About Thyroid Tests and Accuracy


The Test for Hypothyroidism

If you have any symptoms of a sluggish or overactive thyroid, there are number of thyroid tests that your doctor may order to help diagnose your condition. Thyroid tests include blood tests that determine whether your body is producing sufficient levels of thyroid hormones. For example, the level of TSH or thyroid stimulating hormone can be measured through a blood test.

  • If you have a high level of TSH, your body may not be producing enough thyroid hormone.
  • A low TSH level may mean that your body is over-producing thyroid hormones.

Thyroid tests can also measure levels of thyroid hormone directly. Specifically, blood tests can be conducted to determine whether the body is producing enough of the thyroid hormones T4 and T3.

Another type of thyroid test, called a thyroid antibodies test, can determine whether antibodies exist that suggest an autoimmune condition – that is, that the body has turned against its own thyroid cells. Anti-thyroid peroxidase and anti-thyroid thyroglobulin are two antibodies that may indicate a problem with thyroid function. If antibodies are present in the blood of a person with low thyroid function, a diagnosis of Hashimoto’s thyroiditis can be made. If the antibodies are present in a person with an over-active thyroid, the diagnosis is usually autoimmune thyroid disease.

Another test used to check the thyroid function measures the level of a protein known thyroid binding globulin, to which thyroid hormones bind. This test is usually conducted when there is an unexplained high or low level of T4 or T3. The level of thyroid binding globulin only affects the volume, not the action, of thyroid hormones, so this test is conducted when a person has altered hormone levels but apparently normal thyroid function. It can help avert misdiagnosis and unnecessary treatment when no symptoms of thyroid disease exist.

There are several other tests that may be conducted to diagnose or rule out thyroid disease. 

For example, functional stimulation tests help to determine whether a suspected thyroid problem lies with the thyroid gland itself or with the pituitary gland (which governs thyroid function). When this test is conducted, the pituitary's response to a hormone injection can be measured to determine the origin of a thyroid condition.

Additional tests may include a thyroid scan or iodine uptake scan, a pair that are often conducted together. Since the hormone T4 contains a significant amount of iodine, which the thyroid gland pulls from the bloodstream, having a patient swallow a radioactive iodine pill and then tracking the path of the iodine molecules can be used to measure thyroid activity.

A thyroid scan, or picture of how well the gland is functioning, also involves giving the patient radioactive iodine, which is concentrated by the thyroid. A picture is then taken that gives an indication of how the gland is functioning based on how the iodine is concentrated within the gland.

It is important to note that there isn't any single thyroid test can give a 100% accurate diagnosis of all types of thyroid disease. Hypothyroidism, as you may know, can be tricky to diagnose and in many cases a simple blood test is not enough. If you are experiencing the typical symptoms of this condition we suggest that other tests are done, such as a urine test, which has been shown to be quite effective and reliable as well as the body basal temperature test which you can do yourself at home. This test may be the most sensitive test of thyroid function as your body temperature indicates the state of your metabolic rate (your metabolic rate is largely determined by thyroid hormones.)

The way to perform the body basal temperature test is as follows:

Place a digital thermometer by your bed so that you have it close at hand as soon as you wake in the morning. Position it in your armpit for ten minutes and try not to move much before or while you are taking the reading. Record the temperature and date after the ten minutes have passed and repeat this for at three or four days in a row, preferably at the same time everyday. If you are a woman who is menstruating (as in not post-menopausal), it is best to do the test on the 2nd, 3rd and 4th day of your period. Post-menopausal women as well as men can do the test at any time of the month. Your basal body temperature should be between 97.6 and 98.2 degrees Fahrenheit or between 36.4 and 36.8 Celsius. Low basal body temperature may indicate low thyroid function, either sub-clinical or fully developed.

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