Thyroid
|
November 6, 2024

6 Lab Tests for Patients With a Family History of Thyroid Diseases

Medically Reviewed by
Updated On
November 8, 2024

Thyroid diseases are among the most common endocrine disorders, affecting 20 million Americans. With a significant genetic component, having a family history of thyroid conditions notably increases an individual's risk of developing related disorders. Early detection through appropriate lab testing allows for effective management and prevention of complications in those at higher risk due to familial predisposition.

This article explores the lab tests that should be ordered for patients with a family history of thyroid diseases, highlighting their significance in diagnosis and ongoing care.

Sign Up to Order Thyroid Labs

[signup]

Understanding Thyroid Diseases

Thyroid disease encompasses a range of disorders affecting the thyroid gland, which is responsible for producing hormones that regulate metabolism, growth, and development. 

Types of thyroid disease include:

  • Hypothyroidism: This condition is characterized by insufficient thyroid hormone production. The most common cause is chronic autoimmune thyroiditis, also known as Hashimoto's thyroiditis. Symptoms include fatigue, weight gain, cold intolerance, and constipation. 
  • Hyperthyroidism: This condition involves excessive production of thyroid hormones. The most frequent cause is Graves' disease, an autoimmune disorder. Other causes include toxic nodular goiter and thyroiditis. Symptoms include weight loss, heat intolerance, palpitations, and anxiety. 
  • Thyroiditis: This refers to inflammation of the thyroid gland and includes several forms, such as Hashimoto's thyroiditis, subacute thyroiditis, and postpartum thyroiditis
  • Thyroid Cancer: This is the most common type of endocrine malignancy. Papillary thyroid carcinoma (PTC) is the most prevalent subtype of thyroid cancer, accounting for approximately 84% of cases. Medullary thyroid carcinoma (MTC) and anaplastic thyroid carcinoma (ATC) are less common but more aggressive forms (7). 

Understanding the Role of Family History in Thyroid Disease Risk

Thyroid diseases have a strong genetic basis. Studies have shown that genetic factors account for 40-65% of the variability in thyroid function tests, such as thyroid-stimulating hormone (TSH) and free T4 (fT4) levels. Specific genetic variants that influence the hypothalamic-pituitary-thyroid (HPT) axis have been identified, contributing to both hypo- and hyperthyroidism.

A family history of thyroid disease significantly increases the risk of developing thyroid conditions. According to one study, 46% of individuals with Hashimoto's thyroiditis have at least one affected relative. The same study determined that the overall risk for first-degree relatives to develop Hashimoto's thyroiditis is 9-fold higher compared to the general population. 

Similarly, research has found that genetic predisposition accounts for 79% of the risk for Graves' disease.

The Importance of Lab Testing for At-Risk Individuals

Given the elevated familial risk, especially among first-degree relatives, it is important to consider family history when assessing the risk of thyroid disease. 

Timely diagnosis through lab testing enables the initiation of appropriate treatments, preventing the progression of thyroid diseases and associated health issues, including complications like:

6 Lab Tests for Patients with a Family History of Thyroid Diseases

The following laboratory tests are integral for the monitoring of thyroid health and the management of thyroid diseases.

1. Thyroid-Stimulating Hormone (TSH)

TSH is a pituitary hormone that regulates thyroid function. It stimulates the thyroid gland to produce and release thyroid hormones, thyroxine (T4) and triiodothyronine (T3).

TSH is the primary screening tool for thyroid dysfunction due to its high sensitivity and specificity. The American Thyroid Association (ATA) recommends using serum TSH as the initial test for evaluating suspected thyroid disorders.

