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Thyroid Function Test Interpretation Table

TSH, Free T4, Free T3 and Associated Condition
#Diagnosis #Endocrinology #Hyperthyroid #Hypothyroid #Function
Free T4, Free T3 ... Endocrinology #Hyperthyroid ... #Hypothyroid #Function
Abnormal Serum TSH - Differential Diagnosis Algorithm
Increased TSH
 • Hypothyroidism
 • Sub-clinical Hypothyroidism
 • Recovery from
Thyrotoxicosis • T3 ... Diagnosis #Algorithm #Hypothyroid ... #Hyperthyroid #
Subacute Thyroiditis

Also known as: de Quervain’s thyroiditis, granulomatous thyroiditis, or viral thyroiditis

What?
Postviral inflammatory process caused by
inflammatory process caused ... after onset Causes ... phase: ↑ T4 and T3 ... levels, ↓ TSH (2) Hypothyroid ... thyroid #diagnosis #management
Laboratory Evaluation of Patients for Thyroid Disease 
Hyperthyroidism:
 • Graves disease - TSH low; free T4
high; in some cases ... , T3 is elevated ... low; free T4 and T3 ... disease course #hypothyroid ... #hyperthyroid #
Hyperthyroidism (low TSH, High T4/T3) - Diagnostic Algorithm

Radioactive iodine scan – get if concern for nodular
low TSH, High T4/T3 ... workup choices AND management ... Hyperthyroidism #Hyperthyroid
Amiodarone Toxicity and Monitoring

Tremor Ataxia 
Ocular neuritis 
Corneal Microdeposits 
Bradycardia 
Pulmonary fibrosis 
Hepatotoxicity 
Blue-gray skin
Photosensitivity Hyperthyroid ... Hypothyroid ... Adverse #Diagnosis #Management
Pharmaceutical Management of Hyperthyroidism / Thyroid Storm
Beta-Blockers 
• Decreases sympathetic hyperactivity 
• Partially blocks peripheral conversion
Pharmaceutical Management ... conversion of T4 to T3 ... conversion of T4 to T3 ... conversion ofT4 to T3 ... #ThyroidStorm #Management
Occult Causes of Non-Response to Vasopressors

vital disclaimer: the cognitive response to hypotension should not be reaching
Occult Causes of ... response -> cognitive pause ... - acidosis - hypothyroid ... toxicologic - 2nd cause ... #Differential #Causes
Hyperthyroidism Overview

Clinical Manifestation of Hyperthyroidism:
 • Fatigue
 • Weight loss
 • Heat intolerance
 • Depression, nervousness
thyrotoxicosis • T3 ... TSH • ↑ Total T3 ... ↑ FT4 and/or ↑ T3 ... : Reduce T4 -> T3 ... hyperthyroidism #causes
Hypercalcemia - Differential Diagnosis Algorithm
Elevated PTH (High or normal):
 • Primary Hyperparathyroidism
 • Familial Hypocalciuric Hypercalcemia
Low
Bone Resorption: Hyperthyroid ... Diagnosis #Algorithm #causes