The purpose of screening is early diagnosis and treatment. Screening tests are usually given to people who do not have current symptoms, but who may be at high risk for certain diseases or conditions. Screening for hypothyroidism remains under question because there is no evidence showing that it benefits patients.
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).
The United States 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.
Screening may be needed in special high-risk groups such as: All newborn infants (required in many states)Pregnant women with or without goiter
A strong family history of thyroid diseaseA personal history of thyroid problems
An autoimmune disease, such as
type 1 diabetesDepression
, especially those taking
Elevated lipid levelsA thyroid noduleDown syndrome
American Academy of Pediatrics. Update of newborn screening and therapy for congenital hypothyroidism.
Cooper DS, Doherty GM, et al.
. November 2009;19(11):1167-1214.
Ladenson P, Singer P, et al. American Thyroid Association Guidelines for Detection of Thyroid Dysfunction.
Arch Intern Med
Surks MI, Ortiz E, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management.
. 2004 Jan 14;291(2):228-238.
The United States Preventive Services Task Force. Screening for thyroid disease: recommendation statement.
Ann Intern Med
Last reviewed March 2015 by Kim A. Carmichael, MD, FACP
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