By Max A. Chernesky, David Gretch, Isa K. Mushahwar, Paul D. Swenson, Patrice O. Yarbough, Stephen Young
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Additional resources for Cumitech 18A: Laboratory Diagnosis of Hepatitis Viruses
Yet many of these symptoms are the same as those of hypothyroidism. The symptoms of hypothyroidism completely overlap with those of normal life variations or those of unrelated health disorders. The proper laboratory test acts as an “honest broker,” providing objective evidence for making the correct diagnosis. Know, however, that such tests are not infallible. This chapter will take you through all of the laboratory tests that can be useful in providing diagnostic answers with respect to your thyroid gland.
Obviously, the ﬁrst and most important tools for this anatomical search are the ﬁngers. A physical examination of the thyroid gland is the best way to see if the thyroid gland is normal in size, shape, and location (see Chapters 1 and 8 for information on self-examinations). The careful examiner will be able to tell if there are any thyroid nodules that should be investigated further. The examination should also include a careful search of the entire neck, looking for enlarged lymph nodes that could represent a thyroid cancer spread in the neck.
In other cases, TSH levels this low warrant careful evaluation and treatment. Many doctors will check the free T4 and the TSH levels a few weeks after noting a subtly low TSH to see if this TSH has spontaneously become normal or has lowered into the deﬁnitively thyrotoxic range. Exceptions to the Rule The “rule” that hypothyroidism comes with high TSH levels and thyrotoxicosis comes with low TSH levels is not always accurate. It assumes that the pituitary gland and hypothalamus are completely normal and that any abnormalities come from the thyroid gland.
Cumitech 18A: Laboratory Diagnosis of Hepatitis Viruses by Max A. Chernesky, David Gretch, Isa K. Mushahwar, Paul D. Swenson, Patrice O. Yarbough, Stephen Young