Understanding TSH Results

2. Free Thyroxine (Free T4)

About 90% of thyroid hormones produced by the thyroid are released as thyroxine (T4). Free T4 (fT4) is the unbound fraction of T4 in the blood that is not attached to serum proteins and is biologically active. 

fT4 is measured to evaluate thyroid function and diagnose thyroid disorders. It is particularly useful in conjunction with TSH levels to provide a more comprehensive picture of thyroid health and hormone signaling. (9)

Understanding fT4 Results

  • Elevated fT4: Indicates hyperthyroidism
  • Low fT4: Indicates hypothyroidism

3. Free Triiodothyronine (Free T3)

Triiodothyronine (T3) is the more biologically active form of thyroid hormone, responsible for regulating various cellular metabolic processes. Most T3 is made through the peripheral conversion of T4 in the liver and kidneys. 

Free T3 (fT3) is the fraction of T3 not bound to serum proteins and is available to tissues. It reflects the amount of active hormone available for physiological functions. 

Understanding fT3 Results

  • Elevated fT3: Indicates hyperthyroidism
  • Low fT3: Indicates hypothyroidism or thyroid hormone conversion issues

4. Reverse T3 (rT3)

rT3 is an inactive metabolite of thyroxine (T4). It works as a natural control system, slowing down metabolism when the body needs to conserve energy. It is not typically used as a routine marker for thyroid function but can be relevant in specific clinical scenarios. 

Understanding rT3 Results

  • Elevated rT3: Often seen in non-thyroidal illness syndrome (NTIS), also known as euthyroid sick syndrome, where it reflects altered peripheral metabolism of thyroid hormones rather than primary thyroid dysfunction. It can also be elevated in conditions such as severe illness, fasting, and taking certain medications. (23)
  • Low rT3: Typically observed in hypothyroidism, chronic stress, and kidney or liver dysfunction.

5. Thyroid Antibodies 

Thyroid antibodies are immune proteins directed against components of the thyroid gland, commonly used to diagnose autoimmune thyroid diseases (AITD). The primary thyroid antibodies include:

  • Anti-Thyroid Peroxidase (Anti-TPO): These antibodies target thyroid peroxidase, an enzyme involved in thyroid hormone synthesis. Elevated anti-TPO levels are strongly associated with Hashimoto's thyroiditis but can also be present in Graves' disease. 
  • Anti-Thyroglobulin (Anti-TG): These antibodies target thyroglobulin, a precursor protein for thyroid hormones. Anti-TG antibodies are also most commonly associated with Hashimoto's thyroiditis but can be present in Graves' disease. 
  • Thyroid-Stimulating Immunoglobulin (TSI): These antibodies mimic TSH and stimulate the thyroid gland, leading to hyperthyroidism. TSI is a hallmark of Graves' disease and is used to confirm the diagnosis.

Studies indicate that thyroid antibodies can be present years before the clinical onset of AITD. This preclinical phase suggests that the presence of these antibodies in asymptomatic individuals should not be overlooked, as they indicate a predisposition to thyroid dysfunction.

Understanding Thyroid Antibody Results

  • Positive Anti-TPO and/or Anti-TG: Suggests Hashimoto's thyroiditis, with a higher risk of hypothyroidism.
  • Positive TSI: Indicates Graves' disease, associated with hyperthyroidism.
  • Negative Antibodies: Reduces the likelihood of AITD but does not entirely exclude it.

6. Vitamin D

Vitamin D exerts immunomodulatory effects that can influence thyroid function and autoimmunity. Several studies have demonstrated an association between low serum vitamin D levels and an increased risk of AITD. For instance, low levels of serum 25-hydroxyvitamin D [25(OH)D] have been linked to higher prevalence and severity of Hashimoto's thyroiditis and Graves' disease.

Vitamin D deficiency is associated with higher levels of thyroid autoantibodies. Vitamin D supplementation has been shown to improve thyroid function and reduce thyroid autoantibody levels in patients with AITD. 

