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Thyroid tests: which ones to do and why are they so important? Symptoms, preparation, norms

The thyroid doesn't hurt and the symptoms of disease can be easily ignored. Take care of prevention and get your thyroid tested.

Matthew Podlecki - AuthorAuthorMatthew Podlecki
Matthew Podlecki - Author
AuthorMatthew Podlecki
Natu.Care Editor

At Natu.Care, she educates about healthy lifestyles and debunks dangerous myths, contrasting them with the results of the latest scientific research. Additionally, she is interested in new technologies and their impact on health and everyday life.

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Thyroid tests: which ones to do and why are they so important? Symptoms, preparation, norms
29 April, 2024
17 min
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Thyroid problems are experienced by more than 22% of Poles of all ages, and most do not know it. Symptoms are easily trivialised and explained away by other ailments. 

Fatigue and lethargy are blamed on overwork. After all, weight fluctuations and hair loss are down to poor diet and stress. You'll buy a cream for dry skin and wrap yourself in a blanket or wear thicker gloves when you're cold. But this only "treats" the symptoms. The most important thing is to find out the cause. Thyroid tests and consultation with your doctor will be key here.

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From this article you will learn:

  • What symptoms thyroid disease can give
  • .
  • What thyroid tests will help diagnose health problems
  • .
  • How often you should get your thyroid tested
  • .
  • How to prepare for thyroid testing
  • .
  • Whether you can do preventive tests at home
  • .

If you notice the symptoms described in this article in yourself, have your thyroid examined and consult an endocrinologist. Early recognition of abnormalities will allow for effective treatment.

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Do you need help?
. Make an appointment
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See also what other examinations are worth doing:

Indications for a thyroid test

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The thyroid gland is a small butterfly-shaped organ. It is located at the anterior base of the neck, just below the laryngeal cartilage. Despite its inconspicuous size, it is one of the most important glands in the entire body, as it regulates many processes, including metabolic metabolism, growth and development of the body, cardiovascular function, and the maintenance of mental-emotional balance.

Thyroid dysfunction is difficult to diagnose unequivocally. Symptoms are usually painless, and sometimes there are so many that it is difficult to imagine that they are caused by a dysfunction of just one organ. 

Both the symptoms of hypothyroidism and undothyroidism can be divided into four groupsand:

  • neurological,
  • .
  • psychological,
  • .
  • changes in appearance,
  • .
  • others,
  • .

Learn about these highlights, compare them and consider whether it is worth opting for comprehensive thyroid testing.

Symptoms that should prompt thyroid testing

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Problem

Changes in appearance

Neurological symptoms

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Psychiatric symptoms

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Other

Hypothyroidism

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hair loss

breakable nails

overweight and obesity

rash

dry skin (especially on knees and elbows)

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frequent feeling of coldness

frequent feeling of coldness

tingling in the limbs

pain in muscles and joints

fatigue

insomnia

depression

apathy

psychotic and paranoid problems

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infertility

irregular menstrual periods

constipation

weak libido

low libido

low blood pressure

Hypothyroidism

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swollen eyelids

redness and exophthalmos of the eyes

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fluffy, weak hair

fatty hair

problems putting on weight

problems gaining weight

sleeping problems

general weakness

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general weakness

general weakness

hot flashes

general weakness

hot flashes

anxiety

irritability

depression

fatigue

insomnia and difficulty falling asleep

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high blood pressure

irregular heartbeat (palpitations)

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diarrhoea

diarrhoea

problems with fertility and menstruation

problems with fertility and menstruation

Do you notice at least some of these symptoms in yourself? That's reason enough to test your thyroid and consult your doctor

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Do you need help?
. Make an appointment
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Thyroid problems mean poor condition hair and nails. Find out how you can help them:

What thyroid tests can be performed?

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The most important thyroid tests are included in so-called thyroid packages or thyroid profiles. You will find two sets of thyroid test packages on offer at diagnostic centres and laboratories - basic and extended. These are needed to detect diseases directly or indirectly related to the thyroid gland, as well as to monitor the treatment of this gland.

Basic thyroid tests

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The TSH test

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Although TSH (thyroid hormone, thyrotropin) is produced by the pituitary gland, it is crucial for the functioning of both the thyroid gland itself and our body. Determination of TSH levels is a fundamental test in the diagnosis of thyroid diseaseand

Too low concentrations suggest hyperthyroidism, Graves-Basedow disease or Sheehan syndrome. Conversely, too high levels suggest hypothyroidism, Hashimoto's disease or adrenal insufficiency .

