons why a physician will recommend a TSH test to a person. A few were listed above, and a few more are as follows:-
1) To determine whether or not the thyroid gland is working properly.
a. Tiredness, dry skin, weight gain, constipation, a feeling of being too cold, or frequent menstrual periods are some of the top symptoms of an underactive thyroid gland (hypothyroidism).
b. Nervousness, diarrhea, weight loss, rapid heart rate, feeling too hot, or experiencing irregular menstrual periods, are some top signs of an overactive thyroid (hyperthyroidism).
2) To see whether the thyroid medications for hypothyroidism are working as expected, or if there’s a need to increase/decrease dosage or change medicines altogether.
3) Look into the cause of an underactive thyroid gland (hypothyroidism). TSH quantities in the bloodstream can help in knowing if a patient has hypothyroidism because of a damaged thyroid gland or some other causes persist therein, such hypothalamus, etc.
4) Tracking the functionality of the thyroid gland in patients with hyperthyroidism. This may include surgery, antithyroid medicine prescription, or radiation therapy.
5) Diagnosing an underactive thyroid gland in a newborn baby (congenital hypothyroidism).
What Makes TSH Fluctuate?
TSH fluctuates due to the change in the TRH. Once TSH makes its way to the thyroid gland, the levels are largely dictated by the amount of T3 & T4 in your blood. The body produces more TSH to stimulate the thyroid when T3 and T4 levels are low. But when T3 & T4 levels are high, the body produces less quantities of these two hormones.
Image Courtesy: Precision Nutrition
There are several other factors too, that can influence TSH levels:
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- Genetics
- Poisonous substances and radiation exposure
- Inflammation of the thyroid gland
- Deficiency or excess of iodine in the diet
- Pregnancy
- Certain medications – antidepressants, cholesterol lowering drugs, chemotherapy drugs, steroids
- Thyroid cancer
How to Prepare for a TSH Test?
Before a TSH test, it is highly advised that a patient must inform his/her physician if he/she has had tests that involved the use of radioactive materials or an X-Ray that used iodine dye, within the last 4 to 6 weeks. These contents are known to hinder with the test results and obtaining precise and accurate result may be difficult.
How is the Test Performed?
The following steps are undertaken for performing a TSH blood test:-
- A lab nurse or technician will first look for a healthy vein around your arm. He/she will then wrap an elastic band around the upper arm to stop the flow of blood. Basically, this makes the vein to swell up and allow easy access.
- The vein puncture point is then cleaned using an alcohol swab.
- A fresh, sterilized needle is then inserted into the vein. (In some rare cases, more than one vein puncture may be needed for easy extraction of the blood)
- The needle is either attached to a syringe or directly to a tube for the collection of blood.
- Post extraction of blood, the point of puncture is tactically closed using another alcohol swab. The band is removed too.
- The application of alcohol swab restricts the outflow of blood and allows the platelets to block the point of puncture.
Additional Tests for Thyroid Health
Given the potential inaccuracies with TSH on its own, comprehensive screening of thyroid health should ideally include these 6 tests:
- TSH
- Free T3
- Free T4
- Reverse T3
- Thyroid Peroxidase Antibodies
- Thyroglobulin Antibodies
- Your doctor should be aware of these tests.
Hypothyroidism TSH Levels
The TSH levels in the blood can theoretically be a good marker of thyroid health. Here’s the chart which shows a simplified version of what different readings can indicate.
TSH Levels | T3 and T4 Levels | Disease Condition |
High | High | Tumor of pituitary gland |
| Low | Low | Secondary hypothyroidism |
Low | High | Grave’s disease |
High | Low | Hashimoto’s disease |
Normal TSH levels
The normal TSH levels in an average adult range between 0.4 and 4.0 mIU/L (milli-international units per liter). For those on thyroxine, the goal TSH level is between 0.5 and 2.5 mU/L.
The reference ranges alter slightly as we grow older and in the case of a pregnancy:
- TSH levels in premature babies (28‑36 weeks)
- TSH level in children
- Birth to 4 days: 1‑39 mIU/L
- 2‑20 weeks: 1.7‑1 mIU/L
- 21 weeks to 20 years: 0.7‑64 mIU/L
- TSH level in adults
- 21‑54 years: 0.4‑2 mIU/L
- 55‑87 years: 0.5‑9 mIU/L
- TSH level during pregnancy
- First trimester: 0.3‑5 mIU/L
- Second trimester: 0.3‑6 mIU/L
- Third trimester: 0.8‑2 mIU/L
It is vital to note that these above mentioned ranges can and/or may vary from one laboratory to another due to the use of different measurement techniques. The best way to check whether or not the levels are normal is by consulting a physician. He/she will give you a precise view of the working of your thyroid as well as the pituitary gland.
High TSH Levels
A high TSH level means the test value falls beyond 4.0 mIU/L. It typically indicates an underactive thyroid gland or the condition of hypothyroidism – producing too little thyroid hormone. Some of the common causes of hypothyroidism include radiation treatment, an autoimmune disease (known as Hashimoto’s disease), or surgical removal of the thyroid gland.
Low TSH levels
A TSH reading below 0.4 mIU/L indicates low TSH levels in the bloodstream. The low amounts typically persist in the case of an overactive thyroid gland, otherwise known as a condition of hyperthyroidism. It means that the thyroid gland produces more than required quantities of T3 and T4 hormones.
Hyperthyroidism is also closely associated with goiter, Graves’ disease, excessive content of iodine in the body, or an overdose of synthetic thyroid hormone.
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For Thyroid Hormones, How Low Is Too Low?
