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FAQ - Thyroid Disease

Q1.What is a TSH test?
Q2.What is TT4 test?
Q3.What is TT3?
Q4.What is FT3?
Q5.What is rT3?
Q6.What is antibody testing?
Q7.What is TRH testing?
Q8.What is T3 testing?
Q9.What is TSAb testing?
Q10.What are Symptoms of hypothyroidism?
Q11.What is Ultrasonic Test?
Q12.What is Fine Needle Biopsy?
Q13.What are symptoms of hyperthyroidism?
Q14.Thyroid Nodules and Cancer
Q15.Treating No cancerous Thyroid Nodules
Q16.Treating Cancerous Thyroid Nodules
Q17.What is Hashimoto disease?
Q18.Why Hashimoto Disease Occurs?
Q19.What is Goiter?
Q20.Pregnancy and child birth
Q21.Risk Factors for Women

Q1. What is a TSH test?
TSH test is a simple blood test that your doctor uses to find out how well your thyroid is working. Normally, the range should be 0.5-5.0uU/ml. We recommend all adults to be tested for thyroid disease beginning at age 35 and every 5 years thereafter.
Thyroid-stimulating hormone (TSH) is your body's signal to your thyroid gland to make less or more thyroid hormone. When your TSH is high, it usually means that there isn't enough thyroid hormone in your blood. This is called
hypothyroidism. A low TSH level means your blood has too much thyroid hormone. This is called hyperthyroidism.

It is very convenient to do the serum TSH testing. The normal range is from 0.5 to 5.0uU/ml. TSH testing is very useful to diagnose hypothyroidism and very important to the dosage adjustment of thyroid incretion treatment. The shortcoming is not sensitive to the low range of TSH testing. It also cannot distinguish hypothyroid status with the normal status. High serum TSH can be found when it is with low thyroid incretion or normal thyroid incretion. Normal serum TSH can be found when it is with normal status or decreasing in thyroid function; low serum TSH can be found when it is with normal status, hypothyroid or decreasing in thyroid function, also hypothyroidism, Graves and early period of pregnancy.

In recent years, some new testing can test TSH with 0.1-0.5uU/ml. The new IRMA uses 2 or 3 antibodies (1 0r 2 is irradiation signal), these cloned antibodies depends on the accepter part in TSH. The irradiation signal of this testing is very stable and sensitive. EIA also use cloned antibodies to test TSH and has similar strongpoint with IRMA. These high sensitive testing can diagnose over 90% hypothyroid patient and can replace TRH testing. The sensitiveness of ICMA to test TSH can be 0.06uU/ml. It also can easily distinguish the normal person with the hypothyroid.


Q2. What is TT4 test?

TT4 is a basic index to know whether our thyroid gland work in normal condition or not. Normally, the range should be 65-155nmol/L. A normal adult will produce T4 90ug a day. 99.97% of T4 will combine with protein (0.03% will be free, FT3) so that it will not lose with urine in kidney. Unless the patient has very serious albuminuria, most of the combined thyroid incretion and the albumen are reversible. Free incretions master the metabolism. But the combined incretion will supply a huge incretion source for the free thyroid incretion, it will not directly affect the metabolism, but it can be alleviant.

When the thyroid incretion level changes, it will not let the thyroid function change immediately. There are 3 major combined albumens in plasm, which are TBG, TBPA and albumin. Among them, 80% to 90% will combine with TBG. TT4 level will also be affected by the amount of the proteid combined with thyroid incretion in the serum other than the status of the thyroid function status, most affected by TBG.