  • The TSH reference values for an adult typically range from: 0.45-4.5 µU/ml. 
  • .
  • The TSH concentration also depends on age or lifestyle.
  • .
  • Variations can also be caused by diet, medication taken, pregnancy or menstruation. TSH limits move upwards with age. A TSH concentration of 4.2 µU/ml may be as optimal for a 30-year-old woman as 7.8 µU/ml is for an 86-year-old.
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The reference values for hormone concentrations will also vary from laboratory to laboratory, so results must always be interpreted according to the accepted ranges at a particular site.
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Dr Witold Tomaszewski.

Witold Tomaszewskidoctor of medical sciences

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Testing fT3 and fT4

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Under the influence of TSH, the thyroid gland produces, among other things, the hormones T3 (triiodothyronine) and T4 (thyroxine), which are responsible for many processes in the body, including the use of energy, maintenance of temperature and body weight. They also support muscle strength and nervous system function. Determination of fT3 and fT4 is important in the diagnosis of thyroid disease, and the results should always be interpreted in combination with TSH levelsand.

  • If the TSH concentration is elevated, the fT4 concentration will be in the lower limits or below reference values - this suggests hypothyroidism 
  • .
  • If TSH levels are reduced, fT4 will be at or above the upper limits of accepted reference values - this in turn suggests the likelihood of hyperthyroidism .

The accepted reference ranges  for fT3 and fT4 oscillate within:

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  • fT3: 4.0-7.8 pmol/l
  • .
  • fT4: 10-25 pmol/l
  • .
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A single result from these tests will not diagnose any disease, but may prompt your doctor to perform additional tests to help fully assess thyroid disorders.
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Dr Witold Tomaszewski.

Witold Tomaszewskidoctor of medical sciences

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Extended thyroid examination

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The extended thyroid testing package includes, in addition to the testing of the hormones mentioned above, the determination of antibody levels, which may be useful in the more accurate diagnosis of specific thyroid disorders.

Extended Thyroid Testing

Anti-TPO test

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Determination of anti-thyroid peroxidase antibodies helps in the diagnosis of Hashimoto's disease (even when TSH and thyroid hormone results are normal), autoimmune thyroid disease or Graves-Basedow disease, among othersand.

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Anti-TG testing

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Determination of antibodies to thyroglobulin (a protein produced by the thyroid gland) can identify autoimmune diseases, as well as monitor patients undergoing treatment for thyroid cancer .

Trab test

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Antibodies to the TSH receptor are characteristic of Graves-Basedow disease .

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Do you need help?
. Make an appointment
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Diagnosis and complementary tests

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Thyroid disorders can be associated with or become the cause of many other ailments and conditions, such as neurological, cardiovascular and skeletal systems. If you have confirmed thyroid abnormalities, check other parameters and indicators.

Morphology - blood tests

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Both hyperthyroidism and hypothyroidism can be responsible for the development of dangerous conditions. Hypothyroidism can contribute to anaemia, while hyperthyroidism caused by Graves-Basedow disease can lead to anaemiaand.

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Regular morphology will control, among other things, the number of red blood cells and the general state of your body, so it is worth doing it at least once a year.
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Dr Witold Tomaszewski.

Witold Tomaszewskidoctor of medical sciences

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Thyroid USG

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It will help to accurately identify and assess the location, structure and size of the thyroid gland and detect nodules or goitre with greater accuracy. It will also be useful in monitoring the progress of therapy and treatment of thyroid diseaseand.

Lipid profile

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People with hypothyroidism are at risk of atherosclerosis and myocardial infarction caused by excessive cholesterol build-up in the body . Checking will help you manage your diet appropriately to prevent this from happening.

Determination of homocysteine levels

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Homocysteine is an amino acid that allows damaged tissues to regenerate. Elevated homocysteine concentrations can accompany hypothyroidism. In the long term, it can cause thrombotic problems, atherosclerotic lesions and increase the risk of heart attackand.

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Determination of iron concentration

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In hypothyroidism, the metabolism of iron and ferritin (i.e. its stores and transport) is impaired. Iron deficiency can lead to abnormal functioning of the thyroid gland, including a decrease in thyroid hormones.

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Remember!

In addition to the aforementioned compounds and minerals, with thyroid disease, additional attention should be paid to the concentration of selenium, zinc, vitamin D, omega-3 fatty acids or vitamin B12, thiamin, vitamin C and E.

If you want to live a healthy and happy life, preventive screenings are a must. You can instantly order them without leaving your home, and consult the results with your doctor in charge. Get tested now!

