Knot insurance
Medullary cancer is not visible by TSH and is poorly recognized by puncture - calcitonin catches it at an early stage, when surgery cures it. A basal level of >100 pg/ml is diagnostic, gray zones are clarified by stimulation. The marker also monitors operated patients and screens families with MEN syndromes.
When is it appointed?
- fatigue, weight gain/loss, palpitations, hair loss - TSH screening;
- thyroid nodules - hormones + calcitonin;
- control of therapy with L-thyroxine and thyreostatics;
- pregnancy planning and pregnancy - mandatory TSH;
- autoimmune thyroiditis - antibodies.
Logic of thyroid tests
TSH is the main regulator and the most sensitive screening: the pituitary gland responds to the slightest changes in gland hormones. Free T4 and T3 clarify the severity of hypo-/hyperthyroidism, antibodies (AT-TPO, AT-TG) find an autoimmune cause, antibodies to TSH receptors confirm Graves' disease, calcitonin protects against medullary cancer in the nodes. Always start with TSH - the rest is according to indications, without unnecessary expenses.
