Goiter laboratory findings

Goiter Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Goiter from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Goiter laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Goiter laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Goiter laboratory findings
CDC on Goiter laboratory findings
Goiter laboratory findings in the news
Blogs on Goiter laboratory findings
Directions to Hospitals Treating Cushing’s disease
Risk calculators and risk factors for Goiter laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Laboratory Findings

• Laboratory testing for the following:
  • Serum TSH
  • Serum T3
  • Serum T4

Condition	T3	T4	TSH
Thyrotoxicosis	Increased	Increased	Supressed
T3 Toxicosis	2X (Increased Twice)	Normal	Supressed
Hypothyroidism	Lo/Normal	Low	Increased

• Serum thyroglobulin
• Serum cholesterol
• Thyroid scintigraphy
• Anti-TPO Antibodies detected in most autoimmune thyroid disease (eg, Hashimoto thyroiditis, idiopathic myxedema, and Graves disease)
• Urinary Iodine levels less than 10 mcg/dL is suggestive of Iodine deficiency

Thyroid function tests:

• In Goiter, serum TSH levels evaluation is advised.
• Patients with Goiter may be in a euthyroid, hypothyroid or hyperthyroid state.
• When the serum TSH is below normal levels, then the serum free T4 and T3 should should be evaluated. The most likely diagnosis in patients with overt or subclinical hyperthyroidism and goiter is either multinodular goiter (MNG) or Graves' disease.
• When theTSH is above normal levels, then the free T4 should be evaluated. Hashimoto's thyroiditis is the most probable diagnosis in patients presenting with overt or subclinical hypothyroidism, except for patients for those in the areas of iodine deficiency leading to endemic goiter.

• Thyroid peroxidase antibodies (TPO): In patients with goiter, serum TPO antibodies have to be evaluated. In patients with goiter and and normal TSH levels, TPO antibodies are measured to rule out Hashimoto's thyroiditis.
• In the United States, TPO antibodies are mostly elevated in patients with elevated TSH (hypothyroidism) and goiter, and the most likely diagnosis is Hashimoto's thyroiditis.