Physical examination report of contemporary young people: I know every word, and when they are put together, they become...

The thyroid gland is the largest endocrine gland in the human body. It controls the body's energy consumption rate, synthesizes protein, and regulates the body's sensitivity to other hormones.

Once there is a problem with the thyroid gland, such as hyperthyroidism, hypothyroidism, thyroid nodules, thyroid cancer, etc., in addition to physical pain, the patient will also experience symptoms such as anxiety and depression, and in severe cases, it may even be life-threatening.

Therefore, it is very necessary for everyone to pay attention to thyroid health and understand thyroid and related diseases. This article is the third article in the [Thyroid] popular science column. If you are interested, please follow.

Introduction

"You have thyroid nodules." The doctor told Ajia after the physical examination results came out.

Triiodothyronine, thyroid stimulating hormone... Looking at the physical examination report, Ajia was puzzled. The indicators on the report made him very confused. What did the small arrows next to the indicators mean?

The current situation of contemporary young people represented by the Argentine Primera División: 20 years old in age, 40-year-old in mentality, 60-year-old in body, afraid to go for physical examinations, and report forms that they cannot understand.

At this moment, Ajia's hand holding the medical examination report was shaking slightly, "Doctor, do you think I still have a chance to understand the report?"

Jia Baoyu (West Lake Omi) | Written by

For most people, it is difficult to understand medical examination reports unless they have received professional and systematic training. The same is true for thyroid function test reports. The medical indicators on the reports do require some professional knowledge.

Today's article will teach you how to understand the thyroid function test report.

What is on the thyroid function test report?

Thyroid function tests fall under the category of blood tests. Below is a thyroid function test report.

Thyroid function test report

These dazzling indicators on the report sheet actually have their own English abbreviations, from top to bottom:

1. Triiodothyronine T3

2. Thyroid hormone T4

3. Free triiodothyronine FT3

4. Free thyroid hormone FT4

5. TSH

6. Anti-thyroglobulin antibody TGAb

7. Thyroglobulin Tg / HTG

8. Anti-thyroid peroxidase antibody TPOAb

9. Thyroid receptor antibody/thyroid stimulating hormone receptor antibody TRAb

10. Calcitonin CT

If you happen to compare your report, you will find a question, "Why don't I have some indicators?"

If not, it means the indicator is normal. There are many thyroid function indicator items in the above report, and we usually do thyroid function test items three , five and seven .

Of course, there are more detailed examinations than the report above. Some examinations will show some new indicators: such as total triiodothyronine (TT3), total thyroid hormone (TT4), reverse triiodothyronine (rT3), etc.

The number of indicators is not important. What is important is whether the indicators on the report are sufficient to help you diagnose your condition. Different symptoms require different thyroid function tests.

How to read the thyroid function test report

If there is a problem with the thyroid gland (such as hyperthyroidism, hypothyroidism, thyroid nodules, thyroid cancer, etc.), these indicators can be used to help us judge the condition of the thyroid gland, which can be roughly divided into two types: hormone indicators and antibody indicators .

In terms of hormone levels:

TT3: can be used to determine whether our thyroid function is normal;

TT4: can determine whether the patient has hyperthyroidism or hypothyroidism;

FT3: This is the most sensitive indicator for judging hyperthyroidism;

FT4: This index is relatively sensitive. Even if some indicators are unstable due to illness or other factors, it can still accurately reflect whether the thyroid function is abnormal.

TSH: It can promote the production of thyroid hormones and can help further determine whether the thyroid function is normal;

CT scan: can help rule out medullary thyroid cancer.

In terms of antibody levels:

TGAb: can be used to diagnose autoimmune thyroid diseases, such as Graves' disease (also known as toxic diffuse goiter), Hashimoto's thyroiditis, etc.

TPOAb: used to determine and test whether a patient has Hashimoto’s thyroiditis;

TRAb: This is the primary diagnostic indicator for Graves' disease.

After understanding what these indicators represent, how do we judge whether the indicators are within the normal range? In fact, the hospital has thoughtfully marked which indicators on the report are high and which are low with small upward or downward arrows. It is very complicated to determine which indicator corresponds to which disease, and it is necessary to comprehensively judge the situation of each indicator.

You can take the report form in your hand and refer to the following table:

For example, if the TT4 indicator is significantly higher than the normal indicator (as shown in the figure), combined with other indicators, if it meets the conditions marked under the "Hyperthyroidism" column, you may be suffering from hyperthyroidism.

Of course, thyroid function tests are only a preliminary assessment of the thyroid condition. This test can help doctors make the first step in making a judgment, and then they can use other diagnostic methods for further identification and diagnosis.

For example, the B-ultrasound and magnetic resonance imaging we are familiar with, as well as the fine needle aspiration (FNA) which is more suitable for the diagnosis of thyroid diseases.

Thyroid B-ultrasound examination Image from: niddk.nih.gov

“Three items”, “five items”, “seven items”, how to choose

The three, five, and seven thyroid function tests mentioned above can be used to check for which thyroid diseases, and how should we choose?

Thyroid function test Image from: ucsfbenioffchildrens.org

The three thyroid function tests are TSH, FT3, and FT4 . The fifth test adds TT3 and TT4 to the three tests. The seventh test adds TPOAb and TGAb.

Three thyroid function tests:

It is a relatively basic thyroid function test that can be used for prenatal checkups, routine physical examinations, etc. It can also be used for preliminary screening of thyroid diseases.

Five thyroid function tests:

The addition of TT3 and TT4 to the five items can help determine whether the thyroid function is normal and diagnose whether there is hyperthyroidism or hypothyroidism. Therefore, it is more suitable for patients with abnormal thyroid function who are taking medication, and can also help determine the cause of the disease.

Seven thyroid function items:

The two items added to the seven items, TPOAb and TGAb, are important indicators that help determine whether the thyroid gland is inflamed and are generally suitable for diagnosing autoimmune thyroiditis.

For people with normal thyroid function, if they want to do a routine check, it is enough to choose three thyroid function tests. But if the thyroid function is abnormal, you can choose five or seven thyroid function tests based on the doctor's judgment and advice.

Learning to read the thyroid physical examination report yourself is only the first step. The most important thing is to communicate carefully with the doctor and follow the doctor's instructions to decide whether to proceed with the next step of diagnosis and treatment.

➽ References:

1. Hyperthyroidism? Hypothyroidism? Or goiter? This article will teach you how to understand various indicators of thyroid function! | Thyroid cancer | 2022 National Cancer Report

2. The diagnostic value of combined detection of seven thyroid function indicators in thyroid diseases--Journal of Clinical Rational Drug Use, Issue 13, 2020 (cnki.com.cn)

3. Analysis of the results of five thyroid function tests and evaluation of their clinical diagnosis compliance rate--Jilin Medicine, 2019, Issue 01 (cnki.com.cn)