Advocates like Ms. Shomon, whose hypothyroidism was diagnosed in 1995, dispute the premise of a normal T.S.H. level. “What’s normal for me may not be normal for you,” she said. “We’re patients, not lab values.” The website she oversees, thyroid.about.com, is operated by About.com, a division of The New York Times Company.
In fact, some small-scale studies indicate that the normal range for T.S.H. may differ from person to person. “We could all have a different thermostat,” said Dr. Philip Orlander, director of endocrinology and metabolism at the University of Texas Health Science Center at Houston.
Complicating matters is that T.S.H. levels fluctuate according to season, health status, time of day and activity level. Several studies indicate that 20 percent to 30 percent of those with mildly elevated T.S.H. revert to normal within months.
Many alternative medicine practitioners argue that T.S.H. readings are inaccurate and advocate monitoring armpit temperature.
Others, like Dr. Steven F. Hotze, who has appeared on television talk programs promoting his book “Hormones, Health and Happiness,” rely solely on symptoms. “You can have a normal blood test and not feel normal,” Dr. Hotze said. “I listen to the patient, and if she tells me she has cold hands and feet, brain fog and lethargy, I put her on a therapeutic trial of thyroid hormone.”
Dr. Hotze, of Houston, says he sees more than 2,000 new patients a year.
Endocrinologists like Dr. Surks, Dr. Cooper and Dr. Orlander said they required blood tests beyond T.S.H. screening before prescribing hormones. Symptoms like weight gain and lethargy are often too vague for a diagnosis, they said. And needlessly taking thyroid hormones can lead to cardiac dysfunction and osteoporosis.
“I see patients all the time who are miserable and unhappy and want to blame something,” Dr. Cooper said. “There are tears and anger when you tell them that it’s not their thyroid that’s causing their problems.”
Blood test for free thyroxine (FT4) ᐈ donate blood for free thyroxine
Description of the analysis:
Free thyroxine (FT4) is a biologically active part of total thyroxine, a hormone that regulates energy and plastic metabolism in the body. Thyroxine is one of the main hormones synthesized by the thyroid gland – it accounts for up to 90% of the total amount of hormones it produces.
T4 is in the blood in a free form or bound to proteins (globulins), and the main amount of thyroxine is bound, and only about 0.1% remains free.Free T4 allows you to assess the function of the thyroid gland, regardless of the concentration of blood proteins that bind it.
The T4 test is usually prescribed in combination with a blood test for TSH (thyroid stimulating hormone produced by the pituitary gland), on which the production of thyroxine depends. If the T4 level is too low, the production of thyroid-stimulating hormone increases to stimulate the thyroid gland. If the level of T4 is too high, then the pituitary gland produces less TSH, weakening the synthesis of thyroxine by the thyroid gland.
Lack of thyroxine provokes the development of symptoms of hypothyroidism: weight gain, fatigue, dry skin, sensitivity to cold and menstrual irregularities. Its excess leads to hyperthyroidism and, as a result, acceleration of metabolic processes, weight loss, sleep problems, tremors in the hands, anxiety and heart palpitations.
Indications for prescribing an analysis for free T4
The examination is usually prescribed by an endocrinologist, but it is possible to appoint other doctors: gynecologists, therapists, pediatricians or neonatologists.
Indication for analysis in endocrinology can be:
- Basedow’s disease;
- thyroiditis;
- hypothyroidism;
- hyperthyroidism;
- endemic goiter;
- Hashimoto’s thyroiditis;
- thyroid adenoma;
- iodine deficiency.
Pediatrician or Physician can order an analysis for symptoms of thyroid dysfunction:
- changes in body weight for no apparent reason;
- heart palpitations;
- protrusion of the eyeballs.
90,028 dry skin;
Gynecologists order an analysis:
- pregnant women prone to thyroid diseases;
- for menstrual irregularities;
- in the diagnosis of the causes of female infertility.
Neonatologists use examination to diagnose congenital hypothyroidism, and also prescribe to children whose mothers are diagnosed with thyroid disease.
Norm of free T4 in blood
The level of free thyroxine in the blood is measured in picomole per liter (pmol / l or pmol / l) and a concentration of 10.3-24.5 pmol / l is considered normal.
Exceeding these results indicates thyroiditis, diffuse toxic goiter, thyroid adenoma or its postpartum dysfunction. An increase in T4 is possible not only due to diseases of the thyroid gland, it can occur in diseases of the kidneys and liver (for example, with hepatitis or cirrhosis), due to obesity. Taking aspirin, furosemide, levothyroxine, heparin and a number of other drugs also provokes an increase in T4.
Decreased levels of free thyroxine can be a symptom in primary hypothyroidism, endemic goiter, Hashimoto’s thyroiditis, thyrotropinoma and iodine deficiency.It can also cause exhaustion, inflammation of the pituitary gland or hypothalamus, lead poisoning. The use of oral contraceptives, anabolic steroids, carbamazepine, lithium and thyreostatics also lowers T4 levels.
Preparation for examination
Two days before the sampling of material for analysis, it is necessary to stop taking steroid and thyroid hormones, as well as drugs that can affect the level of T4 in the blood. It is important to exclude stress and physical activity the day before the study, and smoking – 3 hours.
Material for research: venous blood.
Research method: IHLA (immunochemiluminescent analysis).
Terms of readiness: 1 working day.
Registration for analyzes
Pass TSH (sensitive) in Samara and Tolyatti – Skylab Laboratory
Thyroid stimulating hormone (thyrotropin) is produced in the pituitary gland and regulates the content of thyroid hormones in the blood – thyroxine and triiodothyronine.The latter are formed in the thyroid gland, are involved in maintaining the energy balance in the body and are vital for its proper functioning.
