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Thyroid Function Tests (TFTs) and Interpretation

 • TSH, Free T4, Free T3
 • T3 Uptake
 •
Thyroid Function ... Free T4, Free T3 ... • T3 Uptake ... FTI) • Reverse T3 ... @DharSaty #Thyroid
Laboratory Evaluation of Patients for Thyroid Disease 
Hyperthyroidism:
 • Graves disease - TSH low; free T4
of Patients for Thyroid ... iodine uptake; thyroid ... iodine uptake; thyroid ... procedure that ablates thyroid ... concentrations of TSH and thyroid
Pharmaceutical Management of Hyperthyroidism / Thyroid Storm
Beta-Blockers 
• Decreases sympathetic hyperactivity 
• Partially blocks peripheral conversion
Hyperthyroidism / Thyroid ... conversion of T4 to T3 ... Blocks synthesis of thyroid ... conversion of T4 to T3 ... conversion ofT4 to T3
Algorithm for the diagnostic workup of hyperthyroidism. (T3 = triiodothyronine; T4 = thyroxine; TSH = thyroid-stimulating
(T3 = triiodothyronine ... thyroxine; TSH = thyroid-stimulating
Amiodarone Thyroid Complications
Amiodarone: 
 - iodine-rich, similar structure to T4, with half life up to 100d
Amiodarone Thyroid ... conversion ofT4 to T3 ... can prevent T4/T3 ... directly toxic to thyroid ... pts w/ latent thyroid
Hyperthyroidism Overview

Clinical Manifestation of Hyperthyroidism:
 • Fatigue
 • Weight loss
 • Heat intolerance
 • Depression, nervousness
thyrotoxicosis • T3 ... TSH • ↑ Total T3 ... ↑ Free T4 • Thyroid ... ↑ FT4 and/or ↑ T3 ... : Reduce T4 -> T3
Approach to Thyroid Function Tests in the Evaluation of Hyperthyroidism
 • Low TSH, Low normal T4
Approach to Thyroid ... normal T4 +/- T3 ... TSH, high T4 +/- T3 ... symmetrically enlarged thyroid ... TSH, high T4 +/- T3
Abnormal Serum TSH - Differential Diagnosis Algorithm
Increased TSH
 • Hypothyroidism
 • Sub-clinical Hypothyroidism
 • Recovery from
Recovery from Non-Thyroid ... Thyrotoxicosis • Non-Thyroid ... Thyrotoxicosis • T3
Thyroid Function Test Interpretation Table

TSH, Free T4, Free T3 and Associated Condition
#Diagnosis #Endocrinology #Hyperthyroid #Hypothyroid #Function
Thyroid Function ... Free T4, Free T3
Approach to the Diagnosis of Hyperthyroidism - Differential Diagnosis and Workup Algorithm

 • Secondary Hyperthyroidism (↑↔TSH,
↑↔TSH, ↑Total T3 ... (↓TSH, ↔Total T3 ... (↓TSH, ↑Total T3 ... (↔TSH, ↔Total T3 ... • Exogenous thyroid