13/07/2015

ThyroidFunctionTestsManagingSideEffectsChemocare

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CareDuringChemotherapyandBeyond

ThyroidFunctionTests
Whatdoesthethyroidglanddoandwhatisathyroidfunctiontest?
Yourthyroidglandisanimportantpartofourmetabolism,andourbody'sfunctioning.Thethyroidgland
controlsmetabolism,orenergyderivedfromthefoodsthatyoueat,andmaintainsyournormalbody
temperature,andheartrate.Yourappetiteandyourdigestivesystemwillalsobeaffectedbyyourthyroidgland.
Thethyroidglandisalsoimportantinmuscleandbonedevelopment,aswellasnormalbrainandnervous
systemfunctioning.Thethyroidglandislocatedinthemiddleofyourneck.
Therearemanythyroidhormones.Eachhasadifferentrole.Itallstartswithiodide,asaltthatisnowfoundin
mostbrandsoftablesalt.
Theiodidethatyouingestistakeninbythethyroidgland.Herebeginsacomplexhormoneprocess:
Onceconvertedtoiodine,yourserumT4,(calledthyroxine)hormoneisformed.
Thethyroxinehormoneisconvertedintoamorepotentoractiveformofhormone,yourserum(blood)
T3.Thisisalsocalledtriiodothyronine.TheseT4andT3hormoneswillcirculateinyourbody,and
regulateyourmetabolism.
YourFT4I(freethyroxineindex)isanothertestusedtomeasureyourthyroidfunction..
Allofthesethyroidfunctiontestsareallindicatorsofyourthyroidglandfunction.
Thyroidstimulatinghormone(TSH),isthemostcommontestthatisorderedifyourhealthcareprovider
thinksthatyourthyroidglandisnotfunctioningproperly.Agland,calledthepituitarygland,secretesTSH.
TSHisresponsiblefortakingiodideoutofyourbloodstream,andintoyourthyroidgland.TSHisalso
responsibleforproductionofthethyroidhormone.
IfyouhaveanabnormallyhighorlowTSHlevel,whetheritiselevatedordecreased,yourhealthcare
providermayorderserum(blood)T3,serumT4,orFT4Itests.Whiletherearemanyotherteststhatcan
bepreformed,thesearethemostcommontestsfordiagnosinghyperthyroidorhypothyroid,andthe
mostspecificindicatorsastohowwellyourthyroidglandisfunctioning.
Basedonyourlaboratoryvaluesofyourthyroidfunctiontests,andyoursymptoms,yourhealthcare
providermaydecidewhetherornottotreatyourdisease,whetheritbehyperthyroidismor
hyporthyroidism.
Incasesofhyperthyroidism,yourTSHlevelwillbedecreased,becausethereistoomuchthyroid
hormoneinyourblood.YourTSHlevelswillbedecreased,if:
YouhaveGrave'shyperthyroidism.Thisisthemostcommoncauseofhyperthyroidism.Formany
reasons,yourbodyisproducingtoomuchofthethyroidhormone.
Yourthyroidglandistoolarge,oryoumayhaveathyroidtumorproducingtoomuchofthethyroid
hormone
Yourthyroidisinfected,orinflamed,producingtoomuchthyroidhormone(resultinginhyperthyroidism).
Yourthyroidglandwasinjured,orremoved,andyouaretakingtoomuchthyroidhormoneinapillform,
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asareplacement.
Incasesofhypothyroidism,thethyroidfunctiontestTSHwillbeincreased,becausethereisnotenough
thyroidhormoneinyourblood.YourTSHlevelswillbeincreased,if:
Yourthyroidglandisnotworkingasitnormallyshould
Yourthyroidglandisinfectedorinflamed,asinHashimoto'sthyroiditis,orautoimmunethyroiditis.This
occurswhenyourbodyisattackingyourthyroidgland,forsomeunknownreason.Thyroiditiscanalsobe
seenafterpregnancy.
Youroveractivethyroidglandwasremoved,andyouarenottakingenoughhormonepillstoreplacethe
normalthyroidhormonethatwaslost,thusresultinginhighTSHlevels.
Youmayhaveadamagedthyroidgland.
ToomuchortoolittleiodideintakeEitheryouarenottakingenoughiodideinyourdiet,oryouaretaking
toomuchiodideinyourdiet.Toomuchiodidewillsuppressthehormoneproduction.
Certainmedications,suchaslithium(forapsychologicalcondition,calledbipolardisorder),or
amiodarone(forheartrhythmabnormalities),maycauselowTSHlevelsorhypothyroidism.Thalidomide,
adrugthatisusedinmanyformsofcancersbecauseofit'spreventsnewbloodcellformationtotumor
cells(antiangiogenesis),maycausehypothyroidismwithlongtermuse.
Radiationtotheneckareamaycausehypothyroidism(asinheadandneckcancer)
Normallevelsofthyroidhormonesinthyroidfunctiontests:
NormalLevelsofThyroidHormones*
TSH
0.55.0mU/L
T3
95190ng/dl
T4
511g/dl
FT4I
6.512.5
*normalvaluesmayvaryfromlaboratorytolaboratory