An increase or decrease in thyrotropin (commonly used abbreviation TSH or the English abbreviation – tsh), due to problems of the pituitary gland, leads to severe consequences for the body with the development of hyper- and hypothyroidism.
In addition, the work of the hypothalamus, which synthesizes thyroliberin, a regulator of thyrotropin production, has a direct effect on the TSH content.Thus, a blood test for TSH is a very important method for diagnosing a whole group of endocrine system disorders.
Preparation for research
Blood from a vein is used for analysis. Since the level of hormones depends on a number of factors, before the procedure, it is necessary to follow several simple rules that will help ensure the most reliable result:
- , in agreement with the doctor, stop taking hormonal drugs two days before blood sampling;
- do not eat or smoke for 3 hours before the procedure;
- avoid physical and emotional stress the day before the study.
The TSH level can change quite a lot during the day, so repeated tests should be taken at about the same time.
Indications for the procedure
A blood test for TSH is prescribed to diagnose thyroid disorders and assess its functions, as well as monitor the effectiveness of treatment. In addition, the study is widely used in the diagnosis of the endocrine form of female infertility.
Symptoms of hyperthyroidism and hypothyroidism are the basis for referral in clinical practice.
As a screening method, the TSH test is performed on newborns who are at risk for thyroid disease.
Prices and terms
Service name
Term
Price
Stimulating antibodies to the thyroid-stimulating hormone (anti-rTTG) receptor
Description
rusyotropic receptor synonyms hormone, thyroid-stimulating immunoglobulin
Synonyms (eng): Thyroid-stimulating immunoglobulins, TSIs, Thyroid-stimulating hormone receptor antibodies, TSH receptor antibodies, TSHRAbs, TSH binding inhibitor immunoglobulin, TBII, TRAb
Indicator (s): Antibodies to thyroid-stimulating hormone receptor
Method (s): Enzyme-linked immunosorbent assay (ELISA)
Type of container and preanalytical features: Biochemical tube with clotting activator, 6 ml (red or brown) )
The receptor for thyroid stimulating hormone is g lycoprotein of two subunits (alpha and beta), expressed on the surface of the follicular cells of the thyroid gland, responsible for the regulation of its function.The interaction of TSH with the receptor leads to the production of thyroid hormones and the growth of thyroid follicular cells. In the case of increased activation of the receptor, excessive synthesis of the hormone and cell growth occurs, which leads to thyrotoxicosis and the formation of goiter. The main cause of receptor hyperactivation is the formation of stimulating antibodies that bind to the receptor extracellular alpha subunit.
In general, antibodies to the TSH receptor can be divided into 3 categories: stimulating, blocking, and neutral.It should be noted that all three types of antibodies can be present in one patient. The cause of the development of Graves’ disease is an autoimmune process with the formation of stimulating antibodies to the TSH receptor. The pathogenetic role of these antibodies was first proven in 1956, when D.D. Adams reproduced the clinical picture of Graves’ disease by injecting plasma from the patient. Since the TSH receptor is located, in addition to thyroid cells, also on fibroblasts, adipocytes and lymphocytes, one of the symptoms of the disease is ophthalmopathy, manifested by protrusion of the eyeball and inflammation of the membranes of the eye, which is associated with the binding of antibodies to these cells in the retrobulbar tissue.Blocking antibodies, interacting with the surface beta subunit, interfere with the interaction of the receptor with TSH. This leads to a decrease in thyroid function, the formation of hypothyroidism and thyroid atrophy. These antibodies are detected in patients with Hashimoto’s atrophic thyroiditis. The presence of blocking antibodies in Graves’ disease may cause fluctuations in thyroid function in these patients. Neutral antibodies are directed to epitopes located outside the TSH binding point, so they do not have a blocking effect.Their pathogenetic role is unknown.
Testing for antibodies to the TSH receptor is necessary if Graves’ disease is suspected in pregnant women. It is important to note that these antibodies can cross the placental barrier and affect the fetal thyroid gland. Thus, stimulating antibodies cause the development of transient hypothyroidism in the newborn, blocking antibodies – transient hypothyroidism. An important role is played by the determination of antibodies to assess the risk of recurrence in patients treated with thyreostatics.The presence of a high concentration of antibodies in the blood is considered a marker of a high risk of recurrence.
The methods used in laboratory practice do not make it possible to distinguish between the presence of stimulating or blocking antibodies in the blood. The LATS test used for these purposes is complex and laborious, which makes it difficult to use it in routine research. The specificity of the test reaches 100%, since antibodies to the TSH receptor are almost never found in healthy people. However, the sensitivity of the test is about 80% due to the low concentration of antibodies in the blood serum.Thus, a negative test result does not rule out disease.
When prescribed
Differential diagnosis of hypothyroidism and hyperthyroidism.
Diagnosis of Graves’ disease (diffuse toxic goiter).
Differential diagnosis of ophthalmopathy and peritibial myxedema.
Preparation for analysis
No special preparation required. The study is carried out on an empty stomach (do not eat for 3 hours before the study, you can drink water).
Interpretation
Normally, the level of antibodies in the blood is ≤ 1.75 IU / L.A negative result may indicate the absence of disease, a low risk of recurrence, and control of the disease during therapy. At the same time, it should be remembered that a negative result in this case does not allow the disease to be ruled out.
A positive result (> 1.75 IU / L) almost always indicates the development of Graves’ disease, since these antibodies are rarely found in healthy individuals. In newborns, such a result may indicate transient thyrotoxicosis / hypothyroidism, and in individuals treated for Graves’ disease, a high risk of recurrence when combined with other indicators.In some cases, the presence of antibodies to the thyroid-stimulating hormone receptor is noted in patients with Hashimoto’s thyroiditis.
