Investigations of thyroid disorders:

       Thyroid Disease is more prevalent in women, so if you are suffering any of these symptoms you need to test your thyroid function:

1. Primary hypothyroidism:
   • High TSH
   • Low total and free T4.
   • Low total and free T3 (20-30 % of 1ry hypothyroidism have Normal T3.)
   • Positive antimicrosomal or anti-thyroglobulin antibodies in Hashimoto's thyroiditis.
   • Other lab. Tests in 1ry hypo thyroidism
   • CK : High
   • Lipids : cholesterol & triglycerides
   • Normocytic or pernicious anemia
   • Iron deficiency anemia due to associated menorrhagia
   • Gonadotrophins (FSH, LH) : low
   • prolactin : High
   • ↑ liver enzymes (AST, ALT)
   • ↑ creatinine
2. Secondary hypothyroidism:
   • Low TSH.
   • Low total and free T4.
   • Low total and free T3.
3. Primary Hyperthyroidism
   • High total and free T4.
   • High total and free T3.
   • Low TSH (use S-TSH).
   • Positive antimicrosomal and antithyroglobulin antibodies in Grave’s disease.
   • Other lab tests in 1ry hyper thyroidism:
     • Lipids : low cholesterol and LDL–c
     • GTT : Diabetic type of curve
     • liver function :Abnormal AST & ALP & GGT due to malnutrition
     • Hypercalcemia, hypercalciuria & ↑ALP (Osteoporsis)
     • low sperm count
     • ↑ SHBG: ↑ Testosterone & estrogens
     • N . Or ↑ LH / FSH .
4. Secondary hyperthyroidism:
   • High total and free T4.
   • High total and free T3.
   • High TSH.