Whataresomekeysymptomsofhypothyroidismandhyperthyroidismtolookfor?
Ifyouhaveahyperactive(overactive)thyroid,youmaynoticethesesymptoms:
Weightloss,eyeorvisionchanges.
Palpitations,rapidheartbeat,shakiness,sweating,feeling"hot"
Diarrhea,stomachandbowelabnormalitiesoranxiety
Insomnia(troublesleeping),fatigue,weakness,orhairloss
Anenlargedthyroidgland,oragoiter,mayresult
Ifyouhaveahypoactive(underactive)thyroid,youmaynoticethesesymptoms:
Weightgain,depression,forgetfulness,decreasedconcentrationorfatigue
Hoarseness,feelingcoldorsluggish,hairloss,dryskin,roundpuffyface(seenwithaseverely
depressedthyroidgland),ortinglinginyourhands/feet
Highcholesterol,constipation,irregularorheavymenstrualperiodsinpremenopausalwomen,low
sexdriveorinfertility.
Thingsyoucandoaboutthyroidmalfunction:
Ifyounoticeanyofthesesymptoms,visityourhealthcareproviderforanexamination.Thediagnosisof
hypothyroidandhyperthyroidincludeahistory(yourfamilyandhealthhistorymayplaceyouatrisk),physical
examination,andkeythyroidfunctiontests.Sometimes,anultrasoundorthethyroidglandmayalsobe
ordered.Therearetreatmentsforeachofthesediseases.Followyourentirehealthcareprovider'sinstructions
regardinglaboratorytestingforyourdisease,andfollowupcaredependingontheresults..
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Trytoexercise.Makeadailywalkalone,orwithafriendorfamilymemberapartofyourroutine.Even
lightwalkingoraerobicactivitymayhelpyoutopromotetheflowofoxygeninyourlungsandblood
(oxygenation),andmakeyoufeelbetter.
Followagooddiet.Ingeneral,increaseyourintakeoffreshfruitsandvegetables.Limityourintakeof
fats.Eatcarbohydrates(suchassugarsandpastas)inmoderation.
Makesureyoutellyourdoctor,aswellasallhealthcareproviders,aboutanyothermedicationsyouare
taking(includingoverthecounter,vitamins,orherbalremedies).Thesecancauseinteractionswith
othermedications.
Remindyourdoctororhealthcareproviderifyouhaveahistoryofdiabetes,liver,kidney,orheart
disease.
Keepyourselfwellhydrated.Drinktwotothreequartsoffluidevery24hours,unlessyouareinstructed
otherwise.
Ifyouexperiencesymptomsorsideeffectsofyourdiseaseortherapy,especiallyifsevere,besureto
discussthemwithyourhealthcareteam.Theycanprescribemedicationsand/orofferothersuggestions
thatareeffectiveinmanagingsuchproblems.
Keepallyourappointments.
Drugsthatmaybeprescribedbyyourdoctortotreathypothyroidismandhyperthyroidism:
Ifyouhaveanoveractivethyroid(hyperthyroidism)yourdoctororhealthcareprovidermayprescribe:
DrugstodecreaseyourthyroidlevelsmayincludeMethimazole(Tapazole ),orpropylthiouracil(PTU).
Thesepillsareusedonceaday,todecreaseyourthyroidhormoneproduction.Youmayneedtotake
thisonceaday,atthesametimeeachday,forayearorlonger,totreatyourhyperthyroidism.
Propranololthisisamedicationtotreatyourhyperthyroidism.Alsousedtotreatheartproblems,
includingpalpitations,itwilldecreaseyourrestingheartrate.
Ifyouareonanyofthesemedications,youmustfollowyourhealthcareprovider'srecommendations,
includingmedicationschedule,andfollowupvisits.
Ifyouhaveanunderactivethyroid(hypothyroidism)yourdoctororhealthcareprovidermayprescribe:
Levothyroxine:Thisisasyntheticformofathyroidhormonethatwillnormalizeallofyourthyroid
functioning.Itisgiveninapillform.Youmaynotseeachangeinyoursymptomsfor3to6weeks.You
maytakethispillonceaday,withorwithoutmeals.
YouwillberequiredtohaveperiodicthyroidfunctiontestsparticularlycheckingyourTSHlevelsto
monitortheeffectivenessofyourdose.Basedonyourcondition,andwhenyouwerediagnosed,
yourhealthcareproviderwillarrangeaschedulethatisrightforyou.
Therearemanydruginteractionswiththethyroidhormone.Makesureyourtellallyourhealthcare
providerswhatmedicationsyouaretaking,sothatyourdosecanbemaintainedata"therapeutic"
level.
ReturntolistofBloodTestAbnormalities
Note:Westronglyencourageyoutotalkwithyourhealthcareprofessionalaboutyourspecificmedical
conditionandtreatments.Theinformationcontainedinthiswebsiteismeanttobehelpfulandeducational,but
isnotasubstituteformedicaladvice.

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