Thyroid Cascading Profile

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

TSH

A TSH test is a lab test that measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It tells the thyroid gland to make and release thyroid hormones into the blood.
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The Thyroid Cascading Profile test contains 1 test with 1 biomarker.

Brief Description: The Thyroid Cascading Profile test is a comprehensive diagnostic approach used to evaluate thyroid function and autoimmunity by sequentially testing based on initial results. This test begins with a Thyroid Stimulating Hormone (TSH) assessment and, depending on the outcome, can reflex to additional tests such as T4 Free, Thyroid Peroxidase Antibodies (TPO), and T3 Free. This tiered testing method ensures a thorough evaluation of thyroid health, providing valuable insights into the gland's function and potential autoimmune activity.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks.

According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay."

Cascade Reflex Pathway

The Thyroid Cascading Profile begins with Thyroid Stimulating Hormone.

  • If the Thyroid Stimulating Hormone result is abnormal, then a T4 Free test will be performed and charged for.
    • If the Thyroid Stimulating Hormone result is elevated and the T4 Free result is either normal or low, then a Thyroid Peroxidase Antibodies test will be performed and charged for.
    • If the Thyroid Stimulating Hormone result is low and the T4 Free result is either normal or low, then a T3 Free test will be performed and charged for.

When and Why the Thyroid Cascading Profile Test May Be Ordered

The Thyroid Cascading Profile test is typically ordered when symptoms suggest a thyroid disorder, such as unexpected weight changes, altered energy levels, abnormal heart rate, and changes in mood or concentration. It's also used for monitoring known thyroid conditions and guiding treatment decisions, offering a cost-effective and targeted approach to thyroid testing.

What the Thyroid Cascading Profile Test Checks For

  • Thyroid Stimulating Hormone (TSH): TSH is a pituitary hormone that regulates thyroid function. Abnormal levels can indicate an overactive (hyperthyroidism) or underactive (hypothyroidism) thyroid.

  • T4 Free (FT4): FT4 measures the free, unbound fraction of the total thyroxine hormone, providing insight into the thyroid's hormone production capabilities.

  • Thyroid Peroxidase Antibodies (TPO): TPO antibodies can indicate autoimmune thyroid disease, such as Hashimoto's thyroiditis, where the immune system attacks the thyroid gland.

  • T3 Free (FT3): FT3 assesses the free, unbound triiodothyronine hormone, crucial for understanding the body's metabolic state and further investigating hyperthyroidism.

Conditions and Diseases Detected by the Test

The Thyroid Cascading Profile test can help diagnose and manage various thyroid-related conditions:

  • Hypothyroidism: Characterized by elevated TSH and potentially low FT4 levels, indicating reduced thyroid hormone production.

  • Hyperthyroidism: Marked by low TSH and possibly high FT4 or FT3 levels, suggesting excessive thyroid hormone production.

  • Hashimoto's Thyroiditis: An autoimmune condition often identified by elevated TPO antibodies, leading to gradual thyroid damage and potential hypothyroidism.

  • Graves' Disease: Another autoimmune thyroid disorder, typically involving hyperthyroidism, which may be suggested by suppressed TSH and elevated FT4 or FT3 levels.

Using the Thyroid Cascading Profile Test in Treatment and Monitoring

Healthcare professionals leverage the results from the Thyroid Cascading Profile test to:

  • Tailor Treatment for Thyroid Disorders: Specific patterns, such as elevated TSH with low FT4, guide the initiation of thyroid hormone replacement for hypothyroidism, while suppressed TSH with high thyroid hormones may indicate the need for anti-thyroid medications or other interventions in hyperthyroidism.

  • Identify and Manage Autoimmune Thyroid Disease: The presence of TPO antibodies can confirm an autoimmune etiology, influencing long-term management strategies and monitoring.

  • Adjust Therapies Based on Metabolic Impact: FT3 levels, in particular, can provide insights into the metabolic effects of thyroid disorders, guiding the fine-tuning of treatments to achieve optimal metabolic balance.

The Thyroid Cascading Profile test offers a strategic and efficient approach to diagnosing and managing thyroid disorders, from common conditions like hypothyroidism and hyperthyroidism to autoimmune thyroid diseases such as Hashimoto's and Graves' disease. By starting with TSH and reflexing to additional tests as needed, this panel ensures a comprehensive evaluation, enabling healthcare providers to make informed decisions about treatment and monitoring, ultimately leading to better patient care and outcomes in thyroid health management.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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