Examination for thyroid diseases

TSH in serum

 * Its concentration is inversely proportional to the concentration of T4 ,
 * assuming normal function of the hypothalamic-pituitary axis reflects the level of T 4 ,
 * Significantly increased: primary hypothyroidism,
 * Sometimes produced modified - you can also find
 * The method of first choice in case of suspected primary hypothyroidism or hyperthyroidism,
 * Monitoring of T4 substitution therapy ,
 * Is investigated in hypercholesterolemia and hyperprolactinemia.

Function test with TRH

 * Reflects TSH secretion
 * in central hypothyroidism, in TSH-producing tumors.

Total thyroxine (TT4) and free (FT4) in serum

 * Current secretion indicators
 * FT4 indicates the availability of the hormone by tissues
 * free thyroxin index – FTI
 * $$FTI=\frac{concentration\ T4 \cdot %T3-Uptake}{100}\ $$


 * Prior to the treatment of hyperthyroidism, TSH secretion may still be suppressed in the long term.

Triiodothyronine total (TT3) and free (FT3) in serum

 * High levels of T3 autonomic hyperactivity of the gland
 * Indications - examination of hyperthyroidism, severity of primary hypothyroidism, differential diagnosis of low TSH levels.

Reverse T3 (RT3)

 * Indirect indicator of T4 to T3 conversion,
 * Examination of unknown causes of low TT3 or TT4.

Serum Thyroglobulin (TG)

 * Indicator of TG release from the active, inflammatory or tumor gland,
 * Follow-up of patients after thyroidectomy for differentiated ca as a tumor marker - diagnosis of relapse (increasing TG).

α-subunit of hCG

 * In general, it detects the formation of molecules with this subunit - even TSH.

Calcitonin, serum thyrocalcitonin

 * Thyroid gland C-cell secretory activity indicator ,
 * In the diagnosis of medullary tumors.

Serum thyroxine binding globulin (TBG)

 * Quantitatively the most important carrier,
 * High values: genetically, in pregnancy, contraception,
 * Low concentrations: malnutrition, malabsorption, hepatic synthesis disorders,
 * We examine at T3 and T4 values ​​that do not correlate with the clinical condition.

Prealbumin, transthyretin in serum

 * The second most important carrier.

Binding capacity of transport proteins, T-uptake

 * Significance and indications as for TBG, saturate the serum sample with a known concentration of T3 and determine the unbound fraction.

Thyroperoxidase Antibodies (Thyreoperoxidase Antibodies, TPOAb)

 * Formerly described as antimicrosomal,
 * Reveal the presence of an autoimmune process, the possible risk of dysfunction,
 * Indications: goiter of unknown etiology, differential diagnosis of hyperthyroidism,
 * Postpartum risk screening.

Anti-thyroglobulin antibodies

 * They reveal the autoimmune process, they can explain incorrect results of TGB determination,
 * Monitoring of differentiated thyroid carcinomas.

Antibodies to TSH receptors

 * They can either stimulate or inhibit,
 * Risk of developing Graves' disease, risk of endocrine ophthalmopathy,
 * Differential diagnosis of hyperthyroidism.

Related articles

 * Thyroid gland
 * Thyroid hormones
 * Hyperthyroidism
 * Hypothyroidism
 * Examination of thyroid function
 * Thyroid disease
 * Radionuclide examinations of the thyroid gland
 * Symptomatic mental disorders in endocrinopathies

Source
ws:Vyšetření u chorob štítné žlázy