Thyroid #4 Comprehensive Blood Test Panel
The Thyroid #4 Comprehensive Blood Test Panel includes a Thyroid Profile with TSH, Tri-iodothyronine (T3) Free Serum, Thyroxine (T4) Free Direct Serum, Thyroid Peroxidase (TPO) Antibodies, Thyroid Antithyroglobulin Antibody (TAA) plus Reverse T3, Thyroxine-binding Globulin (TBG) and Thyroid-stimulating Immunoglobulin (TSI).
Thyroid #4 Comprehensive Blood Test Panel includes:
Thyroid Panel with Thyroid-Stimulating Hormone (TSH) - Thyroid function is crtical to your metabolism and affects your energy level, heart rate, weight control, and more. The thyroid-stimulating hormone is produced in the pituitary gland and stimulates the production of thyroid hormones. The TSH helps identify an underactive or overactive thyroid state. This comprehensive evaluation of your thyroid hormone levels includes: T-3 Uptake, T4, Free Thyroxine Index (T7), and Thyroid-Stimulating Hormone (TSH).
Free T3: Test for evaluating thyroid function and assessing abnormal binding protein disorders.
Free T4: Free T4 may be indicated when binding globulin (TBG) problems are perceived, or when conventional test results appear to be inconsistent with clinical observations. It is normal in those with high thyroxine-binding globulin hormone binding who are euthyroid (i.e., free thyroxin should be normal in nonthyroidal diseases). It should also be normal in familial dysalbuminemic hyperthyroxinemia.
Thyroid Peroxidase (TPO) Antibodies - antibodies to thyroid microsomes (thyroid peroxidase) are present in 70% to 90% of patients with chronic thyroiditis. They are also present in smaller percentages of patients of other thyroid diseases. Antibody production may be confined to lymphocytes within the thyroid, and serum may be negative. Small numbers (3%) of people with no evidence of disease may have antibody. This is more frequent in females and increases with age.
Thyroid Antithyroglobulin Antibody - This test may be ordered to investigate the cause of an enlarged thyroid gland (goiter) and/or performed as a follow-up when other thyroid test results (such as T3, T4, and/or TSH) show signs of thyroid dysfunction. One or more thyroid antibody tests also may be ordered if a person with a known non-thyroid-related autoimmune condition, such as rheumatoid arthritis, systemic lupus erythematosus, or pernicious anemia, develops symptoms that suggest thyroid involvement. Such involvement may occur at any time during the course of the other condition(s).
Reverse triiodothyronine (rT3) is an isomer of triiodothyronine (T3) with no demonstrated biological activity. The majority of rT3 is produced through peripheral enzymatic monodeiodination of T4 at the 5 position of the inner ring of the iodothyronine nucleus of thyroxine (T4). A lesser amount of rT3 is secreted directly by the thyroid gland. T3 is biologically inactive and does not stimulate thyroid hormone receptors.concentrations are elevated in chronic or acute diseases because of changes in peripheral rates of conversion of T4 to T3 and reverse T3. Drugs such as amiodarone and glucocorticoids cause increased levels of reverse T3. Reverse T3 levels are elevated at birth and will decline to normal levels by the first week of life. Measurement of reverse T3 may be of use in the assessment of thyroid function and metabolism in the newborn.
Thyroxine-binding Globulin (TBG) distinguishes between high T4 levels due to hyperthyroidism and due to increased binding by TBG in euthyroid individuals who have normal levels of free hormones; document cases of hereditary deficiency or increase of TBG; work-up of thyroid disease. In patients with low T4, high T3 (uptake) or the reverse, who clinically seem eumetabolic and have normal FTI, measurement of TBG is only occasionally needed. Some such patients may have hereditary anomalies of TBG. TBG is increased by estrogens, tamoxifen, pregnancy, perphenazine, and in some cases of liver disease, including hepatitis. Decreased TBG is found with some instances of chronic liver disease, nephrosis and systemic disease, and with large amounts of glucocorticoids, androgens/anabolic steroids, and acromegaly. Although alterations of TBG are usually resolved by the thyroid profile, TBG must occasionally be directly measured.
Thyroid-stimulating Immunoglobulin (TSI) is a second-order testing for autoimmune thyroid disease, including:
-Differential diagnosis of etiology of thyrotoxicosis in patients with ambiguous clinical signs and/or contraindicated (eg, pregnant or breast-feeding) or indeterminate thyroid radioisotope scans
-Diagnosis of clinically suspected Graves disease (eg, extrathyroidal manifestations of Graves disease: endocrine exophthalmos, pretibial myxedema, thyroid acropachy) but normal thyroid function tests
-Determining the risk of neonatal thyrotoxicosis in a fetus of a pregnant female with active or past Graves disease
-Differential diagnosis of gestational thyrotoxicosis versus first trimester manifestation or recurrence of Graves disease
-Assessing the risk of Graves disease relapse after anti-thyroid drug treatment
The laboratory tests most helpful for the diagnosis and monitoring of patients with Graves’ disease include the Free T4 (FT4), Free T3 (FT3), TSH test, and TSI test.
Thyroid-stimulating immunoglobulins (TSI) can be detected in the majority of patients (77.8%) with Graves' disease. These antibodies have also been associated with a small portion (15.9%) of patients with toxic multinodular goiter. It has also been reported that TSI measurement can be used to predict relapse or remission when methimazole or radioiodine is used to treat Graves' disease. These assays have also been advocated for use in patients with subclinical Graves' hyperthyroidism or patients with unilateral ophthalmopathy.
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