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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.
Screening for thyroid disease in patients without symptoms is a debated topic although commonly practiced in the United States. [8] If dysfunction of the thyroid is suspected, laboratory tests can help support or rule out thyroid disease. Initial blood tests often include thyroid-stimulating hormone (TSH) and free thyroxine (T4). [9]
The RAIU test is a reliable measurement when using a dedicated probe with a reproducibility of 1 percent and a 95%-least-significant-change of 3 percent. [3] The normal uptake is between 15 and 25 percent, but this may be forced down if, in the meantime, the patient has eaten foods high in iodine, such as dairy products and seafood. [4]
Regardless of the inconsistent findings, a 2007 study by Andersen et al. states that the distinction between sub-clinical and overt thyroid disease is in any case somewhat arbitrary. [55] Sub-clinical hyperthyroidism has been reported in 63% of euthyroid Graves' disease, [56] but only in 4% of cases where Graves' disease was in remission. [57]
Thyroid hormone binding ratio (THBR) is a thyroid function test that measures the "uptake" of T3 or T4 tracer by thyroid-binding globulin (TBG) in a given serum sample. This provides an indirect and reciprocal estimate of the available binding sites on TBG within the sample.
The most common type of hyperthyroidism, Graves' disease, may additionally cause eye problems (Graves' ophthalmopathy) and skin changes of the legs (pretibial myxedema). [6] Thyroid disease may also cause muscle weakness in the form of thyrotoxic myopathy, but this is constant rather than episodic. [5]
Subacute lymphocytic thyroiditis can only be diagnosed correctly by taking a radioactive iodine uptake test (RAIU) test. [1] [3] During both the hyperthyroid and hypothyroid phases, radioiodine uptake is decreased. [4] This situation contrasts greatly with the elevated iodine uptake found in patients with Graves' disease. [1]
Unlike the Wolff–Chaikoff effect, the Plummer effect does not prevent the thyroid from taking up radioactive iodine, e.g. in the case of nuclear emergencies.Therefore, "plummering" with high-dose iodine is only effective in a short time window after the release of radionuclides. [9]
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