(1). factors which can increase TT41are the following. For the high TGB, pregnancy is a frequent reason. Oral contraceptive, estrogen treatment, hepatitis, knub which can produce estrogen and lymphosarcoma can also increase TBG and let the TT4 increase. But the patient's FT4 is normal which can distinguish with the hypothyroid.2. Family TBG increase is the excessive TBG caused by concatenate transmissibility disease which let TT4 and TT3 increase, while FT4 and FT3 is normal.3. Psychopathic high T4. Cohen and Swiger report 480 psychopaths. TT4 of 30% of new inpatients increase. Swige report 645 psychopaths. TT4 of 33% increase. FT4I of 18% increase. Low after the disease gets catabatic.4. Some medicine will cause high T4, like thyroid incretion preparation, ethylamine iodine ketone, Benzedrine, heroin, clofibrate. Half of the patient who has ethylamine iodine ketone will cause high TT4 and FT4I. It is because ethylamine iodine ketone can partially stop the transform from T4 to T3 which increase T4 and let it change to be the inactive rT3.

(2) The factor to reduce TT41. Kidney function exhaust, kidney is the place for Thyroxine to release ammonia and iodine. Therefore, kidney disease, especially the patients with kidney function exhaust have low T4. Because such patients lose albumen day by day term and get cacotrophia so TBG becomes low and then affect TT4. 2. Hepatocirrhosis cause the decreasing of the combined albumen and then affect the TT4.3. Acute mental illness. About 10% patients with acute mental illness had low TT4. After having the treatment, it will become normal.

4. Serious disease. There is stayer stop the combination of thyroid incretion and serum albumen in the patients'blood circulation. Then, their TT3 and FT3 become low, rT3 becomes high, and TT4 usually becomes low. The major difference between this and hypothyroidism is TSH low or normal.

5. Some medicine, such as Benzene barbital, Male hormone preparation, 5-flurin pyrimidine.


Q3. What is TT3?
The ration in serum that T3 connected with protein is 99.7%. The normal range of TT3 is from 1.2 to 3.2nmol/L, it is also affected by TBG. The concentration of TT3 changes parallel with TT4. But in the early period or early recrudescence period of hyperthyroidism, TT3 increased very quickly, about 4 times than the normal; TT4 increased a little bit slowly, only the 2.5 times than the normal. Therefore, TT3 is referred to be the index to diagnose if hyperthyroidism is sensitive or not, especially in the early period of this disease and in the observation period of the treatment or to be the aura of the recrudescence. TT3 will also not be very high when patients are in old age or with long time hyperthyroidism history.

Q4. What is FT3?
About 99.97% T4 and 99.7% T3 in plasm connected with plasm protein by non covalent bond. The Free T4 and T3 are very small. T4 or T3 that is connected with protein is in homeostasis with FT4 and FT3. The dissociative incretion can enter into cell and connected with accepted part in the cell to affect the compound of the protein and the adjustment of the metabolism. It can also reflexly adjust the secretion of TSH in the pituitary. The thyroid protein does not affect FT4 and FT3. The state of the hypothyroid is tied up with FT3 and FT4. The sensitiveness and special particularity far exceed TT3 and TT4. The normal range of FT4 is from 9 to 25prmol/L, FT3 is from 3 to 9pml/L(RIA). The difference exists by different laboratory.

Q5. What is rT3?

During the metabolism of the thyroid incretion, T4 gets ride of Iodine in outside of No. 5 of benzene ring will become T3. However, if the inside Iodine of No.5 of benzene releases, it will cause rT3. rT3 is not active in our body. It concentrates in the blood proportional changes with T3 and T4, especially with T4's change. It can also to be the index of the hypothyroid. Some of the hyperthyroid only have the high rT3 when in the early stage. It increases very quickly and to be the key index if gets seriously cacotrophia or some systemic disease.

rT3 is useful in following:1. To be used to diagnose hypothyroid is 100% correct. Its concentration increasing is much sensitive than TT3 and TT4. 2. To be used to diagnose the anti-thyroid medication. TT3 falls quickly in the hyperthyroid treatment, while rT3 falls slowly. When TT3 reaches the normal range, T4 will lower than the normal range. So, if both rT3 and T4 lower than the normal range, it means excessively in medication. 3. To be used to diagnose hypothyroidism. For such case, rT3 is much important than TT3 and TT4. But TSH is still to be the key index to diagnose hypothyroidism.4. To be used to observe the treatment of hypothyroidism. The sequence for the hypothyroidism treatment by thyroid incretion are TT3, rT3, TT4 and then TSH. So combine rT3 result with TT3 and TT4 value can judge the curative effect. If rT3 and T3 rise quickly while T4 is in the normal range, it means the thyroid incretion is excessively used.