References
- Lapin S.V. Totolyan A.A. Immunological laboratory diagnostics of autoimmune diseases. Publishing House “Chelovek”, St. Petersburg – 2010
- Tietz Clinical guide to laboratory tests. 4-th ed. Ed. Wu A.N.B. – USA, W.B Sounders Company, 2006,1798 p.
- Conrad K, Schlosler W., Hiepe F., Fitzler M.J. Autoantibodies in Organ Specific Autoimmune Diseases: A Diagnostic Reference / PABST, Dresden – 2011.
- Conrad K, Schlosler W., Hiepe F., Fitzler M.J. Autoantibodies in Systemic Autoimmune Diseases: A Diagnostic Reference / PABST, Dresden – 2007.
- Gershvin ME, Meroni PL, Shoenfeld Y. Autoantibodies 2nd ed./ Elsevier Science – 2006.
- Shoenfeld Y., Cervera R, Gershvin ME Diagnostic Criteria in Autoimmune Diseases / Humana Press – 2008.
- Tozzoli, R., Bagnasco, M., & Villalta, D. Thyrotropin Receptor Antibodies / Autoantibodies, 375–383 – 2014
- Weetman, A.P. (2014). Thyroid Disease. / The Autoimmune Diseases, 557–574 – 2014.
- Test System Manufacturer’s Manual
RULES FOR PREPARATION FOR LABORATORY STUDIES
Preparation for blood tests
Complete blood count
It is recommended to donate blood in the morning, from 8 to 11 am, on an empty stomach. It is advisable to exclude fatty, fried and alcohol from the diet 1 – 2 days before the examination.
In the morning, it is recommended to drink 1-2 glasses of regular still water, this will reduce the viscosity of the blood, and allow you to take a sufficient amount of biomaterial for the study.
You should not donate blood immediately after physiotherapy procedures, instrumental examinations, X-ray and ultrasound examinations, massage and other medical procedures.
For 1-2 hours before donating blood, refrain from smoking, do not drink juice, tea, coffee. Eliminate physical stress (exercise, running, fast climbing stairs), emotional excitement.It is recommended to rest and calm down 15 minutes before donating blood.
Blood biochemistry
On the eve of the study (within 24 hours), exclude alcohol, intense physical activity, medication (as agreed with the doctor).
On the evening before the study, a light dinner without fatty foods.
For 1-2 hours before donating blood, refrain from smoking, do not drink juice, tea, coffee. Eliminate physical stress (exercise, running, fast climbing stairs), emotional excitement.It is recommended to rest and calm down 15 minutes before donating blood.
You should not donate blood immediately after physiotherapy procedures, instrumental examinations, X-ray and ultrasound examinations, massage and other medical procedures.
When monitoring laboratory parameters in dynamics, it is recommended to carry out repeated studies under the same conditions – in the same laboratory, donate blood at the same time of day, etc.
Urea
One or two days before the study, it is necessary to follow a diet: to refuse the use of food rich in purines – liver, kidneys, and also to limit meat, fish, coffee, tea in the diet as much as possible.Intense physical activity is contraindicated.Cholesterol, lipid profile
After 10-12 hours of fasting. Two weeks before the study, it is necessary to cancel the drugs that lower the level of lipids in the blood, if the goal is not to determine the hypolipidemic effect of therapy with these drugs.Glucose
When donating blood for glucose (in addition to the basic requirements for preparing for tests), do not brush your teeth and chew gum, drink tea / coffee (even unsweetened).A cup of coffee in the morning will dramatically change your glucose readings. Contraceptives, diuretics, and other medications also work.Glucose tolerance test
Performed only if preliminary results of fasting glucose are available, without exercise. Plasma glucose is measured on an empty stomach and 2 hours after glucose loading.
Glucose tolerance test is performed at normal and borderline (at the upper limit of the norm) blood glucose levels.The test is recommended if hyperglycemia was previously registered at least once during a stressful situation (myocardial infarction, stroke, pneumonia, etc.). The test is carried out after the condition has stabilized.Haptoglobin
Before the study, it is necessary to exclude the intake of drugs: dapsone, methyldopa, sulfasalazine, estrogens, oral contraceptives, tamoxifen, androgens.Alpha-2-macroglobulin
Abstain from meat food for three days before the study.
Hormones
Blood for hormonal studies must be donated on an empty stomach in the morning, from 8 to 11 am.
In the absence of such an opportunity, blood for some hormones can be donated 4-5 hours after the last meal in the daytime / evening hours (except for those studies for which blood must be donated strictly in the morning). Before taking tests, you must consult a specialist doctor.
1-2 days before the test, exclude foods high in fat from the diet, the last meal should not be plentiful.Psychoemotional and physical comfort is required 1 day before the study (calm state without overheating and hypothermia).
Thyroid hormones
When checking the level of thyroid hormones for the first time, stop drugs that affect the function of the thyroid gland 2-4 weeks before the study (after consultation with the attending physician). When monitoring treatment – exclude taking drugs on the day of the study and be sure to note this in the referral form (also note information about taking other drugs – aspirin, tranquilizers, corticosteroids, oral contraceptives).It is recommended to donate blood for TSH before 10 am.Sex hormones
In women of reproductive age, the results of hormonal studies are influenced by physiological factors associated with the phase of the menstrual cycle. During the examination for sex hormones, indicate the phase of the menstrual cycle. Hormones of the reproductive system must be taken strictly according to the days of the cycle:
LH, FSH – 2-3 days of the cycle;
Estradiol – 2-3 or 21-23 days of the cycle;
Progesterone – 21-23 days of the cycle, with a 28-day cycle.If the cycle is more or less 28 days, then 7 days before the expected menstruation.
