Transcription of Thyroid Disorders Testing Algorithm - ARUP Consult
1 INDICATIONS FOR Testing Increased or decreased metabolism (heat or cold intolerance, weight loss or gain, depression, anxiety, etc) Family history of autoimmune thyroiditis Goiter on physical exam Central hypothyroidism Severe illness Euthyroid sick syndrome subclinical hyperthyroidism Drug interference hyperthyroidism Primary hypothyroidism Thyroid ablation removal Euthyroid sick syndrome Transient thyroiditis subclinical hypothyroidism Euthyroid sick syndrome Transient thyroiditis Autoimmune thyroiditisFacilitate treatment decisionsCONSIDER Radioiodine Thyroid scan and % uptakeORDERT hyroid Stimulating Immunoglobulin (TSI) Thyroid Peroxidase (TPO) AntibodyThyroid Stimulating Hormone Receptor Antibody (TRAb)
2 ORDERT hyroid Stimulating Hormone with Reflex to Free Thyroxine Thyroid hormone resistance TSH resistance TSH secreting adenoma Probabletoxic nodule/sAutomimmune Thyroid disease 2006 ARUP Laborat ories. All Rights Reserved. Last updated: November 2018 Graves diseaseThyroid Disorders TestingLow TSH suggests hyperthyroidism High TSH suggests hypothyroidismNormal free T4 TSI Ab+ TPO+TRAb+Clinical indications of Graves ophthalmologic disease presentDiffuse Thyroid gland enlargementTPO Ab-TSI Ab-Normalfree T4 Positive antibodiesHigh free T4 Low free T4 Low free T4 Highfree T4 Normal TSH and free T4If still concerned with hyperthyroidism , ORDER Triiodothyronine, Total (Total T3) hyperthyroidism unlikelyT3 hyperthyroidismNormalHighCONSIDER Thyroid Antibodies Triiodothyronine, Total (Total T3)
3 T3 by dialysis Normal T3 Low T3 Hypothyroidism unlikelyT3 hypothyroidismThyroid disease unlikelyThyroid disease unlikelyNegative antibodiesClick here for topics associated with this Algorithm