5. To be used to diagnose chronically lymphocyte hypothyroid. rT3 rise very quickly when it is acute miocardial infarction, hepatocirrhosis, diabetes, uraemia, cerebrovascular disease and tummy cancer. TT3 and TT3/Rt3 drop quickly. rT3 is very meaningful to the judgement and the over savation of non-hypothroid, especially the TT3/rT3.


Q6. What is antibody testing?

If it is the self-immunity related hypothyroidism, the antibodies can be tested in the blood. In fact, all the Hashimoto disease and most of the Graves disease have the (antibodies) Thyroid Throub and TMAb. TMAb is treated as catalase amtibpdoes. The judgment way is TRCA or RIA. The former is to use cell to adsorb hypothyroid globin or microsome. And then add serum of the sufferer. If the serum has such antibodies of antigen, then it can let the cell to agglomerate.

During the early period of the self-immunity related hypothyroid, titration of antibodies rise and then drop after years. High titration means Hashimoto or Graves. Low titration also can be found in the hypothyroid and hypothyroid cancer. 15% old women can find TGAb because they have the Hashimoto which is not found. Low titration also can be found in some other self-immunity related disease, such as insulin depended on diabetes or malign anaemia. The electropositive TGAb or TMAb increase with age. About 20% of patients have such electropositive antibodies. The titration of Hashimoto usually is high to 1:1000000 and with the whole life. The pregnancy incretion treatment can let antibodies titration drop.


Q7. What is TRH testing?

This testing is to get the blood sample to test the serum TSH basic figure. After injecting 500ug of TRH in vein, then get serum again after 30min and 60min to test TSH again. The normal person after 40 years old can increase 2-5 times or at least 6uU/ml. Female is sensitive than male. The reaction of 40 years old male is much slower, and 2uU/ml for them is normal. hypothyroidism is not sensitive for such testing. This testing is very helpful to hypothyroid patients who do not have much increased serum thyroid incretion. 80% Graves who only is incretion related and do not have clinic hypothyroidism also do not have reaction to the TRH. The hypothyroidism is sensitive of the TRH reaction. But it is not necessary for them to have the test since the TSH figure can be the index of hypothyroidism. TRH testing can judge the pathological changes of recurring hypothyroidism which is in pituitary or the below part of thalamencephalon.

Thalamencephalon hypothyroidism presents lingering reaction. But pituitary hypothyroidism reaction will decrease. Estrogen, alkaline and anti-hypothyroid medicine can strengthen the reaction to TRH. But thyroid preparation and L-dopa can restrain the reaction of TRH. Within 2 min after the TRH injection, about half patients can have rose-cheeked, naupathia and emiction. According to what said before, TRH testing is replaced by the high sensitive TSH testing.


Q8. What is T3 testing?
T3 testing is to judge whether high Iodine 131 absorption rate is caused by hypothyroid or goiter. The way is: After test Iodine 131 absorption rate, have T320ug, 3 times every day, last for 6 days (or have thyroxine 60mg, 3 times every day, last for 8 days). Then test Iodine 131 absorption rate again and compare the 2 results.

Normal repressive rate is large than 50%. It means hypothyroid has normal adjustment relationship with pituitary. And it is can be diagnosed that the patients do not have hypothyroidism. Repressive rate which is lower than 25% is less of restrain, and it can be diagnosed to be hypothyroid. Repressive rate between 25% and 50% is partially restrained. It can be diagnosed to be doubtful hypothyroidism, and needed to be analyzed with other figures. This test is very meaningful to hypothyroidism and goiter. The Iodine 131 absorption rate for both of them can be higher than the normal range, but the repressive rate will be different. hypothyroidismism is less of restrain while goiter is normal.