Understanding Vitamin D Levels

  • Deficiency: Serum 25(OH)D <20 ng/mL (4
  • Insufficiency: Serum 25(OH)D 20-29.9 ng/mL (4
  • Optimal for Thyroid Function: Serum 25(OH)D >30-50 ng/mL (27, 33

Thyroid Cancer Screening

The U.S. Preventive Services Task Force (USPSTF) advises against screening for thyroid cancer in asymptomatic adults due to the potential harms outweighing the benefits.

For symptomatic individuals or those with abnormal thyroid tests, the following laboratory tests are recommended for detecting thyroid cancer:

Complete Blood Count (CBC)

The ATA recommends a CBC as part of the initial evaluation for patients with suspected thyroid malignancies to assess the patient's overall physiological status and to provide baseline parameters for further medical care.

Certain hematologic abnormalities, such as an elevated white blood count, anemia, low platelets, or an elevated neutrophil-to-lymphocyte ratio, can be measured with a CBC and may indicate cancer (3, 26).

Calcitonin

Calcitonin is a hormone produced by the parafollicular C-cells of the thyroid gland. The ATA recommends measuring serum calcitonin in patients with nodular thyroid disease when MTC is suspected. Elevated levels (>100 pg/mL) strongly suggest MTC. (21, 63

Thyroglobulin (Tg)

Tg is a protein produced by thyroid follicular cells that serves as a precursor for thyroid hormone synthesis. 

The ATA advises against routinely measuring serum Tg for the initial evaluation of thyroid nodules; however, Tg is an important biomarker for monitoring patients with differentiated thyroid cancer (DTC) post-treatment to detect residual or recurrent disease (24). TSH-stimulated Tg levels >2 ng/mL are highly predictive of disease.

Thyroid Ultrasound

The ATA recommends thyroid ultrasound for all patients with suspected thyroid nodules (24).

Findings suggestive of malignancy on thyroid ultrasound include (24): 

  • Microcalcifications
  • Irregular margins
  • Hypoechogenicity (nodules that appear darker than the surrounding thyroid tissue)
  • Taller-than-wide shape
  • Solid composition
  • Extrathyroidal extension (extending beyond the thyroid capsule)
  • Central vascularization (increased nodular blood flow)

Nodules highly suspicious of malignancy should be biopsied with fine-needle aspiration (24).

Frequency and Timing of Testing

The ATA recommends that thyroid function should be measured in all adults beginning at age 35 years and every five years after that. More frequent screening, such as annually, may be appropriate for high-risk individuals. (57

For specific populations, the ATA provides additional guidance:

  • Women of Childbearing Age: TSH measurement before pregnancy or during the first trimester.
  • Pregnant Women: Measure serum TSH approximately every 4 weeks until midgestation and at least once near 30 weeks gestation in women with hypothyroidism or at risk for hypothyroidism (e.g., anti-TPO or anti-Tg positive).

Additional tests should be conducted if initial results are abnormal or patients begin to experience new symptoms indicative of thyroid dysfunction.

Next Steps After Testing

If thyroid screening results are normal, continued screening and general thyroid support are recommended. General recommendations to support thyroid health and prevent disease in high-risk individuals may include:

  • Eat a well-balanced diet rich in thyroid-supportive nutrients, including iodine, magnesium, zinc, and selenium. 
  • Reduce stress by fostering a strong support system, practicing mindfulness exercises, and prioritizing good quality sleep.
  • Engage in 150-300 minutes of moderate exercise weekly, and avoid overexercising.
  • Avoid exposure to endocrine-disrupting chemicals.

Patients with abnormal lab results require further evaluation and management:

  • Referral to an endocrinologist 
  • Hypothyroidism: thyroid hormone replacement therapy
  • Hyperthyroidism: antithyroid medications, radioactive iodine therapy, or surgery
  • Thyroid Autoimmunity: immunomodulatory treatments alongside standard thyroid therapies

[signup]

Key Takeaways

  • Proactive lab testing is a vital component of preventive healthcare for individuals with a family history of thyroid diseases. 
  • By understanding and utilizing essential lab tests, healthcare providers can facilitate early detection, personalized management, and the prevention of complications associated with thyroid disorders. 
  • Emphasizing regular monitoring and comprehensive care ensures that at-risk individuals maintain optimal thyroid health and overall well-being. 
  • Advances in thyroid disease research continue to enhance diagnostic and treatment strategies, promising improved outcomes for those with a genetic predisposition.
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.

