HOW TO ASSESS THE FUNCTIONAL STATE OF THE THYROID GLAND AND WHAT TO DO IN THE SITUATION WHERE THE TESTS ARE INADEQUATE?

Abstract: In most cases, the assessment of the functional state of the thyroid gland is not difficult. Often, according to the results of a hormonal study, it can be concluded that there is a manifest (subclinical) hypothyroidism or a manifest (subclinical) hyperthyroidism. There are usually no difficulties in making a diagnosis and prescribing treatment for a patient in such a situation. However, in clinical practice, one may encounter a situation where the results of laboratory studies do not correspond to the clinical picture and/or the normal functioning of the pituitary-thyroid axis according to the principle of logarithmic negative feedback. In these situations, inadequate results can often be explained by laboratory errors, drug effects, or the presence of a genetic disease. Also, more and more questions have recently arisen in the diagnosis of thyroid pathology syndrome. In these situations, the correct algorithm of action will play a key role in making a diagnosis and determining further tactics for managing a patient. This paper will consider the factors leading to changes in laboratory parameters and a structured approach to the study of the functional state of the thyroid gland, which is of great importance in clinical practice.

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