The key feature of Graves is that it does not have clinic hypothyroid behavior and one goggle-eyed or both goggle-eyed. The serum thyroid incretion is normal. But pituitary-hypothyroid adjustment is abnormal. The Iodine 131 absorption rate is similar with hypothyroid. At this moment, The clinic applied value is limited. It has been replaced by the high sensitive TSH testing. And for pregnancy and old man and cardiac muscle bloodless it is not suitable to have T3 and T4, and it is forbidden to have this testing.



Q9. What is TSAb testing?
The electropositive rate of TSAb in Graves patient can reach 80% to 95%. It is meaningful to the early diagnose, the state of the illness and whether it will recrudesce or not. And it can be the key index of stopping medicine .

Q10. What are Symptoms of hypothyroidism?
The signs and symptoms of hypothyroidism are often very subtle and can be easily mistaken as other illnesses or usual signs of aging. Not everyone with hypothyroidism will have the same signs and symptoms. In fact, some people may have only a few, and some people may not have any. Keep that in mind as you read the following list of possible signs and symptoms of hypothyroidism.
- Fatigue
- Weight gain
- Cold intolerance
- Skin dryness
- Hair dryness or loss
- Depression
- Dementia
- Infertility
- Menstrual problems (especially heavy menstruation)
- Constipation
- Slow heartbeat
- Muscle cramps or myalgia (muscle pain)

Q11. What is Ultrasonic Test?
Ultrasonic test is very important in diagnosis and therapy. It uses very high frequent sound wave to reach our organs and get the image with sound wave refract back. It is used to check organs shape, size, position and working condition inside our body. It is very safe, quick, to check nodules in human body. Patients do not need to expose to radiation, without paining and side-effect. Even pregnant women and baby are safe to use it.

Q12. What is Fine Needle Biopsy?
FNB is fine needle biopsy. When doctor finds there are nodules / goiter inside patients' body. Doctor will suggest that patients should have FNB. It is commonly used to check the nodules / goiters whether cancerous or not. Doctor will use very small needle to get very small tissues from nodules or organ surface and then submit it to professional tester to check the abnormal organ, pathogeny, cancer and infection. Fine Needle Aspiration I often used, too. this is done with a fine needle to sting in side patient body to collect body fluid or tissues. The procedures of FNA and FNB basically are the same. Sometimes they will be done together. The location will be confirmed with ultrasound wave or CT.

Q13. What are symptoms of hyperthyroidism?
The following are symptoms of hyperthyroidism, as detailed by the Merck Manual, the American Association of Clinical Endocrinologists, and the Thyroid Foundation of America
- Heart feels like it's skipping a beat, racing and feel like having heart palpitations
- Pulse is unusually fast even when resting or in bed, is high
- Hands are shaking and having hand tremors
- Feel hot when others feel cold and feel inappropriately hot or overheated
- Having increased perspiration
- Losing weight inappropriately but appetite has increased
- Like have a lot of nervous energy need to burn off
- Having diarrhea or loose or more frequent bowel movements
- Feel nervous or irritable
- Muscles feel weak, particularly the upper arms and thighs
- Having difficulty getting to sleep, staying asleep, or going back to sleep after awakening in the middle of the night
- Feel fatigued, exhausted
- Hair is coarse and dry, breaking, brittle, falling out
- Have a hoarse or gravely voice
- Have pains, aches in joints, hands and feet
- Having irregular menstrual cycles (shorter, longer, or heavier, or more frequent, or not at all)
- Feel depressed, restless or anxious Additional symptoms, which have been reported more frequently in people with

- Hair is falling out
- Difficult to remember things
- Have no sex drive, or am having sexual performance problems
- Feel shortness of breath and tightness in the chest
- Eyes feel gritty, dry and sensitive to light
- Easily get jumpy/tics in eyes, which makes me dizzy/vertigo and have headaches
- Get strange feelings in neck or throat
- Have tinnitus (ringing in ears)
- Feel some lightheadedness
- Have severe menstrual cramps