Learn more

No items found.

Lab Tests in This Article

No lab tests!
  1. Alexander, E. K., Pearce, E. N., Brent, G. A., et al. (2017). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid, 27(3), 315–389. https://doi.org/10.1089/thy.2016.0457
  2. Antonelli, A., Ferrari, S. M., Ragusa, F., et al. (2020). Graves' disease: Epidemiology, genetic and environmental risk factors and viruses. Best Practice & Research Clinical Endocrinology & Metabolism, 34(1), 101387. https://doi.org/10.1016/j.beem.2020.101387
  3. Bible, K. C., Kebebew, E., Brierley, J., et al. (2021). 2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer. Thyroid, 31(3), 337–386. https://doi.org/10.1089/thy.2020.0944
  4. Bordelon, P., Ghetu, M. V., & Langan, R. (2009). Recognition and Management of Vitamin D Deficiency. American Family Physician, 80(8), 841–846. https://www.aafp.org/pubs/afp/issues/2009/1015/p841.html
  5. Bothra, N., Shah, N., Goroshi, M., et al. (2017). Hashimoto's thyroiditis: relative recurrence risk ratio and implications for screening of first-degree relatives. Clinical Endocrinology, 87(2), 201–206. https://doi.org/10.1111/cen.13323
  6. Boucai, L., Zafereo, M., & Cabanillas, M. E. (2024). Thyroid Cancer: A Review. JAMA, 331(5), 425–435. https://doi.org/10.1001/jama.2023.26348
  7. Cabanillas, M. E., McFadden, D. G., & Durante, C. (2016). Thyroid cancer. The Lancet, 388(10061), 2783–2795. https://doi.org/10.1016/S0140-6736(16)30172-6
  8. Choi, Y. M., Kim, W. G., Kim, T. Y., et al. (2014). Low Levels of Serum Vitamin D3 Are Associated with Autoimmune Thyroid Disease in Pre-Menopausal Women. Thyroid, 24(4), 655–661. https://doi.org/10.1089/thy.2013.0460
  9. Christie, J. (2022, December 6). The ultimate guide to thyroid hormones. Rupa Health. https://www.rupahealth.com/post/a-complete-guide-to-thyroid-hormones-a-functional-medicine-approach
  10. Cloyd, J. (2023, July 4). The Impact of Stress on Thyroid Health and How to Manage It with Integrative Medicine. Rupa Health. https://www.rupahealth.com/post/the-impact-of-stress-on-thyroid-health-and-how-to-manage-it-with-integrative-medicine
  11. Cloyd, J. (2023, October 20). What Do High TSH Levels Indicate? Rupa Health. https://www.rupahealth.com/post/what-do-high-tsh-levels-indicate
  12. Cloyd, J. (2023, November 15). What Are Thyroid Antibodies? Rupa Health. https://www.rupahealth.com/post/what-are-thyroid-antibodies
  13. Cloyd, K. (2023, October 3). Functional Medicine Protocol for Autoimmune Diseases: Balancing the Immune System. Rupa Health. https://www.rupahealth.com/post/functional-medicine-protocol-for-autoimmune-diseases-balancing-the-immune-system
  14. Cloyd, K. (2023, October 9). Endocrine disruptors: Unveiling the impact of environmental factors on hormonal health. Rupa Health. https://www.rupahealth.com/post/endocrine-disruptors-unveiling-the-impact-of-environmental-factors-on-hormonal-health
  15. DeCesaris, L. (2022, August 8). Worried About Your Thyroid Health? Ask Your Doctor For These 3 Thyroid Labs. Rupa Health. https://www.rupahealth.com/post/treating-the-thyroid-naturally
  16. Delitala, A. P., Scuteri, A., & Doria, C. (2020). Thyroid Hormone Diseases and Osteoporosis. Journal of Clinical Medicine, 9(4). https://doi.org/10.3390/jcm9041034