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Do you need help?
. Make an appointment
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Thyroid disease is often accompanied by skin problems. See how you can support it:

How often to do thyroid tests?

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The thyroid gland regulates the function of virtually the entire body, so you need to take care of it. Remember - prevention is the most important thing, and prevention is better than cure. If someone from your immediate family has a thyroid disease - it is also worth getting yourself examined, especially if the symptoms may suggest some dysfunction of this gland.

Thyroidism is a disease of the thyroid gland.

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Basic and dilated thyroid examinations are worth doing at least once a year, and thyroid ultrasound at least once every two years. Especially if you have a history of thyroid disease in your immediate family.
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Dr Witold Tomaszewski.

Witold Tomaszewskidoctor of medical sciences

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Of course, how often to do thyroid tests depends on your condition. 

For thyroid-related diseases, testing of TSH, fT3 and fT4 levels is usually done every three months, and every six weeks when changing treatment to check the effectiveness of the therapy. In Hashimoto's disease, on the other hand, a check of the anti-TPO and anti-TG levels once every one or two years is sufficient.

The final decision will always rest with the treating physician.

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Why is it important to have thyroid tests done?

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Blood tests for the diagnosis of thyroid disease will helpand:

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    .
  • prophylactically assess thyroid function,
  • .
  • determine whether distressing symptoms have an endocrine basis,
  • .
  • in case of "bad" results, make an earlier diagnosis and initiate effective treatment,
  • .
  • diagnose or confirm dangerous thyroid diseases such as hypothyroidism, hyperthyroidism or Hashimoto's or Graves-Basedow's disease,
  • .
  • save the time you spend in queues and the doctor's surgery,
  • .
  • with the choice of testing packages, save money too.
  • .
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Are you in need of help?
. Make an appointment
.
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Where to get your thyroid tested?

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All thyroid tests can be done privately, as well as on the National Health Service.

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Thyroid tests on the National Health Service

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You can have all thyroid tests done free of charge as part of your National Health Service reimbursement - however, a referral from your GP (in which case you will be able to have basic tests) or an endocrinologist (full package) is required.

Private Thyroid Tests

Private Thyroid Tests

Private thyroid tests

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If you are pressed for time and don't want to wait for a referral, you can benefit from paid private thyroid tests.

How much do thyroid tests cost

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The price depends primarily on the number of parameters you want to determine and the complexity of the tests you choose. You can order individual tests, but it is definitely more cost-effective to use packages. Diagnostic centres and laboratories usually offer two packages - basic and extended.

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How thyroid tests are done - preparation and results

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Blood tests to assess thyroid function are non-invasive and require no special preparation. All you need to do is take a blood sample and submit it for laboratory analysis. 

What conditions must be met for the results of thyroid tests to be reliable?

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    .
  • Do the tests in the morning or, in the case of repeated tests, at a specific time: TSH shows a variation in secretion throughout the 24-hour period. 
  • .
  • You do not need to be fasting.
  • .
  • Women can do thyroid tests on any day of the cycle: it does not affect the results.
  • .
  • Do not come to the test after a lot of physical exertion and stress: these can falsify the results.
  • .
  • Blood tests are best carried out in good health: infection and a cold should not affect the results.
  • .
  • If it is a control test, do not do the test after taking thyroid medication. Taking substances such as glucocorticosteroids, dopamine or biotin may also affect the results. 

How long to wait for thyroid test results?

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You will usually receive the results of individual tests or the whole package on the same or next working day - it all depends on the workload of the specific laboratory.

How to test and check your thyroid gland yourself (and if it's even possible)?

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Detailed examinations of the thyroid gland, combined with additional tests, will allow you to accurately determine its state and condition. In between, you can monitor its condition yourself without leaving your home. A simple self-examination can help detect nodules or changes that may indicate thyroid disease.

To perform a thyroid self-examination, all you need is a mirror and a glass of water.

How to perform a thyroid self-examination?

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  1. Stand in front of a mirror so that you can see the front of your neck in its entirety.
  2. .
  3. Tilt your head back slightly.
  4. Tilt your head back slightly.
  5. Stretch your neck upwards.
  6. .
  7. Take a sip of water.
  8. .
  9. Carefully observe in a mirror the moment of swallowing, without lowering your head.
  10. .

Moving your oesophagus will make it easier to spot asymmetrical changes and nodules - if you are unsure, repeat the observation.

