Thyroid diagnostics involves various procedures for examining the thyroid gland for diseases. Thyroid disorders can have a significant impact on a person’s well-being. Thorough thyroid diagnostics are essential for determining the correct treatment. Only with the correct diagnosis can a doctor develop an appropriate treatment plan.
Here you will find further information as well as a selection of specialists in thyroid diagnostics.
When are thyroid tests used?
The optimal functioning of the human body depends, among other things, on a healthy thyroid gland. Thyroid hormones are involved in many metabolic processes.
However, thyroid disorders are widespread and can sometimes occur as early as childhood and adolescence. In particular, autoimmune disorders such as
- Hashimoto’s thyroiditis (symptoms of hypothyroidism) or
- Graves’ disease (symptoms of hyperthyroidism)
are becoming increasingly common and usually cause significant disruptions to the entire metabolism. If left untreated, they can even lead to serious health complications.
If a thyroid disorder is suspected, various tests are necessary. Thyroid diagnostics encompass all measures taken to identify disorders of the gland.
A thyroid examination is indicated for the following problems:
- Enlarged thyroid gland (goiter),
- palpable nodules in the thyroid area,
- Changes in the eyes (protrusion),
- suspected thyroid dysfunction (hyperthyroidism or hypothyroidism),
- inability to conceive, and
- pain in the thyroid area.
The thyroid gland is an important organ located at the front of the neck © SciePro | AdobeStock
Thyroid Diagnostic Procedures
The following procedures are used in thyroid diagnostics:
- Laboratory tests, primarily blood tests,
- Thyroid ultrasound,
- Thyroid scintigraphy,
- fine-needle aspiration.
Diagnosis also includes a comprehensive medical history. During this process, the doctor will ask you about
- family history of disease,
- existing autoimmune diseases, or
- possible stress factors.
Laboratory tests
The doctor will draw blood, which will be analyzed in the lab. The following parameters will be measured:
- TSH (thyroid-stimulating hormone),
- T3 (triiodothyronine),
- T4 (thyroxine),
- TRH test (to detect thyroid hormone resistance),
- thyroid antibodies (e.g., TSH receptor antibodies, antibodies against thyroglobulin, antibodies against thyroid peroxidase; these are measured when hypothyroidism or hyperthyroidism is suspected),
- Thyroglobulin (measured when thyroid carcinoma or certain functional disorders are suspected),
- Calcitonin (measured when thyroid carcinoma is suspected),
- Urine iodine measurement (performed when iodine contamination is suspected).
The following values are used for the early detection of potential complications that may result from thyroid disease:
- Cholesterol,
- blood pressure and pulse,
- Inflammation markers,
- liver and kidney function tests,
- fat and water retention.
Ultrasound (thyroid sonography)
Ultrasound (sonography) plays an important role in thyroid diagnostics. This imaging procedure reveals possible structural changes in the organ when a thyroid disorder is suspected.
The examination is performed using a high-frequency transducer and is completely painless.
Thyroid sonography allows the doctor to
- shape,
- location,
- size,
- volume, and
- nodules
can be accurately assessed. Even thyroiditis can be clearly visualized on an ultrasound.
Thyroid Scintigraphy
Scintigraphy is a nuclear medicine procedure that uses radioactively labeled iodine.
A thyroid scintigraphy is used to rule out thyroid cancer. It also provides information about nuclide uptake in specific areas of the thyroid gland as well as the organ’s overall function. Thus, thyroid scintigraphy can also visualize the structure of the thyroid gland.
Sometimes, a so-called suppression scintigraphy is performed afterward. This procedure examines the hormonal feedback loop of the pituitary gland. By administering thyroid hormones, the physician artificially induces a short-term hyperthyroidism. As a result, TSH secretion decreases, and the scintigram reveals reduced radionuclide uptake in normal thyroid tissue.
Fine-Needle Aspiration
Fine-needle aspiration is a gentle method of obtaining a tissue sample from the thyroid gland.
In this procedure, the doctor uses a small, very thin needle to extract a small amount of thyroid tissue directly through the skin. The procedure is almost painless and takes only a few seconds.
To prevent bruising, which may be accompanied by a feeling of pressure, good compression after the puncture is very important. Fine-needle aspiration can be performed under ultrasound guidance if it is not possible to stabilize the nodule to be punctured with a finger.
The extracted tissue is then placed on a glass slide. A pathologist examines the cells under a microscope.
Other procedures for diagnosing possible thyroid disorders
As a rule, the diagnostic procedures mentioned above are sufficient. Additional imaging procedures are rarely used.
If a large goiter develops, the trachea may become narrowed. An X-ray of the neck can determine whether a narrowing is present and how severe it is.
An MRI (magnetic resonance imaging) is necessary only very rarely.
If the thyroid extends into the chest cavity and surgery is required, a computed tomography (CT) scan should be performed prior to the procedure.
Which doctor should you see for thyroid disorders?
If you suspect you have a thyroid disorder, your primary care physician is the first person to contact. They will first take your medical history (through a consultation). If the suspicion is confirmed, they will refer you to an internist specializing in internal medicine.
Usually, an endocrinologist—a specialist in glands and hormones—will also be consulted. Endocrinologists are also specialists in internal medicine. They specialize in the diagnosis and treatment of glandular and hormonal disorders. This also makes them specialists in thyroid disorders.
Diagnostic procedures are also performed by specialists in nuclear medicine.
