Diagnosing a Thyroid Problem

Ultrasound probe on neck and needle in nodule on thyroid gland.
Fine needle aspiration.

Your healthcare provider thinks you may have a thyroid problem. In many cases, a thyroid problem can be easy to diagnose. Your healthcare provider is likely to ask about your medical history, give you a physical exam, and have you take blood tests. You may also need other tests. Based on the results, your healthcare provider may refer you to a hormone specialist (endocrinologist) or a surgeon.

Medical history

Your healthcare provider will ask about your medical history. Tell him or her if you:

  • Have had changes in body temperature, heartbeat, weight, or energy level

  • Are taking any medicines or supplements

  • Have ever had thyroid surgery

  • Have a family history of thyroid problems

  • Are pregnant or plan to become pregnant

  • Have ever been treated with radiation to the head or neck

Physical exam

After the medical history, your healthcare provider will examine you. He or she will feel your neck to check your thyroid gland for changes in size or shape. Your healthcare provider may also look for changes in heart rate, reflexes, muscle strength, or skin texture.

Blood tests

Your healthcare provider will order blood tests. They may include:

  • TSH test. This shows how much thyroid stimulating hormone (TSH) is being made by the pituitary gland. This test can show if your thyroid is normal, overactive (hyperthyroidism), or underactive (hypothyroidism).

  • T3 and T4 tests. These show the levels of T3 and T4 thyroid hormones in the blood. This test can help diagnose hyperthyroidism or hypothyroidism.

Other tests

Based on the results of your exam and blood tests, you may have other tests. They may include:

  • Thyroid antibody tests. These are blood tests that look for problems with the immune system. These tests are most often to look for underactive or overactive thyroid.

  • Ultrasound. This test uses sound waves to create an image showing the size and shape of the thyroid gland. It is most often used to check for a lump in the thyroid (nodule) or enlarged thyroid(goiter).

  • Radioactive iodine uptake test. This test measures how much iodine the thyroid gland takes in. It is most often to check for overactive thyroid.

  • Thyroid scan. This is an imaging test that can show if part of the thyroid gland is making too much thyroid hormone. It is most often used to check for overactive thyroid.

Fine needle aspiration (FNA)

If you have a nodule, you may have a fine needle aspiration done. This is a type of biopsy. A biopsy is a procedure to remove a small sample of tissue. FNA is the best test to find out if thyroid cells are cancer. The healthcare provider uses a needle to take cells from the thyroid. The cells are then checked with a microscope. If cancer is suspected, other tests may also be done to help determine the type of cancer. Risks and complications of FNA are rare, but include mild discomfort, bleeding, and skin infection.

Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Hurd, Robert, MD
Last Review Date: 11/1/2016
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