You can also perform a so-called palpation examination of the thyroid gland. This involves tactile assessment and feeling for the presence of any nodules. 

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Palpation thyroid examination can help in the early diagnosis of cancer - by palpation we are able to detect nodules. It is worth performing as part of regular prevention. It should especially be done by women over 40, who can combine it with a regular thyroid ultrasound.
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Dr Witold Tomaszewski.

Witold Tomaszewskidoctor of medical sciences

.
.
.
Do you need help?
. Make an appointment
.

One of the symptoms of thyroid disease is mood swings, sleep problems and even depression. This is why mental balance and healthy sleep are so important. Read how you can take care of these:

Hopefully you now know why prevention is so important and you won't be looking for excuses not to get your thyroid tested. If you still have questions or concerns, feel free to drop by the comments section.

See also:

Summary

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Proper thyroid function is one of the keys to your health and well-being.

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From this text, remember that:

  • The thyroid gland is a small gland that regulates many processes in our body - from metabolism and energy expenditure to cardiac function and mental wellbeing.
  • The thyroid gland is a small gland that regulates many processes in our body - from metabolism and energy expenditure to cardiac function and mental wellbeing.
  • Symptoms of thyroid disorders and diseases can be easily overlooked and attributed to other conditions.
  • Preventive thyroid blood tests should be done at least once a year and thyroid ultrasound once every two years - unless otherwise advised by your doctor.
  • .
  • Basic diagnostic tests include determination of TSH levels, as well as fT3 and fT4. 
  • .
  • The extended thyroid package also includes anti-TPO, anti-TG and TRAb tests.
  • .
  • At home, you can perform a thyroid self-examination, as well as a so-called palpation test, which can help to detect nodules or asymmetrical lesions early.
  • There are also a number of tests you can perform at home.
  • You can perform the tests privately or free of charge on the National Health Service, but you will need a doctor's referral for this.
  • The most common thyroid problems are hypothyroidism or hyperthyroidism, Hashimoto's disease, Graves-Basedow's disease, goiter and thyroid cancer.
  • The most common thyroid problems are hypothyroidism or hyperthyroidism, Hashimoto's disease, Graves-Basedow's disease, goiter and thyroid cancer.

FAQ

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. What tests are performed on the thyroid gland?.

Basic thyroid tests include an indication of TSH, fT3 and fT. Enhanced tests (the so-called thyroid package) also include anti-TPO, anti-TG and TSH receptor antibody (TRAb) determination. In the diagnosis of thyroid disease, it is also worthwhile to carry out blood morphology, thyroid ultrasound, lipidogram, and determination of iron and homocysteine.

. What TSH result is of concern?.

The determination of TSH levels is fundamental to the diagnosis of thyroid disease. Reference values for adults are in the range of 0.45-4.5 µU/ml.

Results below the range suggest hyperthyroidism and Graves-Basedow disease. Concentrations that are too high - hypothyroidism or Hashimoto's disease.

Ranges in the concentration range suggest hypothyroidism and Hashimoto's disease.

The TSH concentration range shifts with age, and fluctuations are caused by diet, lifestyle, medications taken, pregnancy or menstruation.

. How much do thyroid tests cost?.

Prices depend on the specific laboratory, as well as the package you choose. You can choose to have single factor testing, a basic package or an extended package. The most cost-effective tests are those in the extended package - they include all the major thyroid tests. Their prices start at around PLN 150.

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. Are thyroid tests reimbursable?.

Thyroid tests can be done privately - in which case they will be charged. A referral for a thyroid hormone test can be made by your GP or an endocrinologist specialist - in which case the tests will be done for free. Unfortunately, an extended package of tests is rarely prescribed straight away at your GP's surgery.

If you suspect you have a thyroid problem, ask your doctor for a referral or have the tests done privately and consult a specialist for the results.

. Hashimoto's disease is hyperthyroidism or hypothyroidism?.

Hashimoto's disease is a condition of chronic inflammation of the thyroid gland and is one of the main causes of hypothyroidism. It is an autoimmune disease in which the immune system gradually destroys thyroid cells. Importantly, it often does not produce the symptoms typical of hypothyroidism. The basis for further diagnosis may be an excessively high TSH level in the blood, which is why regular check-ups are so important.

. How to detect hypothyroidism?.

Basic tests in the diagnosis of hypothyroidism are determinations of the concentrations of its hormones. This begins with a TSH test - elevated concentrations suggest inefficient function of this gland. To confirm, diagnostic tests are usually ordered, i.e. fT3 and fT4. An ultrasound of the thyroid gland will also be helpful. In the process of diagnosing Hashimoto's disease, anti-TPO and anti-TG tests are additionally performed.

