THYROID DISEASE
12/06/2003
Thyroid Disease
The American Thyroid Association and the American Association of Clinical Endocrinology
recommend the following:
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Free T4 and TSH (3rd generation) are reliable tests in diagnosing
A thyroid dysfunction.
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Adults should be screened for thyroid disease beginning at age 35
and every 5 years thereafter.
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All women considering pregnancy should be tested.
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All pregnant women with normal thyroid functions and high anti-TPO
are at risk of subsequent clinical hypothyroidism(50%-80% chance).
Thyroid disease is a common condition with adverse multisystem effects.
The Incidence of the disease increases with age and women are 8 times more prone
to developing thyroid dysfunction than men.
Postpartum thyroid disease occurs in up to 9% of pregnant women.
Up to 40% of people taking thyroid medication are uncontrolled.
The adverse effects of thyroid disease include;
1) Cardiovascular disease:
risk of myocardial infarction, elevated serum cholesterol, atherosclerosis
and atrial fibrillation.
2) Adverse pregnancy outcomes:
high risk of fetal death, children with reduced IQ and increased risk
of postpartum thyroid disease.
3) Mental health:
depression, increased risk of dementia and Alzheimer’s
(Clinical Endocrinology 2000;53:733-737)
Anti-Thyroid peroxidase antibodies (anti-TPO)
Thyroid peroxidase is a membrane bound glycoprotein that mediates the oxidation
of iodide ions and the incorporation of iodine into tyrosine residues of thyroglobin
Clinical applications of anti-TPO include
Risk factor for auto-immune thyroid disease.
Diagnosis of auto-immune thyroid disease.
Risk factor for post partum thyroiditis.
Risk factor for miscarriage and in vitro fertilisation failure.
TSH receptor antibody applications
Diagnosis and therapy control of Grave’s disease.
Assessing the risk of fetal thyroid problems in mothers with a history of Grave’s
disease.
Hypothyroidism with suspected blocking-type antibodies
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