Hidden cause of stones
5% of stone formers have a parathyroid adenoma: the “calcium↑ + PTH↑” pair finds it, and a small operation permanently stops both stones and bone loss. Secondary hyperparathyroidism in CKD and vitamin D deficiency is interpreted differently - an endocrinologist will analyze the profile. Urological check of stone formers without PTH is incomplete.
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.
