Thyroid Problems Diagnosis - When to Seek Medical Care

Thyroid Problems Diagnosis

The medical history and physical exam are important parts of the evaluation for thyroid problems. The health care practitioner will focus on eye, skin, cardiac (heart), and neurologic findings.

Blood tests

• Thyroid-stimulating hormone (TSH): In most cases, this is the single most useful lab test in diagnosing thyroid disease. When there is an excess of thyroid hormone in the blood, as in hyperthyroidism, the TSH is low. When there is too little thyroid hormone, as in hypothyroidism, the TSH is high.
• Free (T4): T4 is one of the thyroid hormones. High T4 may indicate hyperthyroidism. Low T4 may indicate hypothyroidism.
• Triiodothyronine (T3): T3 is another one of the thyroid hormones. High T3 may indicate hyperthyroidism. Low T3 may indicate hypothyroidism.
• TSH receptor antibody (TSI): This antibody is present in Grave's disease.
• Antithyroid antibody: This antibody is present in Hashimoto's and Grave's disease.

Nuclear thyroid scan: During this scan a small amount of radioactive iodine is swallowed or a similar material 99m-technetium, is injected into the blood, and then an imaging study of the thyroid is taken that reveals localization of the radioactivity. Increased uptake of the radioactive material in the thyroid gland indicates hyperthyroidism, while decreased uptake is present in hypothyroidism. This test should not be performed on women who are pregnant.

Thyroid ultrasound: Thyroid ultrasound helps to determine the size and number as well as the different types of nodules in the thyroid gland. This exam can also detect if there are enlarged parathyroid glands or lymph nodes near the thyroid gland.

Fine-needle aspiration: During this procedure, a small needle is inserted into the thyroid gland in order to get a sample of thyroid tissue, usually from a nodule. This test can be done in a health care practitioner's office without special preparations. The tissue is then observed under a microscope by a pathologist to look for any signs of cancer.

Computerized axial tomography (CT) scan: A CT scan is occasionally used to look for the extent of a large goiter into the upper chest or to look for narrowing or displacement of the trachea (breathing tube) from the goiter.

When to Seek Medical Care

The signs and symptoms of hypothyroidism and hyperthyroidism typically develop slowly over a period of weeks to months. If an individual has prolonged symptoms or signs of either condition, call a doctor to be evaluated.

Untreated hypothyroidism may have severe effects on the brain as well as causeintestinal obstruction and inability of the heart to beat effectively. An infection, exposure to cold, trauma, and certain medications may often cause a worsening of hypothyroidism.

Seek immediate attention at a hospital's emergency department if you have these signs and symptoms associated with thyroid problems.

• Shortness of breath
• Abdominal pain
• Vomiting
• Confusion
• Coma

Severe hyperthyroidism, called thyrotoxic crisis (thyroid storm), may be life-threatening because of the effects it has on the heart and brain. It often occurs in people who are untreated or are receiving inadequate treatment for thyroid problems. A severe infection can also cause a thyrotoxic crisis.

Seek immediate attention at a hospital's emergency department if you have these signs and symptoms associated with thyroid problems.

• Chest pain
• Rapid and/or irregular heartbeat
• Shortness of breath
• Abdominal pain
• Vomiting
• Extreme agitation or irritability
• Dizziness
• Disorientation (person has no knowledge of the date or location)
• Coma

Severe goiter or nodule problem: Seek immediate attention at a hospital's emergency department if you have these signs and symptoms associated with thyroid problems.

• Shortness of breath especially with stridor (a whistling sound in your neck when you breathe)
• Extreme pain in your thyroid gland that prevents you from swallowing
• Sudden enlargement of your thyroid gland, especially if associated with problems breathing or swallowing
• Pain and high fever with the thyroid enlargement

Slide show about Thyroid