Level of thyroid-stimulating hormone as basic diagnostic marker and criterion of treatment success of thyroid diseases

В. І. Паньків

Abstract


In the article information is generalized on the aspects of early diagnostics of thyroid disorders. The value of thyroid-stimulating hormone is underlined as basic test for determination of the thyroid functional state and criterion of treatment success of thyroid diseases. Particular attention is paid to subclinical hypothyroidism, in which the clinical manifestations of the disease are very subtle. As emphasized in the article, in fact, the presence or absence of symptoms depends on the attention of the doctor who examines the patient, and the appropriate patient’s attitude even to minor changes in his body.

In addition, one of the main tasks in the family doctor’s practice is the early diagnosis of subclinical hyperthyroidism and the appointment of appropriate treatment with thyreostatics, which allows to restore the normal activity of heart or prevents the progression of cardiovascular disorders into more severe forms of heart failure.

Recommendations for diagnosing thyroid dysfunction of the American Thyroid Association recommend a screening test for the thyroid-stimulating hormone level in all adults over 35 years with an interval of 5 years.

During the last three decades, laboratory methods used to diagnose thyroid diseases have been significantly improved. To date, the first level test, which is used at the initial stage of diagnostic search and screening for congenital hypothyroidism in newborns, is the determination of the thyroid-stimulating hormone concentration by a sensitive method.

In Ukraine, under the conditions of iodine deficiency, the absence of a national program for the prevention of iodine deficiency disorders, an unfavorable ecological situation, it is recommended the determination of thyroid-stimulating hormone at the beginning of treatment of patients with cardiological, gynecological, gastroenterological, neurological, dermatological, and other pathologies. The success of treatment and the achievement of a state of compensation for thyroid pathology are also determined by the level of thyroid-stimulating hormone. Patients with nodular pathology of the thyroid gland should also be sure to determine the level of calcitonin, the high content of which in the blood is the most important diagnostic criterion of medullary thyroid cancer.


Keywords


thyroid; thyroid-stimulating hormone; diagnostics

References


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GOST Style Citations


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4. Bahn, R.S., Burch, H.B., Cooper, D.S., et al.: American Thyroid Association; American Association of Clinical Endocrinologists. “Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.” Thyroid 21.6 (2011): 593–646. DOI: 10.1089/thy.2010.0417

5. Clinical Management of Thyroid Disease. Ed. by F.E. Wondisford, S. Radovick. Baltimore, Maryland. John Hopkins University School of Medicine (2009): 860 p.

6. Kahapola-Arachchige, K.M., Hadlow, N., Wardrop, R., et al. “Age-specific TSH reference ranges have minimal impact on the diagnosis of thyroid dysfunction.” Clin Endocrinol (Oxf) 77.5 (2012): 773–9. DOI: 10.1111/j.1365-2265.2012.04463.x

7. Koulouri, O., Auldin, M.A., Agarwal, R., et al. “Diagnosis and treatment of hypothyroidism in TSH deficiency compared to primary thyroid disease: pituitary patients are at risk of under-replacement with levothyroxine.” Clin Endocrinol (Oxf) 74.6 (2011): 744–9. DOI: 10.1111/j.1365-2265.2011.03984.x

8. Menconi, F., Marcocci, C., Marinò, M. “Diagnosis and classification of Graves’ disease.” Autoimmun Rev 13.4–5 (2014): 398–402. DOI: 10.1016/j.autrev.2014.01.013





DOI: http://dx.doi.org/10.18370/2309-4117.2017.35.84-88

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