. Do you need to be fasting for thyroid testing?".

The TSH test does not require much preparation - you do not need to be fasting. It is important to have your blood drawn in the morning or at a specific time for repeat testing. This is all because TSH has a pulsatile secretion pattern throughout the day - the highest concentrations are observed late in the evening and the lowest in the midday hours.

. Can a diseased thyroid be cured?.

Hypothyroidism requires treatment with levothyroxine preparations and regular TSH monitoring - unfortunately, very often for life. However, there are cases of spontaneous remission and resolution of the disease.

The complete cure of hyperthyroidism depends primarily on its cause. After surgical treatment or therapy with radioactive iodine, hypothyroidism may develop, requiring thyroxine and medical follow-up for the rest of the patient's life.

The following is a summary of the cases of hypothyroidism.

. What is TSH in a blood test?.

TSH is a hormone produced by the pituitary gland that stimulates the thyroid gland to secrete the hormones T3 and T4. TSH concentration in the blood is determined when a thyroid disorder is suspected and during hormone treatment with thyroxine preparations.

Too low concentrations may suggest hyperthyroidism and too high concentrations may suggest hypothyroidism.

. When to test TSH in an infant?.

The risk of fetal and neonatal thyroid disorders is negligible. Nonetheless, it is worthwhile to determine TSH levels as a standard screening test.

All newborns at risk should have their TSH and fT4 levels measured in cord blood or venous blood - sometimes the test will need to be repeated several times.

Important observation within two weeks after birth. If signs of hypothyroidism are present, TSH and fT4 levels should be measured within 7-10 days of life.

The following is an important step.

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Resources

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. See all.

Catargi, B., Parrot-Roulaud, F., Cochet, C., Ducassou, D., Roger, P., & Tabarin, A. (1999). Homocysteine, hypothyroidism, and effect of thyroid hormone replacement. Thyroid: Official Journal of the American Thyroid Association, 9(12), 1163-1166. https://doi.org/10.1089/thy.1999.9.1163

Chatterjee, S., Chakrabarti, P., & Sinhamahapatra, P. (2021). Relationship between iron metabolism and thyroid hormone profile in hypothyroidism. International Journal of Research in Medical Sciences, 9(3), 790-793. https://doi.org/10.18203/2320-6012.ijrms20210879

Fischli, S., von Wyl, V., Trummler, M., Konrad, D., Wueest, S., Ruefer, A., Heering, K., Streuli, R., Steuer, C., Bernasconi, L., Recher, M., & Henzen, C. (2017). Iron metabolism in patients with Graves' hyperthyroidism. Clinical Endocrinology, 87(5), 609-616. https://doi.org/10.1111/cen.13450

Rugge, J. B., Bougatsos, C., & Chou, R. (2014). Introduction. In Screening for and Treatment of Thyroid Dysfunction: An Evidence Review for the U.S. Preventive Services Task Force [Internet]. Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK285870/

Sheehan, M. T. (2016). Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed - A Review for Primary Care. Clinical Medicine & Research, 14(2), 83-92. https://doi.org/10.3121/cmr.2016.1309

Triiodothyronine (T3) Tests: MedlinePlus Medical Test. (n.d.). Retrieved March 16, 2023, from https://medlineplus.gov/lab-tests/triiodothyronine-t3-tests/

Wang, F., Tan, Y., Wang, C., Zhang, X., Zhao, Y., Song, X., Zhang, B., Guan, Q., Xu, J., Zhang, J., Zhang, D., Lin, H., Yu, C., & Zhao, J. (2012). Thyroid-stimulating hormone levels within the reference range are associated with serum lipid profiles independent of thyroid hormones. The Journal of Clinical Endocrinology and Metabolism, 97(8), 2724-2731. https://doi.org/10.1210/jc.2012-1133

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Meet the team
Matthew Podlecki - Author

Natu.Care Editor

At Natu.Care, she educates about healthy lifestyles and debunks dangerous myths, contrasting them with the results of the latest scientific research. Additionally, she is interested in new technologies and their impact on health and everyday life.

Witold Tomaszewski - Reviewed by

Doctor of Medicine

Verified by an expert

Doctor of Medicine, food and pharmaceutical law expert and experienced medical professional.

Gregory Dill - Fact-checking

Fact-checker

Gregory Dill

Grzegorz Koper is in charge of verifying quoted sources and checking that published content is truthful.

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