  17. Exercise and Diet Risks Associated With Uncontrolled Thyroid. (2021, November 26). Cleveland Clinic. https://health.clevelandclinic.org/uncontrolled-thyroid-exercise-diet-risks
  18. Free Thyroxine. Rupa Health. https://www.rupahealth.com/biomarkers/ft4
  19. Free Triiodothyronine. Rupa Health. https://www.rupahealth.com/biomarkers/ft3
  20. General Information/Press Room. (2016). American Thyroid Association. https://www.thyroid.org/media-main/press-room/
  21. Giannetta, E., Guarnotta, V., Altieri, B., et al. (2020). ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus. European Journal of Endocrinology, 183(6), R197–R215. https://doi.org/10.1530/eje-20-0506
  22. Golden, S. H., Robinson, K. A., Saldanha, I., et al. (2009). Prevalence and Incidence of Endocrine and Metabolic Disorders in the United States: A Comprehensive Review. The Journal of Clinical Endocrinology & Metabolism, 94(6), 1853–1878. https://doi.org/10.1210/jc.2008-2291
  23. Halsall, D. J., & Oddy, S. (2021). Clinical and laboratory aspects of 3,3',5'-triiodothyronine (reverse T3). Annals of Clinical Biochemistry, 58(1), 29–37. https://doi.org/10.1177/0004563220969150
  24. Haugen, B. R., Alexander, E. K., Bible, K. C., et al. (2016). 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid: Official Journal of the American Thyroid Association, 26(1), 1–133. https://doi.org/10.1089/thy.2015.0020
  25. Hutfless, S., Matos, P., Talor, M. V., et al. (2011). Significance of Prediagnostic Thyroid Antibodies in Women with Autoimmune Thyroid Disease. The Journal of Clinical Endocrinology & Metabolism, 96(9), E1466–E1471. https://doi.org/10.1210/jc.2011-0228
  26. Jiang, C., Wu, Y., Huang, J., et al. (2024). Clinical value of complete blood count ratio in benign and malignant thyroid diseases. Cancer Epidemiology, 92, 102636–102636. https://doi.org/10.1016/j.canep.2024.102636
  27. Koehler, V. F., Filmann, N., & Mann, W. A. (2019). Vitamin D Status and Thyroid Autoantibodies in Autoimmune Thyroiditis. Hormone and Metabolic Research, 51(12), 792–797. https://doi.org/10.1055/a-1023-4181
  28. Koulouri, O., Moran, C., Halsall, D., et al. (2013). Pitfalls in the measurement and interpretation of thyroid function tests. Best Practice & Research Clinical Endocrinology & Metabolism, 27(6), 745–762. https://doi.org/10.1016/j.beem.2013.10.003
  29. Lekurwale, V., Acharya, S., Shukla, S., et al. (2023). Neuropsychiatric Manifestations of Thyroid Diseases. Cureus, 15(1). https://doi.org/10.7759/cureus.33987
  30. Mazzilli, R., Medenica, S., Di Tommaso, A. M., et al. (2022). The role of thyroid function in female and male infertility: a narrative review. Journal of Endocrinological Investigation, 46(1). https://doi.org/10.1007/s40618-022-01883-7
  31. Medici, M., Visser, T. J., & Peeters, R. P. (2017). Genetics of thyroid function. Best Practice & Research Clinical Endocrinology & Metabolism, 31(2), 129–142. https://doi.org/10.1016/j.beem.2017.04.002
  32. Medici, M., Visser, W. E., Visser, T. J., et al. (2015). Genetic Determination of the Hypothalamic-Pituitary-Thyroid Axis: Where Do We Stand? Endocrine Reviews, 36(2), 214–244. https://doi.org/10.1210/er.2014-1081
  33. Mirhosseini, N., Brunel, L., Muscogiuri, G., et al. (2017). Physiological serum 25-hydroxyvitamin D concentrations are associated with improved thyroid function—observations from a community-based program. Endocrine, 58(3), 563–573. https://doi.org/10.1007/s12020-017-1450-y