17-OH-progesterone, Testosterone – 2-3 days;
Dihydrotestosterone, Androstenediol glucuronide, Free testosterone, Androstenedione, Globulin, which binds sex hormones, Antimüllerian hormone – for 2-3 days of the cycle.Prolactin, Macroprolactin – on day 2-3 of the menstrual cycle, donate blood in the morning at rest, exclude palpation of the mammary glands before examination.Macroprolactin is determined if prolactin is greater than 30 ng / ml.
Anti-Müllerian hormone (AMH / MIS), Inhibin B
For women, the study is carried out on the 3-5th day of the menstrual cycle. 3 days before blood sampling, exclude intense sports training. The study should not be carried out during any acute illness. Do not smoke 1 hour before blood sampling.Parathyroid hormone
It is recommended to donate blood before 10 am.
Epinephrine and norepinephrine
For 8 days before the study, exclude drugs: salicylates, β-blockers. 1 day before the study, it is necessary to refrain from heavy physical activity, exclude alcohol, coffee, tea, B vitamins, bananas.Renin, angiotensin
Before the study, exclude the intake of estrogens (in 1-2 months), diuretics (in 3 weeks), antihypertensive drugs (in one week).Take blood while sitting or standing.Aldosterone
By agreement with the doctor, 8 days before the study, cancel antihypertensive drugs, β-blockers, laxatives, corticosteroids, diuretics, antidepressants. Discontinue aldosterone antagonists 3 weeks prior to the study.ACTH, cortisol
Since ACTH and cortisol are stress hormones, you need to calm down and relax for 20 minutes before donating blood.Any stress causes an unmotivated release of these hormones into the bloodstream, which will lead to an increase in this indicator.
The level of these hormones changes cyclically during the day, therefore the most informative results of studies carried out in the morning before 9 o’clock.Insulin, C-peptide
Donate blood strictly in the morning.Gatrin 17, Gastrin-17 stimulated, pepsinogen I, pepsinogen II, H. Pylori IgG
Blood for research must be taken strictly on an empty stomach after a 12-hour fast.
For 1 week before the study, refrain from taking medications that affect gastric secretion: Pepcedin, Zantac, Nizax, Ranimex, Esofex, Losec, Somac, Ranixal, Ranil.
One day before the study, refrain from taking medications that neutralize hydrochloric acid secreted by the stomach: Alsucral, Balancid, Prepulsid, Metropam, Librax, Gaviscon.
If you have any difficulties with drug withdrawal, be sure to inform your doctor about it.
For 3 hours before donating blood, refrain from smoking.
Hemostasis
Basic coagulogram (prothrombin time, INR, APTT, fibrinogen)
It is preferable to take blood in the morning on an empty stomach, after 8-14 hours of the night fasting period In the morning it is recommended to drink 1-2 glasses of plain still water. It is permissible to donate blood in the afternoon 4 hours after a light meal. If you are taking medications (anticoagulants, antiplatelet agents), be sure to notify your doctor about this and tell the procedural nurse about this during blood sampling.
Protein C, Protein S, von Willebrand factor
Do not conduct a study during acute periods of illness and while taking anticoagulant drugs (at least 30 days must elapse after discontinuation). Biomaterial for research must be taken on an empty stomach. At least 8 hours should elapse between the last meal and blood collection. Women are not advised to take hemostasis tests during menstruation.
Tumor markers
PSA (total, free)
After prostate biopsy and prostate massage, blood for PSA determination can be donated no earlier than 2 weeks later.The post-surgical PSA level is determined no earlier than 6 weeks after the intervention.CA-125 ovaries – it is more informative to donate 2-3 days after menstruation.
Blood tests for infections
For 1-2 days before the study, exclude foods high in fat from the diet. 2 days before donating blood for viral hepatitis, exclude citrus fruits, orange fruits and vegetables from the diet.
The results of studies for the presence of infections depend on the period of infection and the state of the immune system, therefore, a negative result does not completely exclude infection. At an early stage of the disease, seroconversion occurs (absence of antibodies in the acute period of the disease).
In doubtful cases, it is advisable to re-analyze after 3-5 days.
A blood test for the presence of IgM antibodies to infectious agents should be carried out no earlier than 5-7 days from the moment of illness, and IgG, IgA antibodies no earlier than 10-14 days.This is due to the timing of the production of antibodies by the immune system and their appearance in the blood in a diagnostic titer.
It is very important to follow these recommendations exactly, since only in this case reliable research results will be obtained.
When monitoring laboratory parameters in dynamics, it is recommended to carry out repeated studies under the same conditions – in the same laboratory, donate blood at the same time of day, etc.
Diagnostic Medical Center ─ Median Laboratory
Diagnostic Medical Center ─ Median Laboratory | Multidisciplinary private clinic in Kiev
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m.Kiev Boryspil metro station Shchaslive village
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ULTRASONIC CAVITATION
In the Median clinic, a pulsed vacuum thermomassage and cavitation apparatus Drumroll V-05 (Czech Republic) is used, with the help of which cosmetologists can carry out high-frequency pulsed vacuum massage, thermal massage and ultrasonic cavitation at the same time.Thanks to an integrated approach, the effectiveness of the procedures increases, which allows you to achieve a pronounced result in the form of a figure and face contour correction in a minimum number of sessions and without any effort on the part of the client.
