Thyroid, tests to keep it under control
Il thyroid cancer it is a pathology that mainly affects women and which, according to forecasts, is destined to see an increase in cases. Prevention and early diagnosis play a fundamental role in protecting thyroid health and make use of a series of specific tests. They are of two types: hematochemical, therefore blood, and image, such as ultrasound or scintigraphy. Here are the details.
«With blood tests, you check the TSH value by TSH reflex. In case of alteration of the latter, the measurement of free T4, the thyroid hormone most secreted by the thyroid, is automatically started, followed by free T3. Also very important are anti-thyroperoxidase (AbTPO) and anti-thyroglobulin (antiTg) antibodies, which are markers of thyroid autoimmunity; anti-TSH receptor antibodies (TrAb), present in Graves’ disease, which is the name used in most of the world to indicate autoimmune hyperthyroidism, also called Graves’ disease. In patients undergoing total thyroidectomy and radioiodine therapy, Thyroglobulin is also checked, which could indicate tumor recurrence or distant metastases. Finally, calcitonin which is a neoplastic marker of medullary thyroid cancer, a rather aggressive type of tumor that is often familial”, he explains Roberto Valcavispecialist in Endocrinology and Internal Medicine and president of the TNT Association (International Association of Thyroid Nodules Therapies).
Depending on the case, other tests are also useful, in particular ultrasound, the best for observing particular alterations, for the diagnosis of nodule and thyroid cancer because, using harmless ultrasound, it can be repeated whenever the specialist deems it necessary. Unlike CT scans and MRI scans which use ionizing radiation or high intensity magnetic fields respectively and must be used sparingly.
Thyroid scintigraphy is used less today than in the past, both because the images are less defined than ultrasound and because it uses radioactive substances.
How often should checks be carried out? «The doctor establishes it based on the type of pathology. We often proceed with annual checks, but there is no particular deadline since different pathologies correspond to different needs for checks”, observes Dr. Valcavi.