  34. Nguyen, Q. T., Lee, E. J., Huang, M. G., et al. (2015). Diagnosis and Treatment of Patients with Thyroid Cancer. American Health & Drug Benefits, 8(1), 30. https://pmc.ncbi.nlm.nih.gov/articles/PMC4415174/
  35. Panicker, V. (2011). Genetics of Thyroid Function and Disease. The Clinical Biochemist Reviews, 32(4), 165. https://pmc.ncbi.nlm.nih.gov/articles/PMC3219766/
  36. Paschou, S. A., Bletsa, E., Stampouloglou, P. K., et al. (2022). Thyroid disorders and cardiovascular manifestations: an update. Endocrine, 75(3), 672–683. https://doi.org/10.1007/s12020-022-02982-4
  37. Patil, N., Rehman, A., Anastasopoulou, C., et al. (2023). Hypothyroidism. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519536/
  38. Peiris, A. N., Medlock, D., & Gavin, M. (2019). Thyroglobulin for Monitoring for Thyroid Cancer Recurrence. JAMA, 321(12), 1228. https://doi.org/10.1001/jama.2019.0803
  39. Perera, H. (2024, March 11). Anterior Pituitary (Its Hormones, Functions, & More). Rupa Health. https://www.rupahealth.com/post/hormones-by-anterior-pituitary
  40. Pirahanchi, Y., Jialal, I., & Toro, F. (2023). Physiology, Thyroid Stimulating Hormone (TSH). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499850/
  41. Preston, J. (2022, December 12). Postpartum Thyroiditis: Symptoms, Lab Tests, & Treatment. Rupa Health. https://www.rupahealth.com/post/5-of-women-experience-postpartum-thyroiditis-here-are-the-main-signs-to-look-out-for
  42. Rattanamusik, N., Uitrakul, S., & Charoenpiriya, A. (2023). Vitamin D Levels in Patients with Active and Remission Graves' Disease. Medicines, 10(7), 41. https://doi.org/10.3390/medicines10070041
  43. Reverse Triiodothyronine. Rupa Health. https://www.rupahealth.com/biomarkers/rt3
  44. Ross, D. S., Burch, H. B., Cooper, D. S., et al. (2016). 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid, 26(10), 1343–1421. https://doi.org/10.1089/thy.2016.0229
  45. Sweetnich, J. (2023, March 6). The Ultimate Guide to Hyperthyroidism Lab Testing. Rupa Health. https://www.rupahealth.com/post/the-ultimate-guide-to-hyperthyroidism-lab-testing
  46. Sweetnich, J. (2023, May 4). Vitamin D 101. Rupa Health. https://www.rupahealth.com/post/vitamin-d-101-testing-rdas-and-supplementing
  47. Sweetnich, J. (2023, May 19). Complementary and Integrative Medicine Treatment for Thyroiditis: Specialty Testing, Nutrition, and Supplements. Rupa Health. https://www.rupahealth.com/post/complementary-and-integrative-medicine-treatment-for-thyroiditis
  48. Sweetnich, J. (2023, June 23). A Comprehensive Guide to Thyroid Supporting Supplements. Rupa Health. https://www.rupahealth.com/post/a-comprehensive-guide-to-thyroid-supporting-supplements
  49. Thyroglobulin. (2020). Rupa Health. https://www.rupahealth.com/biomarkers/tg
  50. Thyroglobulin Antibodies. Rupa Health. https://www.rupahealth.com/biomarkers/anti-tg
  51. Thyroid Cancer: Screening. (2017, May 9). United States Preventive Services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/thyroid-cancer-screening
  52. Thyroid Hormone. (2022, February 15). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22391-thyroid-hormone