Q14. Thyroid Nodules and Cancer
A thyroid nodule is a lump or growth in your thyroid gland. Many thyroid nodules go undetected by both you and your doctor. What is more, many thyroid nodules that are discovered? However, about 10 percent of thyroid nodules are cancerous. If you or someone you know has been diagnosed with thyroid nodules, you will be glad to learn the recovery rate is very high with “Thyroid-Throu” treatment.
You may discover a thyroid nodule yourself, or your doctor may find one during a routine exam. If a thyroid nodule is found, you will probably undergo several tests to determine if the nodule is cancerous and whether it requires treatment. These tests may include:

- A TSH test to determine the amount of thyroid-stimulating hormone in your bloodstream
- A thyroid imaging test (a type of X-ray) to show if your thyroid is functioning normally
- An ultrasound to show the exact size and location of the nodule
- A biopsy to determine if the thyroid nodule is benign or cancerous


Q15. Treating No cancerous Thyroid Nodules

Your doctor may prescribe thyroid hormone tablets to try to shrink the nodule. You will need to be tested periodically to see if your thyroid has shrunk, to be sure that your thyroid-stimulating hormone is in the proper range, and to adjust the dosage of your thyroid hormone. If the nodule does not shrink after treatment, or continues to grow, your doctor may recommend that the nodule be removed surgically.

However, if you take “Thyroid Throu” nodules will become soft at second treatment and shrink after third or fourth treatment. It will shrink at very fast way after the nodules become soft or watered.

Hard nodules --> Soft nodules --> Shrinkage --> Disappear


Q16. Treating Cancerous Thyroid Nodules

Most suspicious nodules turn out to be non-cancerous (benign). However, if a nodule is cancerous, your doctor will want to begin treatment quickly. You may have surgery to remove part or all of the thyroid gland. Most people who have their thyroid gland removed will become hypothyroid and will need thyroid hormone replacement.

“Thyroid-Throu” can't cure if all of your thyroid gland removed out at surgery operation. It just let you feel easier during suffering.


Q17. What is Hashimoto disease?
Hashimoto's disease is the most common disease of the thyroid gland. It occurs 5 times more often in women than in men. Hashimoto's disease occurs when your body's immune system attacks your thyroid gland. When this happens, your thyroid gland often can't make enough thyroid hormone, which leads to hypothyroidism.

Q18. Why Hashimoto Disease Occurs?
Your body's immune system fights infections. It does this by identifying cells that are not part of your body, like viruses and bacteria. When cells like these enter your body, your immune system sends out protector cells and substances called antibodies. These attack and damage these foreign cells.

With Hashimoto's disease, your immune system thinks your thyroid gland is a group of foreign cells, and attacks it with protector cells. This is called an autoimmune condition. This simply means that your immune system is attacking your own cells.

Q19. What is Goiter?
A goiter is an enlarged thyroid gland. Your thyroid gland may be enlarged because it's not working right, or for other reasons. A goiter is usually a reliable sign of a thyroid problem.
If you have a goiter, your neck may look wider or there may be more swelling on one side. Signs and symptoms of a goiter include:- Visible enlargement of the neck
- Pain in your throat
- Hoarseness
- Difficult or painful swallowing

Goiter has several causes:
hypothyroidism (under active thyroid gland)
hyperthyroidism (overactive thyroid gland)
Thyroid nodules (lumps in the thyroid)


Q20. Pregnancy and child birth
The thyroid gland affects every organ system in the body, including the reproductive system. hypothyroidism can affect women of childbearing age in several ways.

hypothyroidism can cause your menstrual flow to be heavier and last longer than in the past. Your periods may also become more frequent than the normal 28-day cycle. If you are hypothyroid, your ovaries may not release eggs. Women with hypothyroidism often find it harder to become pregnant, or support a pregnancy.

Pregnant women are at a greater risk for developing hypothyroidism than people in general. Untreated hypothyroidism during pregnancy can cause problems for you or your unborn baby.