by Carmichael KA

Screening for Hypothyroidism

The purpose of screening is early diagnosis and treatment. Screening tests are given to people who do not have current symptoms, but who may be at high risk for certain diseases or conditions.

Screening Guidelines

The US Preventive Services Task Force found insufficient evidence to recommend for or against routine screening of adults for thyroid disease. The American Thyroid Association recommends screening adults every 5 years starting at age 35 years. Other organizations may have different recommendations. Talk to your doctor about whether or not you should have screening tests.
Screening may be needed in special high-risk groups such as:
  • All newborn infants (required in many states)
  • Pregnant women with or without goiter
  • People with:
    • A strong family history of thyroid disease
    • A personal history of thyroid problems
    • An autoimmune disease, such as type 1 diabetes
    • Mental health disorders, especially those that use lithium for treatment
    • Elevated blood cholesterol or triglyceride levels
    • A thyroid nodule
    • Down syndrome

Screening Tests

A physical exam by your doctor may reveal signs of hypothyroidism. These signs may include dry skin, a slow pulse, or slowed reflexes. A thorough history may reveal symptoms of weight gain, fatigue, and constipation.
The best screening test is a blood test that measures thyroid-stimulating hormone (TSH). A high level of TSH suggests hypothyroidism. If this is high, then your doctor may order a free thyroxine (FT4).

References

American Academy of Pediatrics, Rose SR, Section on Endocrinology and Committee on Genetics, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006;117(6):2290-2303.
American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS. Thyroid. 2009;19(11):1167-1214.
Hypothyroidism. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/endocrine/hypothyroidism/Pages/fact-sheet.aspx. Updated February 27, 2012. Accessed November 20, 2012.
Hypothyroidism in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115914/Hypothyroidism-in-adults. Updated July 12, 2016. Accessed October 4, 2016.
Ladenson P, Singer P, Ain KB, et al. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med. 2000;160(11):1573-1575.
Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004;291(2):228-238.
US Preventive Services Task Force. Screening for thyroid disease: recommendation statement. Ann Intern Med. 2004;140(2):125-127.

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