  53. Thyroid Peroxidase Antibodies. Rupa Health. https://www.rupahealth.com/biomarkers/anti-tpo
  54. Thyroid-Stimulating Immunoglobulin. (2020). Rupa Health. https://www.rupahealth.com/biomarkers/thyroid-stimulating-immunoglobulin
  55. Total Thyroxine. Rupa Health. https://www.rupahealth.com/biomarkers/t4
  56. Total Triiodothyronine. Rupa Health. https://www.rupahealth.com/biomarkers/t3
  57. U.S. Preventive Services Task Force. (2004). Screening for Thyroid Disease: Recommendation Statement. American Family Physician, 69(10), 2415–2418. https://www.aafp.org/pubs/afp/issues/2004/0515/p2415.html
  58. Vojdani, A. (2022, April 25). The Importance of Detecting Autoimmune Diseases During Preclinical and Clinical Stage. Rupa Health. https://www.rupahealth.com/post/the-importance-of-detecting-autoimmune-diseases-during-preclinical-and-clinical-stage
  59. Weinberg, J. L. (2022, March 18). Fatigue, weight gain, depression, and brain fog are common signs of This autoimmune disease. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-hashimotos-disease
  60. Weinberg, J. L. (2022, September 7). An Integrative Medicine Approach to Hypothyroidism. Rupa Health. https://www.rupahealth.com/post/understanding-hypothyroidism-and-how-to-treat-it-naturally
  61. Weinberg, J. L. (2023, January 24). Functional Medicine Treatment for Graves' Disease. Rupa Health. https://www.rupahealth.com/post/functional-medicine-treatment-for-graves-disease
  62. Weinberg, J. L. (2023, February 7). A Functional Medicine Protocol for Hyperthyroidism. Rupa Health. https://www.rupahealth.com/post/5-functional-medicine-labs-that-can-assist-a-root-cause-treatment-for-hyperthyroidism
  63. Wells, S. A., Asa, S. L., Dralle, H., et al. (2015). Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma. Thyroid, 25(6), 567–610. https://doi.org/10.1089/thy.2014.0335
  64. Wouters, H. J. C. M., Wolffenbuttel, B. H. R., Muller Kobold, A. C., et al. (2023). Hypothyroidism, comorbidity and health-related quality of life: a population-based study. Endocrine Connections, 12(12). https://doi.org/10.1530/ec-23-0266
  65. Yazdaan, H. E., Jaya, F., Sanjna, F., et al. (2023). Advances in Thyroid Function Tests: Precision Diagnostics and Clinical Implications. Cureus, 15(11), e48961. https://doi.org/10.7759/cureus.48961
  66. Yoshimura, H. (2023, August 18). A Root Cause Medicine Approach to Euthyroid Sick Syndrome. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-approach-to-euthyroid-sick-syndrome
  67. Yoshimura, H. (2023, September). A Functional Medicine Approach to Subacute Thyroiditis (De Quervain's). Rupa Health. https://www.rupahealth.com/post/integrative-and-complementary-approach-to-subacute-thyroiditis-de-quervains
Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless — and best of all, it's free for practitioners.

Latest Articles

View more on Thyroid
Subscribe to the Magazine for free
Subscribe for free to keep reading! If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey Practitioners! Ready to become a world class gut health expert? Join Jeannie Gorman, MS, CCN, for a Free Live Class that dives into how popular diets impact the gut microbiome, the clinical dietary needs of your gut, biomarkers to test to analyze gut health, and gain a clear understanding of the Doctor’s Data GI360™ profile. Register here.