How do you diagnose Hashimoto’s Thyroiditis?

[j-man1]

Dr. Mariano,

How do you diagnose Hashimoto’s Thyroiditis? What tests/levels, etc? Thanks.

[DrMariano2]

Diagnosis of Hashimoto’s Thyroiditis generally means that a patient presents with a history, exam, and lab tests with findings supporting the pathophysiology and diagnosis of Hashimoto’s Thyroiditis.

Lab tests may include:

Free T4, TSH, Free T3, Total T3, Total T4, Reverse T3,
Thyroglobulin Antibodies, Thyroid Peroxidase Antibodies.

Thyroid Stimulating Immunoglobulin and other labs may also be ordered.

If a person has one autoimmune illness, they can have several.

Some patients have both Hashimoto’s Thyroiditis AND Grave’s Disease.

Thus, a screen for other autoimmune illnesses is important to consider.

Here’s a good resource:
http://www.mayoclinic.com/health/hashimotos-disease/DS00567

[j-man1]

What does high Thyroglobulin and Thyroglobulin AB mean, with a thyroid panel (T3, Free T3, T4, Free T4, rT3) that is good usually mean?

[DrMariano2]

Elevated thyroglobulin antibodies and/or thyroid peroxidase antibodies may mean a person has Hashimoto’s thyroiditis. The immune system attack on the thyroid gland may cause a elevated release of thyroglobulin. Thyroid levels may be normal until there isn’t enough thyroid gland remaining.

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