If a thyroid it works abnormally, and the whole body naturally suffers, since an excess or deficiency of hormones significantly affects the basal metabolic rate – protein and mineral. It is possible to identify the true causes of the lesion and the degree of their severity, as well as to develop a treatment plan, only after a full diagnostic cycle. It includes not only the examination of the thyroid gland by a doctor, but also a number of tests and examinations.
Diseases of the thyroid gland: diagnosis
All diseases of the thyroid gland sooner or later lead to the fact that disrupted production hormones or the size of the gland changes. However, it is impossible to make a diagnosis only on the basis of complaints and general medical examination, probing the area where the thyroid gland is located, and the adjacent areas. The doctor can only guess which diseases of the thyroid gland can give some symptoms, but final confirmation will be given only after undergoing a series of tests and procedures. Naturally, for each specific disease of the thyroid gland a set of studies will be different, however, there are basic and additional methods that help establish and clarify the diagnosis and develop a treatment plan.
These include:
- Consultation therapist and referral to the endocrinologist
- Taking tests (general and hormones, immunological, histological studies)
- Instrumental diagnostics (ultrasound, if necessary, X-ray, MRI or CT, scintigraphy, biopsy, puncture)
- Additional consultations of specialists (cardiologist, surgeon, oncologist, neurologist) and conducting additional research by them (ECG, REG and others).
For each individual patient, a survey plan is developed individually, each of the procedures must have strict indications, especially if it is radiation or invasive, studies with radioactive substances.
The study of thyroid hormones
The most important of laboratory studies, which allows to evaluate the functions of an organ, is an analysis of hormones, produced not only by the gland itself, but also by the pituitary gland (thyrotropin). It is the concentrations of these types of hormones that will reveal the level of damage and the features of the dysfunction of the organ.
The definition of TSH is important for the reasons that it is this hormone that controls the work of the gland. If its level is exceeded, this indicates that the thyroid gland is reduced, and by strengthening the signals from the center, the body tries to compensate for this, to activate its functions.Accordingly, the reduced hormone TSH will indicate that the thyroid gland is excessive, and he is trying to suppress its activity.
Equally important will be the levels of the gland’s own hormones. The interpretation of the results has its own characteristics. Thyroxine is one of the hormones, it is also called T4. It is synthesized by the gland cells, but its effect on metabolic processes is not as great as T3 (or triiodothyronine).The latter is formed in the liver of T4. In blood plasma, both of these hormones are associated with proteins, and do not possess activity. Therefore, the determination of the overall level of T4 will give little information about the functional activity of the gland, since it largely depends on the concentration of plasma binding proteins. The activity of the thyroid gland itself can be most accurately determined by the level of free hormones (both T4 and T3). When analyzing the results, the physician takes into account both values - both the bound and the free hormone.
Determination of thyroxin-binding globulin
The definition of a specific protein that binds to hormones and transports them in the blood plasma is also important for diagnosis. If the concentration of this protein changes, the plasma hormone concentrations also change regularly, which is important in many pathologies. By changing the level of this protein, the concentration of free thyroid hormones that is currently required is regulated. Doctors know that an increase in thyroxin-binding globulin is possible in pregnant women or in the presence of viral hepatitis, sometimes its number is also increased as a result of the influence of hereditary factors. In addition, its concentration is affected by the use of contraceptives or synthetic estrogens, as well as narcotic drugs and certain medications.
It is also possible to reduce the level of protein, which happens with problems with the kidneys and liver, dysfunction of the pituitary and adrenal glands, as well as a deficiency in the female body of estrogen. The amount of protein may decrease as a result of congenital problems or after a long fast, pathological loss of plasma proteins. Reduce the level of this globulin some drugs – furosemide and aspirin steroids.
Determination of thyroglobulin antibodies
Anti-thyroglobulin antibodies are produced in the presence of autoimmune thyroid disease. The immune system has special mechanisms, and against certain antigens, in this case against the tissues of the gland, strictly specific antibodies are produced. Their identification and quantitative characteristics can give an idea of the degree of damage to the gland. If during the study antithyroid antibodies are detected, this confirms the cause of the disease.
Thyroid ultrasound
Today, ultrasound is widespread in the diagnosis of pathologies of many internal organs. Of particular importance is the ultrasound of the thyroid gland. This is a non-invasive and rapid study with no contraindications. It can detect many structural abnormalities in the organ. With the help of ultrasound, the thyroid gland determines its volume and size of the lobes, isthmus, as well as the presence of cysts and nodes, other changes in the structure of the organ. The study does not require special training, can be conducted in almost any clinic where there is an ultrasound diagnostic device and a specialist with research skills.
Examination determines the structure of the gland, the degree of its increase, the presence of various pathological elements. In addition, according to the thyroid gland ultrasound, it is possible to determine the exact localization of pathological formations for further biopsy.