Inquiries for traveling abroad
In our medical center, you can issue medical certificates confirming that the passenger is vaccinated or has had the SARS-CoV-2 coronavirus.The certificate allows you to travel freely to some European countries, etc.
REMOVAL FROM THE “VDOMA” APP DISCOUNT FOR PCR TEST -10%
At the Median Medical Center you have the opportunity to complete your two-week self-isolation ahead of schedule. To do this, you need to pass a PCR test at one of our branches or invite a specialist home.Take a PCR test for coronavirus in our laboratory and get a 10% discount
PLANNING A HOLIDAY? DISCOUNT -10% ON PCR TEST FOR COVID – 19
Plan your vacation with Median Medical Center. We provide a DISCOUNT -10% for PCR test in COVID – 19 for everyone who is going on vacation.
We carry out PCR testing within 6-24 hours.For testing, a preliminary appointment is required by phone
Consultation
Analyzes
Aspartate aminotransferase (AST)
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Blood group + Rh factor
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Analysis of feces for protozoan cysts by the enrichment method
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Coprogram
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Detailed blood test
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General blood test
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Alanine aminotransferase (ALT)
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Urine according to Sulkovich (calcium in urine, qualitative definition of Art.cloudy)
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Mononuclear cells (virocytes)
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A detailed blood test cito (URGENT) On Yaroslavskaya55 execution is possible in 2 hours
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General urine analysis
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Scraping for enterobiasis
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Analysis of feces for eggs of worms (enrichment method)
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Urine diastasis (quantitative)
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Clotting time according to Sukharev
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PLASMA THERAPY
Plasma therapy is officially recognized by medicine as an innovative method of cellular autorejuvenation.The procedure is considered as safe as possible, because it is injected into the skin by injecting its own platelet-rich plasma (PRP). Accordingly, we have an absolute bioavailability of the drug to which there is no allergy.
Author: Yakob Natalia Emelyanovna
TOXOPLASMOSIS
Toxoplasmosis is a parasitic disease from the group of animal diseases that are dangerous to humans.The greatest danger is for pregnant women and persons with immunodeficiency. These risk groups are given special attention in the diagnosis, prevention and treatment of toxoplasmosis.
Author: median
NONVIRUSOLOGICAL LABORATORY MARKERS IN THE CONTEXT OF COVID-19 DISEASE
More than 100 years ago, the influenza pandemic or the so-called “Spanish flu” in 1918 claimed at least 50 million lives worldwide (according to some estimates, 100 million).Now humanity is facing another pandemic – the outbreak of the new coronavirus SARS-CoV-2, forcing us to live with this virus, possibly for a long time. Since December 2019, scientists and doctors have learned a lot about this disease called COVID-19 (1). The mortality rate for COVID-19 is estimated in the range of 0.5 to 3.5%, and the clinical prognosis for the disease is: 40% mild, 40% moderate, 15% severe, 5% critical.
Author: median
HOW TO PROTECT YOURSELF FROM CORONAVIRUS?
Panic in media and social networks has created the basis for manipulation and the spread of fakes.Many companies offer products, medicines, dietary supplements or even vaccines that have you protected against the new virus. However, so far there is no specific treatment and vaccine for the Wuhanska coronavirus. Does not protect against SARS-CoV-2 coronavirus:
Author: median
WHAT IS MASSAGE?
Massage is a mechanical, dosed effect on the skin, muscles and internal organs of a person, used as a concomitant therapy for various health problems.
Author: Antonov Valery Viktorovich
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PIXEL
90,000 Thyroid Research – Research
Main indications for the study of the thyroid gland (TG)
- Diffuse-nodular goiter.
- Thyroiditis.
- Hyperthyroidism.
- Congenital diseases of the thyroid gland.
Purpose of the study
- Determination of functional activity and anatomical and topographic characteristics (area of location, presence and features of aberrant tissue, indication of the structure and shape of the gland, identification of structural disorders) thyroid gland.
Contraindications to research
- Pregnancy.
Preparation for examination
- Stop hormone replacement therapy within 3-4 weeks *.
- For 2 weeks, stop taking thyreostatics *.
- The study should not be carried out within 3-4 weeks after intravenous administration of iodine-containing contrast agents.
- Compliance with a diet with the abolition of iodine-containing products (seafood, iodized salt, nuts, persimmons, dairy products) for 2 weeks before the study.
- Taking cordarone blocks the thyroid gland.
* in agreement with the endocrinologist – it is possible to conduct studies while taking medications.
Bring with you
- Passport.
- Referral for research.
- Discharge epicrisis, advisory opinions, results of ultrasound, thyroid scintigraphy, CT, as well as tests for hormones (TSH, T3, T4, TSH, antibodies), endocrinologist records and other data that allow a more detailed study of the history of the disease.
- The results of our research together with illustrations (if you are with us again).
- If you are undergoing research at the expense of the compulsory health insurance fund (MHI), you must additionally provide a referral in the form 057 / u-04, a medical policy and SNILS (for more details, see the MHI section).
Attention! Dear patients, we would like to remind you that immediately after an RFP injection you become a source of ionizing radiation, which means that contact with you is associated with radiation exposure.Considering this, during the waiting period for scanning, it is necessary to use the toilet located in the patient waiting room; it is highly undesirable to leave the patient waiting room, walk along the corridor. For the same reason, there should be no attendants in the room where you are waiting for the scan. Warn them about this in advance and offer to wait for you in the laboratory hall or outside the laboratory.
Do not accompany pregnant women and small children!
From the patient room at the time determined by the doctor, the patient is invited to the tomograph for scanning.
