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Thyroid function tests (TFTs) is a collective term for blood tests used to check the function of the thyroid. [1] TFTs may be requested if a patient is thought to suffer from hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroid-suppression or hormone replacement therapy.
Initial blood tests often include thyroid-stimulating hormone (TSH) and free thyroxine (T4). [9] Total and free triiodothyronine (T3) levels are less commonly used. [9] If autoimmune disease of the thyroid is suspected, blood tests looking for Anti-thyroid autoantibodies can also be obtained. Procedures such as ultrasound, biopsy and a ...
An increase in TSH above the normal range indicates under-replacement or poor compliance with therapy. A significant reduction in TSH suggests over-treatment. In both cases, a change in dose may be required. A low or low-normal TSH value may also signal pituitary disease in the absence of replacement. [citation needed]
The TSH, in turn, stimulates the thyroid to produce thyroid hormone until levels in the blood return to normal. Thyroid hormone exerts negative feedback control over the hypothalamus as well as anterior pituitary, thus controlling the release of both TRH from hypothalamus and TSH from anterior pituitary gland. [2]
Blood free thyroxine and TSH levels are monitored to help determine whether the dose is adequate. This is done 4–8 weeks after the start of treatment or a change in levothyroxine dose. Once the adequate replacement dose has been established, the tests can be repeated after 6 and then 12 months, unless there is a change in symptoms. [ 8 ]
The test is used in the differential diagnosis of secondary and tertiary hypothyroidism. First, blood is drawn and a baseline TSH level is measured. Then, TRH is administered via a vein. After 30 minutes blood is drawn again and the levels of TSH are measured and compared to the baseline. Some authors recommend additional blood sampling at 15 ...
Abnormal breast enlargement in men [12] Augmented calcium levels in the blood (by as much as 25% – known as hypercalcaemia). This can cause stomach upset, excessive urination, and impaired kidney function. [13] Diabetes may be activated or intensified, and its control worsened. The diabetes is ameliorated or may disappear when the ...
Another study demonstrated the TSH index to inversely correlate to thyroid's secretory capacity and thyroid volume. [26] It is unclear if this finding reflects shortcomings of the index (i.e. low specificity in the setting of subclinical hypothyroidism) or plastic responses of the pituitary gland to beginning hypothyroidism. [citation needed]