Laboratory Assessment of Thyroid Function
Continuing Education Credits
The material presented in this course is intended to explain the role of the laboratory in diagnosing thyroid conditions/diseases and in determining the effectiveness of thyroid treatment. The basic biochemistry of the thyroid hormones and the feedback mechanism between the thyroid and pituitary will be discussed, as well as thyroid disorders and the assays used to assess thyroid function.
Objectives
- Recall the basic biochemistry of the thyroid hormones.
- Describe the basic feedback mechanism between the thyroid and pituitary.
- Identify the classic symptoms of hypothyroidism and hyperthyroidism.
- List the assays used to assess thyroid function.
- Explain the role of the laboratory in determining the effectiveness of thyroid treatments.
Course Outline
- Introduction
- Thyroid Gland
- Thyroid Anatomy and Histology
- Overview of the Anatomy of the Thyroid Gland
- Thyroid Gland: Location
- Locating the Thyroid Gland
- Thyroid Gland: Structure
- Structure of the Thyroid Gland
- Which statement is true regarding the thyroid?
- Thyroid Gland: Histological Features
- Histological Features of the Thyroid Gland
- Thyroid Function
- An Overview of Thyroid Function
- Thyroid's Roles in Metabolism and Metabolic Rate
- Metabolism and Metabolic Rate
- Other Endocrine Roles
- Non-Metabolic Roles of the Thyroid
- Pregnancy and Fertility
- Neonatal Development and Newborn Screening
- Biochemistry of Thyroid Hormones
- The Biochemistry of Thyroid Hormones
- Thyroid Biochemistry: Summary
- Thyroxine (T4)
- Assembly of the T4 Molecule
- Triiodothyronine (T3)
- Assembly of the T3 Molecule
- Total and Free Forms of T3 and T4
- Total and Free Forms of T3 and T4
- What components are required to assemble thyroid hormones?
- Endocrinological Relationships
- The Thyroid Gland's Relationship within the Endocrine System
- Pituitary Gland
- The Pituitary Gland and Regulation of Thyroid Function
- Thyroid-Stimulating Hormone (TSH)
- Hypothalamus
- The Hypothalamus and Regulation of Thyroid Function
- Thyrotropin-Releasing Hormone (TRH)
- Parathyroid Glands
- Parathyroid Glands in Relation to the Thyroid
- Disorders of the Thyroid Gland
- Disorders of the Thyroid Gland
- Euthyroid
- Euthyroid: Definition
- Hypothyroidism
- Hypothyroidism: Clinical Symptoms
- Hypothyroidism: Types
- Hypothyroidism: Subclinical
- Hypothyroidism: Incidence and Risk
- Hypothyroidism: Laboratory Findings
- Hypothyroidism: Treatment and Monitoring
- Which of the following would not be considered among the classic symptoms of hypothyroidism?
- Hyperthyroidism
- Hyperthyroidism: Clinical Symptoms
- Hyperthyroidism: Types
- Hyperthyroidism: Incidence and Risk
- Hyperthyroidism: Laboratory Findings
- Why would an excessive production of thyroid hormone cause the level of TSH to be low?
- Which of the following is not considered among the classic symptoms of hyperthyroidism?
- Autoimmune Disorders of the Thyroid
- Autoimmune Disorders of the Thyroid: Overview
- Graves' Disease
- Hashimoto's Thyroiditis
- Neoplasm and Malignant Conditions
- Benign and Malignant Hyperplasia of the Thyroid: Overview
- Benign Hyperplastic Conditions
- Malignant Thyroid Hyperplastic Conditions
- True or False: Benign hyperplastic conditions of the thyroid may lead to an overproduction of functional thyroid hormones and present with symptoms of hyperthyroidism.
- Laboratory Analysis of Thyroid Markers
- Analytical Methods for Thyroid Hormone Measurement
- TSH
- Analysis of Thyroid-Stimulating Hormone (TSH)
- Thyroid-Stimulating Hormone (TSH) Screening Recommendations
- Hormones Produced by the Thyroid Gland
- Analysis of T4 and Free T4 (FT4)
- Analysis of T3 and Free T3 (FT3)
- Reverse T3
- Analysis of Reverse T3 (RT3)
- T-Uptake
- Historical Assessment of T-Uptake
- Free Thyroxine Index
- Historical Estimation of the Free Thyroxine Index (FTI)
- Thyroglobulin
- Analysis of Thyroglobulin (Tg)
- Thyroglobulin Antibody (TgAb)
- Analysis of Thyroglobulin Antibody (TgAb)
- Thyroperoxidase Antibody (TPOAb)
- Analysis of Thyroid Peroxidase Antibody (TPOAb)
- True or False: The sensitivity of thyroid function testing has improved through the development of immunoassay methods with enhanced detection capabilities.
- Clinical Case Studies
- Clinical Case Study #1
- Primary Hypothyroidism: Case Report
- Clinical Case Study #2
- Secondary Hyperthyroidism: Case Report
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Jack A. Maggiore, PhD, MLS(ASCP) serves as the Assistant Laboratory Director of Chemistry and is Head of Research and Development at Doctor's Data, Inc. in Saint Charles, Illinois. Dr. Maggiore is a medical technologist, certified by the ASCP, with a Master of Science in Clinical Chemistry and a Doctorate in Pathology from the University of Illinois. His expertise includes clinical instrumentation, method development and validation, quality assurance, medical device clinical trials, and scientific regulatory affairs. His clinical research interests include the development of novel biomarkers for chronic diseases using blood spots and other non-conventional samples. Dr. Maggiore holds several medical device patents, has authored more than fifty peer-reviewed and invited publications and textbook chapters, and has presented his research findings at international scientific society meetings. Dr. Maggiore's mission is to work with health care professionals to empower consumers to take a more active role in their health maintenance.
The author has no conflict of interest to disclose.
Reviewer Information:
Roger Beckering, M.Ed., MLT(ASCP) has been an educator of medical laboratory sciences for over 25 years. He started as an instructor at the Medical Institute of Minnesota (MIM), later known as Argosy University. At Argosy, Roger held positions as Professor, Clinical Coordinator, and Program Director. In 2014, Roger moved to the Phoenix area where he works as a Professor and Administrator for MLT and MLS programs at Brookline College.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab by Vastian. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Course Description: The material presented in this course is intended to explain the role of the laboratory in diagnosing thyroid conditions/diseases and in determining the effectiveness of thyroid treatment. The basic biochemistry of the thyroid hormones and the feedback mechanism between the thyroid and pituitary will be discussed, as well as thyroid disorders and the assays used to assess thyroid function.