Attention! When scanning the patient’s body (in the neck and chest area), there should be no objects containing metal (chains, jewelry, etc.). You are kindly requested to remove all these items from yourself before the start of the study, so as not to waste time when placing them in the tomograph. During scanning, it is necessary to be in a state of complete rest, breathing should be even, calm, you cannot move, try not to swallow. It is important to remember that any movement can affect image quality.The time spent by the patient in the tomograph is on average 15-20 minutes.
After scanning, the patient is awaiting a conclusion and is released home.
90,000 🧬 Why are thyroid hormones tested?
The thyroid gland controls the body’s metabolism, from energy production to regulating body temperature. Failure in her work leads to serious health problems. We will tell you how tests for thyroid-stimulating hormone, thyroid hormones and thyroglobulin antibodies help to find out what is happening with the thyroid gland and choose the right treatment.
When doing it
Doctors order thyroid hormone tests to check for abnormalities in the thyroid gland. The problem may be in an elevated level, that is, in hyperthyroidism, or in deficiency – hypothyroidism.
“Any healthy person should be tested for thyroid-stimulating hormone, or TSH, once a year. This test is included in many screenings because the symptoms of hypothyroidism are of varying severity.In the early stages, people may not suspect that something is wrong with them, – advises the Semeynaya clinic therapist Alexander Lavrishchev.
According to Alexander Lavrischev, popular science articles often write that hypothyroidism is when a person gets noticeably fat, feels sleepy or swells all the time. But gradual unreasonable weight gain and edema are already extreme manifestations of an advanced form of hypothyroidism, which he saw only 2-3 times in 11 years of practice.
In practice, the doctor begins to suspect that a person may have hypothyroidism when the possible manifestations of the disease have not yet become so bright: for example, a person’s body temperature is constantly slightly lowered. Depression and decreased mood also give the doctor a reason to assume that hypothyroidism may be the problem.
“People with pronounced hypofunction of the thyroid gland have an accelerated heartbeat, high blood pressure, tremors of the hands and sometimes a goiter can be seen on the neck – an enlarged thyroid gland, as in the picture in the textbook for Graves’ disease.But I also met only two or three such patients. As a rule, the symptoms are milder: patients with suspected hyperfunction of the thyroid gland are more often irritable, anxious, they have an accelerated speech, high body temperature, ”Alexander Lavrishchev shares his observation.
Alexander Lavrishchev clarifies that, in addition to tests for TSH, which every person must take once a year, in practice, therapists rarely use other tests for thyroid hormones, because they are needed mainly by endocrinologists, and they are prescribed according to indications.
It makes sense to do additional tests only if there are changes in TSH, or if a person has already been diagnosed – for example, hyperthyroidism or hypothyroidism. If a person is already being treated, and the doctor informs the patient that he should have a certain target level of TSH and T4, then it makes sense to donate blood for both tests at the same time.
Healthy people without complaints do not need to be tested for T4, or for other hormones besides TSH. Any laboratory test rates are just the average indicator of most healthy people in the population.Analytical data alone are not enough to understand what is happening with the patient. It is imperative to consult a doctor who will take into account the complaints and symptoms, and will be able to distinguish a real illness from an accidental error.
Abroad, it is believed that there is no need to specially prepare for the analysis. But in our country it is customary to donate blood in the morning, refusing food and cigarettes 3 hours before the study. You can drink clean non-carbonated water.
Blood test for thyroid-stimulating hormone
What it is.A venous blood test, in which the concentration of thyroid-stimulating hormone (TSH) is determined in a sample. Allows you to understand how effectively the thyroid gland works.
“Thyroid stimulating hormone, or TSH, is a pituitary hormone that regulates the function of the thyroid gland,” says Zilya Kalmykova, endocrinologist at GMS Clinic. “It is prescribed for examination for thyroid diseases, as well as a screening.”
How it works.TSH works like a biochemical “gas pedal”. With it, the pituitary gland – a small gland located at the base of the brain – controls the thyroid gland. If there are too few hormones in the blood, the pituitary gland increases the production of TSH. This causes the thyroid gland to increase the synthesis of its own hormones. And if there are too many of them in the blood, the pituitary gland stops producing TSH. In healthy people, this leads to a decrease in the production of thyroid hormones.
Why appoint.If hypothyroidism is suspected – a condition in which the thyroid gland does not produce enough hormones, and hyperthyroidism, in which, on the contrary, it is overly active, and there are too many hormones in the blood.
How to understand the results. All over the world, it is believed that the normal level of TSH in the blood of an adult is 0.3-5.0 mIU / L. In our country, the normal range of TSH is already: 0.32-3.0 mIU / L. If the TSH in the blood is less than normal, the doctor has the right to assume that the thyroid gland is working too actively.And if there is too much TSH, most likely the thyroid gland is not active enough.
At the same time, the analysis for TSH does not allow us to understand what is the cause of the problems with the thyroid gland, and how far the disease has gone. To deal with these issues, doctors prescribe additional tests.
Free thyroxine blood test
What it is. A venous blood test, in which the concentration of free thyroxine (T4) is determined in a sample.Most often, an analysis is prescribed if the test results for TSH are higher or lower than normal.
According to Zili Kalmykova, T4 is a hormone produced by the thyroid gland itself. It increases the rate of many reactions of cellular metabolism – for example, the breakdown of fats and the metabolism of carbohydrates.
How it works. Information about how much free T4 a person has in his blood allows us to clarify the stage of the disease. In the body, T4 is present in two forms: inactive, that is, associated with the protein thyroxine binding globulin (TSH), and active, that is, not associated with TSH.An analysis for free T4 is prescribed for the purpose of a more detailed assessment of the thyroid status. For example, to diagnose hypothyroidism or hyperthyroidism syndrome.
