Doctors prescribe completely different sets of hormone indicators for blood tests in the diagnosis of the thyroid gland. Some endocrinologists always determine only TSH. And the majority of them! More literate always with the TTG rate rate T4-free. Others, instead of T4sv. determine the total fraction of thyroid hormones. And how to make a blood test?
There are practiced simple rules for determining the determination of hormone blood tests. Use them, regardless of the opinion of a local specialist, and always get the opportunity to complete diagnosis.
1. Blood test for the first time.
If thyroid gland hormones have not been previously determined or such a study has been done for a long time (more than 9-12 months), then it is better to determine such a set of indicators: TSH, T3fr., T4fr., T4tot., AT-TPO, AT-TG.
2. Blood test control (repeated).
Always, at a minimum, define three indicators: TSH, T3fr. and T4fr. If changes to other indicators have been identified before, evaluate them as well. For example: 1) TSH, T3fr., T4fr. and AT-TPO, or 2) TSH, T3fr., T4fr., T4 total., AT-TPO.
3. Blood tests only TSH or a combination of TSH with any one other indicator is not complete.
It is also not a complete diagnosis when combined with TSH with common hormone fractions.
4. Blood test for thyroid nodules.
If it is known in advance that there is a node or nodes in the thyroid gland, then along with the obligatory three indicators (TSH, T3fr. and T4fr.) It is advisable to determine Thyroglobulin (show the amount of tissue death in the node) and Calcitonin (show the probability of medullary cancer - it is extremely rare) . But these indicators can be assessed after ultrasound, if the doctor determines the class of the node by TI-RADS of 4A or more (this approach will save).
5. Always determine the main thyroid hormone consumed - T3 (in free form).
Whatever you say or write about T3fr., you should know: there are only two energy-carrying thyroid hormones - T4 and T3, of which T4 consumes only 10-20%, and T3 hormone - 80%. Those. T3 - the main hormone consumed.
The thyroid gland produces more T4, but almost the entire amount of T4 is converted outside the gland (in the liver, kidneys, muscles, intestines, nervous system, etc.) into the hormone T3cv, which is absorbed by all cells of the body.
6. Thyroid Blood test can be done regardless of the day of the menstrual cycle, which has little or no effect on the result.
7. Endocrinologists recommend taking a hormonal drug after blood sampling in the laboratory.
However, there are studies showing little effect of the drug on the day of "blood donation" in the laboratory. Therefore, if by habit we took a hormonal drug immediately upon awakening, then we can not postpone the trip to the laboratory.
8. Mark on the form from the blood test results the dose of the medication taken (hormonal or thyreostatic).
Such a rule will help the competent physician to orient in the features of hormonal metabolism and the sufficiency of forces in your thyroid gland during the study period.
It will be useful to watch a special movie about a blood test for patients from the “Clinic of the thyroid gland” by Dr. A.V. Ushakov.
Also pay attention to the book for patients "Blood test for diseases of the thyroid gland." You can watch a movie about the book.