Thyroid Function Tests

Thyroid disorders are very common and may affect one out of every 10 adults. Women are more likely to be affected than men. The thyroid gland is located in the neck, very close to the voice box (larynx). Its purpose is to manufacture and strategically release thyroid hormone (also known as thyroxine or T4). T4 affects almost every cell in the body and regulates the metabolic rate of the cells functions. The thyroid gland is under the control of the pituitary gland. The pituitary is located on the underside of the brain, just behind the eyes. The pituitary is about the size of a pea. It manufactures a number of hormones in order to control a broad spectrum of endocrine functions including the thyroid gland. The way it controls the thyroid is by producing the hormone known as TSH (or Thyroid Stimulating Hormone or Thyrotropin). When the body level of T4 falls too low the pituitary responds by releasing TSH which then turns on the thyroid to release T4. When the T4 level becomes too high, the pituitary responds by shutting-off TSH. The thyroid gland will then turnoff and the blood T4 will fall back to normal. This regulatory process is known as a feedback loop.

There are three types of disorder that are worthy of discussion: Hyperthyroidism, Hypothyroidism, and Thyroid Cancer. Hyperthyroidism Hyperthyroidism occurs when the thyroid gland makes too much T4 and the normal feedback loop cannot correct the situation. This is probably due to an aberration of the immune system. When too much T4 is fed into the blood stream (T4 increases)

a number of bodily changes occur. These include: tremor, muscle weakness, intolerance to heat, nervousness, exhaustion, increased metabolism, rapid pulse, and eye problems (including eye bulging or exophthalmus). The lab findings in hyperthyroidism include a high T4, a high Free T4, and a very low (suppressed) TSH. This is because the TSH becomes turned off by the excess T4. Hypothyroidism Hypothyroidism occurs when the thyroid gland becomes inefficient and fails to produce enough T4. The pituitary gland (through the feedback loop) will produce increased amounts of TSH. In the early stages of hypothyroidism, the T4 level will remain normal, but the TSH will be raised. Eventually, the thyroid gland will fail sufficiently to cause the T4 to fall below normal and the TSH will become significantly raised. Hypothyroidism causes exhaustion, metabolic slowing, cold intolerance, hair loss, and depression. The lab findings (early on) are a normal T4 and Free T4 with an elevated TSH. Later the T4 and Free T4 become low and the TSH rises even higher. Treatment is achieved by taking thyroid replacement therapy (L-thyroxine) by mouth on a daily basis. Measuring the TSH can be used to monitor how appropriate the therapy is but should not be done more than once a month when treatment is started and no more often than once per year thereafter (unless there are unusual symptoms). Thyroid Cancer

Lumps in the thyroid gland occur in up to 4% of all people. In contrast, thyroid cancer is relatively uncommon and accounts for only about 5 deaths per million population per year. The diagnostic dilemma is to distinguish benign disease from cancer. This diagnostic problem is solved using clinical examination, radioactive scanning, ultrasound, and needle biopsies Thyroid function tests performed on blood samples play a secondary role in diagnosis of cancer. They are used to determine whether thyroiditis (inflammation of the thyroid) is the cause of the lump or if there is a raised T4 as seen in toxic goiter. After diagnosis and treatment a patient may be given Thyroid pills to raise the level of T4 in the blood stream as a way to shrink the thyroid gland. In such cases it is necessary to measure TSH at intervals in order that the TSH is maintained between 0.3 and 0.5 U/L.

Another test, Thyroglobulin, is used to monitor patients after treatment for thyroid cancer. Successful treatment is accompanied by a low level of thyroglobulin. A recurrence of the cancer may be heralded by an increase in the Thyroglobulin before it is too late to take further action.

What form(s) does Eltroxin come in?

50 g Each white, round, scored tablet engraved with "50" on one side contains 50 g of levothyroxine. Nonmedicinal ingredients: acacia powder, cornstarch, lactose, and magnesium stearate. 100 g Each yellow, round, scored tablet engraved with "100" on one side contains 100 g of levothyroxine. Nonmedicinal ingredients: acacia powder, colorcon yellow, cornstarch, lactose, and magnesium stearate. 150 g Each blue, round, scored tablet engraved with "150" on one side contains 150 g of levothyroxine. Nonmedicinal ingredients: acacia powder, colorcon blue, cornstarch, lactose, and magnesium stearate. 200 g Each pink, round, scored tablet engraved with "200" on one side contains 200 g of levothyroxine. Nonmedicinal ingredients: acacia powder, cornstarch, erythrosine, lactose, magnesium stearate. 300 g Each green, round, scored tablet engraved with "300" on one side contains 300 g of levothyroxine. Nonmedicinal ingredients: acacia powder, colorcon green, cornstarch, lactose, and magnesium stearate.

Who should NOT take Eltroxin?

Levothyroxine should not be used by anyone who:

is allergic to levothyroxine or to any of the ingredients of the medication is having a heart attack has acute thyrotoxicosis (too much thyroid hormone in their system) has uncorrected adrenal insufficiency