Why appoint. To figure out whether a person is sick, or so far only at risk. For example, if a person has an elevated TSH level, and at the same time a normal T4 level, then he has a risk of developing hypothyroidism. And if he has a high TSH level and a low T4 level, the disease has already developed.
How to understand the results.Both in our country and abroad, the free T4 rate is 12-30 pmol / l. However, a person may have symptoms of hyperthyroidism or hypothyroidism, even if free T4 is within the normal range. To avoid mistakes, this analysis, as a rule, is prescribed together with TSH – it turns out much more informative.
What the test results can say:
- TSH is slightly elevated, but free T4 is normal – mild thyroid insufficiency, which can develop into hypothyroidism.As a rule, in this situation, an additional test for thyroid antibodies is prescribed. This allows you to understand if the person needs immediate treatment.
- TSH high, free T4 low – hypothyroidism requiring treatment.
- TSH low, free T4 low – secondary hypothyroidism associated with insufficient work of the pituitary gland, or the result of a serious disease not associated with the thyroid gland.
- TSH low, free T4 high – hyperthyroidism requiring treatment.
If you wish, everyone who is interested in the health of their thyroid gland can get tested for TSH and T4. At the same time, it is important to remember that it is impossible to diagnose oneself, and even more so to prescribe treatment.
In addition, both hypothyroidism and hyperthyroidism can have many reasons – from a lack or, on the contrary, an excess of iodine in food to tumors or autoimmune diseases. Only a doctor at a personal appointment can figure out what exactly is happening with the patient.
Blood test for total triiodothyronine (T3)
What it is. A venous blood test, in which the concentration of total triiodothyronine (T3) is determined in a sample. Typically, the test is prescribed along with TSH and T4 to determine if a person has hyperthyroidism.
Zilya Kalmykova says that T3 is a hormone very similar to T4 in its functions, but at the same time it is 3-4 times more active, so it is produced 10 times less.A total T3 test is prescribed to assess thyroid status in detail.
How it works. Like T4, T3 exists in the body in a free and bound form. But since there is little of it, in laboratory practice, both forms are determined at once – this is called total triiodothyronine. And since there is less total T3 in the body, fluctuations in its level in some cases can give more information than an analysis for free T4.
Why appoint.To figure out whether a person has hyperthyroidism or not. There are situations when a patient has symptoms of hyperthyroidism – heart palpitations, weight loss, trembling and sweating, tests show low TSH levels, but free T4 is normal. To clarify what is happening to the person, the patient is prescribed an analysis for free T3.
How to understand the results. Abroad, the norm of total T3 is 1.1-2.6 nmol / l. In our country, the norm is wider – 1.23-3.0 nmol / l. By themselves, these indicators say almost nothing.It is necessary to evaluate the result of the analysis, focusing on the results of tests for TSH and free T4.
If a person has symptoms of hyperthyroidism, while the level of TSH is low, and free T4 is normal, but:
- T3 above normal – most likely, he still has hyperthyroidism
- T3 is normal – most likely, there is no hyperthyroidism, and the symptoms are associated with other causes.
Blood test for antibodies to thyroid proteins
What it is.A venous blood test, which measures the level of antibodies to thyroid proteins in a sample. These tests allow you to identify not only the very fact of problems with the thyroid gland, but also to clarify their real cause.
According to Zili Kalmykova, endocrinologists prescribe antibodies to thyroglobulin to assess the risk of recurrence after radical treatment of certain thyroid diseases. For example, to exclude recurrence of thyroid cancer after its removal.
How it works. TSH is a protein made by thyroid cells. Thyroid peroxidase is an enzyme that is found inside the cells of the thyroid gland, and thyroid-stimulating hormone receptors are proteins with which the thyroid gland receives orders from the pituitary gland. And antibodies are protective proteins that destroy viruses, microbes, and cancer cells. If antibodies to thyroid proteins appear in a person’s blood, this means that its cells are attacked by its own immune system.
Why appoint. To distinguish autoimmune hypo- or hyperthyroidism from a disease associated with other causes, such as iodine deficiency or iodine deficiency.
How to understand the results. Normally, antibodies to the thyroid gland should not exceed 50 IU / ml. If their number increases, then it’s not amiss.
If the number of antibodies to TSH increases, this may indicate chronic Hashimoto’s thyroiditis, hypothyroidism, diffuse toxic goiter and sometimes some rare autoimmune diseases such as pernicious anemia.At the same time, sometimes the level of antibodies can increase, including in healthy people – for example, in older women.
If the number of antibodies to thyroid peroxidase increases, this may indicate Hashimoto’s thyroiditis, diffuse toxic goiter, neonatal hyperthyroidism, congenital hypothyroidism, postpartum thyroiditis, euthyroid goiter. These antibodies can also increase in other conditions, such as idiopathic hypothyroidism, adenoma, and thyroid cancer.And also – for all types of autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, insulin-dependent diabetes mellitus, autoimmune adrenal insufficiency and pernicious anemia. Antibody levels can be elevated in 5% of healthy men and women.
If the level of antibodies to TSH receptors increases, this may indicate thyroid atrophy, hypothyroidism, diffuse toxic goiter, euthyroid goiter, acute and subacute thyroiditis, neonatal hyperthyroidism and congenital hypothyroidism.In this case, the level of antibodies can increase with a viral infection.
Although a blood test for antibodies to thyroid proteins does help to clarify the diagnosis, it will not be possible to figure it out without the help of a doctor – after all, there are probably too many options.
Important to remember
- It makes sense for every person to be tested for TSH once a year.