Hypothyroidism: Symptoms, Diagnosis, Non Invasive Tests


Hypothyroidism Diagnosis

Overview
Hypothyroidism is an underactive thyroid gland. When the thyroid gland doesn’t make enough thyroid hormones T4 and T3 to meet your body’s needs, the condition is called Hypothyroidism. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the body’s metabolism, so they affect nearly every organ in your body, even the way your heart beats. Without enough thyroid hormones, many of your body’s functions slow down.

Symptoms
Common symptoms of Hypothyroidism may include:
  • fatigue
  • weight gain
  • a puffy face
  • trouble tolerating cold
  • joint and muscle pain
  • constipation
  • dry skin
  • dry, thinning hair
  • decreased sweating
  • heavy or irregular menstrual periods
  • fertility problems
  • depression
  • slowed heart rate
  • Goiter
Hypothyroidism symptoms can vary from person to person. Many of these symptoms, especially fatigue and weight gain, are common and don’t always mean that someone has a thyroid problem.

Are you at risk for Hypothyroidism?

Your risk of becoming hypothyroid are based on two main factors—age and sex. Hypothyroidism chances increase with age, and they are greater if you're a woman. Hypothyroidism occurs primarily in women older than 50.

You are more likely to have hypothyroidism if you
  • have a family history of thyroid disease or any autoimmune disease
  • have had a thyroid problem before, such as a goiter
  • have had surgery to correct a thyroid problem
  • have received radiation treatment to the thyroid, neck, or chest
  • were pregnant in the past 6 months
  • have type 1 diabetes or rheumatoid arthritis
  • have Turner syndrome, a genetic disorder that affects females
Understanding the symptoms of hypothyroidism and getting regular screenings to ensure an early diagnosis will help prevent the onset of the complications.

Diagnosis

There are various tests used to diagnose hyperthyroidism. The doctor may start by asking
  • Medical and family history
  • Undergone any thyroid surgery
  • If you’ve ever had radiation to your neck to treat cancer;
  • Any medication that can cause hypothyroidism— amiodarone, lithium, interferon alpha, interleukin-2, and maybe thalidomide;
  • Physical examination to check your thyroid gland and for any symptomatic changes such as dry skin, swelling, slower reflexes, and a slower heart rate.
  • Blood tests
  • TSH (thyroid-stimulating hormone) test.
  • T4 tests.
Based on the results of the assessment and tests, further tests may be required.

Laboratory Tests
The Laboratory tests include blood tests to measure the amount of thyroid hormones in the blood. The most common blood test is the TSH test. The T3, T4, and thyroid autoantibody tests are additional blood tests used to confirm the diagnosis or determine its cause.

The doctor may run a complete thyroid panel, testing levels of T3 and T4, TSH, and thyroid autoantibodies in order to fully establish the health and activity of the thyroid gland.

There may also be tests to check cholesterol levels, liver enzymes, prolactin, and sodium.

The Complete Thyroid Panel Tests usually includes:
  • TSH (thyroid-stimulating hormone) – to test for hypothyroidism, hyperthyroidism and to monitor treatment for a thyroid disorder

    “The normal range of TSH levels is 0.4 to 4.0 milli-international units per liter. If you're already being treated for a thyroid disorder, the normal range is 0.5 to 3.0 milli-international units per liter. A value above the normal range usually indicates that the thyroid is underactive. This indicates hypothyroidism.”
  • Free T4 (thyroxine) – to test for hypothyroidism and hyperthyroidism; may also be used to monitor treatment

    “The normal range for free T4 in adults is 0.8 to 2.8 nanograms per deciliter (ng/dL). A level of free T4 that is higher than normal could mean you have an overactive thyroid. Conditions associated with hyperthyroidism include Graves disease, an autoimmune disorder.”
  • Free T3 or total T3 (triiodothyronine) – to test for hyperthyroidism; may also be used to monitor treatment.

    “The reference range of free triiodothyronine (FT3) in adults is 260-480 pg/dL, or 4-7.4 pmol/L. The reference range of total triiodothyronine (T3) is 80-220 ng/dL in adults.”High T3 levels might also indicate high levels of protein in the blood. In rare cases, these elevated levels could indicate thyroid cancer or thyrotoxicosis.

Non-Invasive Tests

Thyroflex

The patented Thyroflex is a non-invasive state of the art system to test, diagnose, titrate, and manage thyroid conditions. It uses reflexes, Resting Metabolic Rate and symptoms to accurately determine Thyroid function.

Ultrasonography

Ultrasonography is an ideal imaging modality in the evaluation of thyroid gland as an easy to perform, non-expensive, non-invasive method free from ionized radiation.

Laser Test

Laser based light absorption technique is another non invasive method of thyroid classification which involves emission and reflectance of light.

Infrared Thermography

Infrared Thermography (IT) is a non-invasive method and complementary to other diagnostic techniques to identify inhomogeneity of the thermal emission of the skin. Secondary aims were to analyze the correlation between thermographic values and: 1) BMI 2) TSH 3) total cholesterol. The association of this technique with the measurement of the REE with indirect calorimetry can provide a valuable tool in the diagnosis of thyroid dysfunction, especially in subclinical and overt hypothyroidism.

Radioactive Iodine Uptake

This can be measured by having an individual swallow a small amount of iodine, which is radioactive. The radioactivity allows the doctor to track where the iodine goes. By measuring the amount of radioactivity that is taken up by the thyroid gland (radioactive iodine uptake, RAIU), doctors may determine whether the gland is functioning normally. A low RAIU is seen when the thyroid gland is underactive (hypothyroidism). In addition to the radioactive iodine uptake, a thyroid scan may be obtained.

Ways to Avoid Thyroid
  • Avoid starvation diets. Eat a healthy nourishing fiber rich diet.
  • No excessive endurance exercise.
  • Protect yourself against X-rays..
  • Stop smoking!
  • Be careful with your Iodine, especially when you are pregnant. Iodine is an essential mineral for thyroid function.

Find out more about the Hypothyroidism with Dr. Dominic Rowley