Thyroid Blood Tests

Thyroid Blood Tests

Medical Author: Ruchi Mathur, M.D.
Medical Editor: William C. Shiel Jr, MD, FACP, FACR

• Introduction
• What are thyroid hormones?
• Thyroid hormone regulation -- the chain of command
• How is hypothyroidism diagnosed?
• How is hyperthyroidism diagnosed?
• Are there other tests of the thyroid gland?
• Patient Discussions: Thyroid Blood Tests - Helped With Your Diagnosis

Introduction

The thyroid gland produces hormones that are essential for normal body metabolism. Blood testing is now commonly available to determine the adequacy of the levels of thyroid hormones. These blood tests can define whether the thyroid gland's hormone production is normal, overactive, or underactive.

What are thyroid hormones?

Thyroid hormones are produced by the thyroid gland. This gland is located in the lower part of the neck, below the Adam's apple. The gland wraps around the windpipe (trachea) and has a shape that is similar to a butterfly - formed by two wings (lobes) and attached by a middle part (isthmus).

The thyroid gland uses iodine (mostly available from the diet in foods such as seafood, bread, and salt) to produce thyroid hormones. The two most important thyroid hormones are thyroxine (T4) and triiodothyronine (T3), which account for 99.9% and 0.1% of thyroid hormones present in the blood respectively. However, the hormone with the most biological activity is T3. Once released from the thyroid gland into the blood, a large amount of T4 is converted into T3 - the active hormone that affects the metabolism of cells.

Thyroid hormone regulation -- the chain of command

The thyroid itself is regulated by another gland that is located in the brain, called the pituitary. In turn, the pituitary is regulated in part by the thyroid (via a "feedback" effect of thyroid hormone on the pituitary gland) and by another gland called the hypothalamus.

The hypothalamus releases a hormone called thyrotropin releasing hormone (TRH), which sends a signal to the pituitary to release thyroid stimulating hormone (TSH). In turn, TSH sends a signal to the thyroid to release thyroid hormones. If a disruption occurs at any of these levels, a defect in thyroid hormone production may result in a deficiency of thyroid hormone (hypothyroidism).

The rate of thyroid hormone production is controlled by the pituitary gland. If there is an insufficient amount of thyroid hormone circulating in the body to allow for normal functioning, the release of TSH is increased by the pituitary gland in an attempt to stimulate more thyroid hormone production. In contrast, when there is an excessive amount of circulating thyroid hormone, TSH levels fall as the pituitary attempts to decrease the production of thyroid hormone. In persons with hypothyroidism (thyroid hormone production is below normal), there is a continuously decreased level of circulating thyroid hormones. In persons with hyperthyroidism (thyroid hormone production is above normal), there is a continuously elevated level of circulating thyroid hormones.

Next: How is hypothyroidism diagnosed? » Source: MedicineNet.com
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