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Diagnosis of Thyroid Disorders
Date: 30 January , 2017 in India ,

Thyroid diseases are, arguably, among the commonest endocrine disorders worldwide. On a global scale, a staggering 200 million people have problems with their thyroid glands, with over 50 percent remaining undiagnosed.

India too, has a significant burden of thyroid diseases. According to the latest study, it is estimated that about 42 million people in India suffer from Thyroid diseases, which accounts for approximately 21 percent of the global population suffering from such disorders.

Being the largest endocrine gland in human body, this butterfly-shaped, bi-lobed gland produces hormones which influence almost all the metabolic processes in the body. The thyroid gland produces two hormones, namely- Triiodothyronine (T3) and its precursor Thyroxine (T4). Under normal conditions, the thyroid produces T3 and T4 at a 20% - 80% ratio.

Thyroid-stimulating hormone (TSH) is another important hormone that is secreted by the anterior pituitary cells in the brain and its primary function is to increase the production of T3 and T4 by the thyroid gland.

The five common thyroid diseases in India are: (1) Hypothyroidism, (2) Hyperthyroidism, (3) Goiter and iodine deficiency disorders, (4) Hashimoto's thyroiditis, and (5) Thyroid cancer.

The two most common forms of thyroid disease are Hypothyroidism and Hyperthyroidism.

An under-production of thyroid hormones slows down the body’s metabolism, causing Hypothyroidism. Common symptoms of this condition are weight-gain despite eating sensibly, feeling cold, fatigue, depression and possibly increased blood pressure and cholesterol levels.

Hyperthyroidism occurs when an excess of T3 and T4 speeds up the body’s metabolism and, if the mild condition is left untreated it can lead to complications such as severe weight-loss despite a healthy appetite, nervousness, staring eyes, accelerated heart rate and insomnia.

In both hypothyroidism and hyperthyroidism, there may be swelling of a part of the neck, which is also known as Goiter.

Figure 1: Clinical Reference Values of Thyroid Function Test

 

 

 

 

 

 

 

 

 

Thyroid diseases are one of the silent epidemics of our time. They may get overlooked in the early stages because of their uncertain and ambiguous symptoms. However,

Thyroid diseases are different from other diseases in terms of their ease of diagnosis, accessibility of medical treatment, and the relative visibility in the form of a small swelling.

Early diagnosis and treatment therefore, remain the cornerstone of thyroid disease management.

Early diagnosis and treatment therefore, remain the cornerstone of thyroid disease management.

The most useful marker of thyroid gland function is serum thyroid-stimulating hormone (TSH) levels. TSH levels are determined by a negative feedback system in which high levels of T3 and T4 suppress the production of TSH, and low levels of T3 and T4 increase the production of TSH. TSH levels are thus often used, as the first indicator of thyroid function.

  • Elevated TSH levels can signify inadequate thyroid hormone production (hypothyroidism)
  • Suppressed TSH levels can point to excessive thyroid hormone production (hyperthyroidism) 

Figure 2: Some Causes of Abnormal Serum TSH Concentrations

 

 

 

 

 

 

 

 

 

 

To further confirm the diagnosis, T3 and T4 levels in blood, are also measured, as a single abnormal TSH level can be misleading. When circulating in the body, T3 and T4 may be bound to the transport proteins present in blood. Only a small fraction of the circulating thyroid hormones are unbound or free, and thus biologically active. T3 and T4 levels can thus be measured as free T3 and free T4, or total T3 and total T4, which are the free hormones in addition to the protein-bound hormones 

Figure 3: Combination of Results and their Interpretation

 

 

 

 

 

 

The immune system normally protects the body from foreign antigens such as bacteria and viruses by destroying these, with substances called antibodies produced by blood cells known as lymphocytes. But in certain abnormal conditions, immune system generates autoantibodies, that is, antibodies against its body’s own antigens. This condition of a dysfunctional immune system is known as Autoimmunity.

Diagnosing thyroid disease is a process that incorporates a number of different types of examinations, including clinical evaluation, blood tests, imaging tests, biopsies, and other tests. The most common and convenient being through laboratory tests for measuring the thyroid function markers – T3, T4 and TSH.

Immunoassays are not only the most common, but also the most accurate and affordable methods for the quantitative determination of Thyroid function markers in serum/plasma.

Transasia Bio-Medicals offers reliable solution to Thyroid Disorder Diagnosis, for your laboratory, with our range of Thyrokit ELISA tests for T3, T4 and TSH. Also available are the ELISA kits for the detection of Anti-TG IgG and Anti-TPO IgG.

References:

  1. Thyroid disorders in India: An epidemiological perspective. Ambika Gopalakrishnan Unnikrishnan, Usha V. Menon. Indian J Endocrinol Metab. 2011 Jul; 15(Suppl2): S78–S81.
  2. Laboratory Evaluation of Thyroid Function. Shashank R. Joshi. Supplement to JAPI, January 2011, Vol. 59, 14-20.
  3. https://en.wikipedia.org/wiki/Thyroid_disease.
  4. http://www.thyroid.org/wp-content/uploads/patients/brochures/FunctionTests_brochure.pdf.
  5. http://www.thyroid.org/thyroid-function-tests.
  6. https://en.wikipedia.org/wiki/Hashimoto's_thyroiditis.

 

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