Hypothyroidism: screening and exams

Hypothyroidism from birth is a cause of mental retardation. In France, it is systematically sought in all newborns in the first days of their life to be treated, if it exists. A drop of blood is taken from the heel of the newborn and allows to measure the thyroid hormones.

Different examinations can be done to explore the functioning of the thyroid. The first examination takes place in the doctor's office: palpation. While palpating the base of your neck, your GP will be able to detect a possible goitre (an increase of the volume of the thyroid gland), but it is rather rare in case of hypothyroidism. Some tests may be prescribed to explore the thyroid.

> Ultrasound allows the thyroid to be visualized and thus to measure its volume, to detect if it is the site of an inflammation (thyroiditis).

> Hormonal assays are essential tests (performed by a blood test). They measure TSH, the thyrotropulin, the hormone that is secreted by the pituitary, in the brain. It is she who directs the thyroid hormone secretions.

TSH rises strongly in the hypothyroid diseases causing disorders; T4, which is directly produced by the thyroid, is lowered. TSH is increased in isolation, with no T4 abnormality, in the more discrete forms that give only few disorders; if a treatment is prescribed, it can not be expected to be of great benefit.

In contrast, the isolated decrease in T3 is not a sign of a hormone deficiency, and is observed in case of weight loss, general illness, under the influence of drug intake ... and does not require no hormonal therapy.

Hypothyroids often have elevated levels of antithyroid antibodies. It is the witness of aggression of the gland.

Rarely the examination of the neck or the ultrasound allows in the subject with hypothyroidism to detect nodules (which are perceived as small balls). The vast majority of these nodules are benign.

A small number are thyroid cancers that can be suspected by ultrasound examination, and especially the needle aspiration is the best way to make a diagnosis. This is a sample of a few cells of thyroid tissue. This is done using a very fine needle. This is hardly painful and cell analysis can give a precise answer and determine whether to operate.

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