Diagnosis of hypothyroidism electricity song omd

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The presence of TPO antibodies (see below) also plays a role in your doctor‘s decision. If you have subclinical hypothyroidism and positive TPO antibodies, your doctor will likely initiate thyroid hormone treatment to prevent the progression of subclinical hypothyroidism into overt hypothyroidism.

The rare diagnosis of central or secondary hypothyroidism is a bit trickier. Central hypothyroidism suggests a pituitary gland or hypothalamus problem. These brain structures control the thyroid gland and may be damaged from tumors, infections, radiation, and infiltrative diseases like sarcoidosis, among other causes.

Positive thyroid peroxidase (TPO) antibodies suggest a diagnosis of Hashimoto’s thyroiditis, which is the most common cause of hypothyroidism in the United States. These antibodies slowly attack the thyroid gland, so the development of hypothyroidism tends to be a gradual process, as the thyroid becomes less and less able to produce thyroid hormone.

This means that a person can have positive TPO antibodies, but a normal thyroid function for some time; in fact, it can take years for a person’s thyroid function to decline to the point of being hypothyroid. Some people even have positive TPO antibodies and never progress to being hypothyroid.

While your doctor will not likely treat you with thyroid hormone replacement medication if your TPO antibodies are positive but your TSH is within the normal reference range, he will likely monitor your TSH over time to make sure that’s still appropriate. Imaging

While blood tests are the primary means of diagnosing hypothyroidism, your doctor may order a thyroid ultrasound if he notes (or simply wants to check for) a goiter or nodules on your physical examination. An ultrasound can help a doctor determine the size of a nodule and whether it has features suspicious for cancer. Sometimes, a needle biopsy (called a fine needle aspiration, or FNA) is performed to obtain a sample of the cells within a nodule. These cells can then be examined more closely under a microscope.

While primary hypothyroidism is the most likely culprit behind an elevated TSH, there are some other diagnoses your doctor will keep in mind. For instance, thyroid blood tests that support a diagnosis of central hypothyroidism may actually be due to a nonthyroidal illness.

People who are hospitalized with a serious illness or who have undergone a bone marrow transplantation, major surgery, or heart attack may have thyroid function blood tests consistent with central hypothyroidism (a low TSH and low T4), yet their "nonthyroidal illness" does not generally warrant treatment.

In nonthyroidal illness, thyroid function blood tests should normalize once a person recovers from their illness. Although, some people develop an elevated TSH after recovery. In these people, repeating a TSH in four to six weeks usually reveals a normal TSH.

Hypothyroidism and adrenal insufficiency may coexist, as they do in a rare condition called autoimmune polyglandular syndrome. This syndrome results from autoimmune processes involving multiple glands, especially the thyroid gland (causing hypothyroidism) and adrenal glands (causing adrenal insufficiency).

One of the biggest dangers associated with this syndrome is treating the hypothyroidism (giving thyroid hormone replacement) before treating the hypoadrenalism (which requires corticosteroid treatment), as this can result in a life-threatening adrenal crisis. Unfortunately, with this syndrome, the hypoadrenalism may be missed because of an elevated TSH and vague symptoms that overlap with those seen in hypothyroidism.