ROJoson PEP Talk: Thyroid - When Do You Need Lab Tests?

ROJoson PEP Talk: Thyroid - When Do You Need Lab Tests?

1. July 06, 2024 1400H - 1500H Via Zoom Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management.

2. July 06, 2024 1400H - 1500H Via Zoom Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. Welcome all! MUTE yourself but always show your video picture. Sign in your name, FB account, or email address in the Chat Box! Include names of companions attending. Use the Chat Box to ask questions and make comments while the PEP TALK is on. There will be group pictures at start and end of PEP TALK – show your face in video.

3. Reminder after the PEP Talk: Take the Online Learning cum Evaluation Test Exercise (OLETE) for mastery of learning and have a perfect score to get a Certificate. Link is in Chat Box.

4. Reminder: 25 OLETE Certificates = 1 Voucher for ROJoson Medical Consultation either Face-to-Face or Telemedical.

5. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. ROJOSON’S REQUEST: FEEDBACK TO THIS PEP TALK! Pls. type in your feedback in the chat box during the open forum and before we adjourn! Thank you!

6. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. LET’S NOW HAVE A GROUP PICTURE TAKING BEFORE WE START PEP TALK PROPER IN 2 MINUTES! Pls. turn on your video! Show your face!

7. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. ROJoson PEP Talk I have a Patient Empowerment Program in which I like to empower the lay people or patients to take control in the management of their health.

8. I started the PEP Talk on May 15, 2021 during the COVID19 Pandemic. There are 3 courses in the PEP Talk. I completed the Core Course on October 9, 2021.

9. From October 23, 2021 onwards, I have been tackling Health Disorder and Health Issue Courses. May 18, 2024 marks the start of YEAR 4 of ROJoson PEP Talk. How long the PEP Talk will last will depend on our enthusiasm , discipline and perseverance .

10. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. My PEP TALK today is entitled: Thyroid – When Do You Need Lab Tests?

11. Contents What is the thyroid? Where is the thyroid gland located? What is the anatomy of the thyroid gland? What are the diseases that may occur in the thyroid gland? What are lab tests for thyroid? When do you need lab tests for thyroid? When do you not have to do lab tests for thyroid? Disclaimer: ROJoson PEP Talk contains ROJoson’s Thoughts, Perceptions, Opinions and Recommendations (TPORs) culled from experiences of ROJoson and writings of other health professionals . Thyroid – When Do You Need Lab Tests?

12. o The THYROID gland is a gland that produces thyroid HORMONES that circulate in the blood and whose functions are to mainly to regulate body metabolism and promote growth and development of the body. Thyroid – When Do You Need Lab Tests?

13. Is The THYROID gland is located on the front and central part of the neck. Normally, it has 2 lobes (right and left) connected by an isthmus. Thyroid – When Do You Need Lab Tests?

14. u A general term for the disorder of the thyroid gland is called GOITER. A GOITER is an abnormality in the thyroid gland. It is a disease in the thyroid gland. GOITER is not just one abnormality or disease. There are many kinds of abnormalities or diseases affecting the thyroid gland. So, there are many kinds of GOITER. Thyroid – When Do You Need Lab Tests?

15. nt The abnormality in a goiter can be in terms of functions and anatomical structure. In terms of functions, the abnormality can either be HYPERTHYROIDISM (producing excessive amount of thyroid hormones) HYPOTHYROIDISM (producing deficient amount of thyroid hormones) Thyroid – When Do You Need Lab Tests?

16. nt The abnormality in a goiter can be in terms of functions and anatomical structure. In terms of anatomical structure, the abnormality is basically a MASS or MASSES which can either be MALIGNANT (CANCER) NON-MALIGNANT (BENIGN) Thyroid – When Do You Need Lab Tests?

17. i The usual starting point in suspecting the presence of GOITER is through palpation of the neck. Normally, the thyroid gland is not palpable or impalpable (cannot be palpated) except for the very thin persons with thin soft tissues over the neck. Thyroid – When Do You Need Lab Tests?

18. r If thyroid is palpable, a GOITER is said to be present. One then proceeds to determine if the GOITER is DIFFUSE or NODULAR and later on, the specific disease that may be present. Thyroid – When Do You Need Lab Tests?

19. If the goiter is DIFFUSE, THYROID CANCER is usually NOT a suspect. Instead, HYPERTHYROIDISM and HYPOTHYROIDISM are usually suspected (although a diffuse goiter can be associated with EUTHYROIDISM – normal amount of hormones). In HYPERTHYROIDISM, the thyroid gland is diffusely enlarged and producing excessive amount of thyroid hormones. In HYPOTHYROIDISM, the thyroid gland is diffusely enlarged and producing deficient amout of thyroid hormones. Thyroid – When Do You Need Lab Tests?

20. If the goiter is NODULAR, THYROID CANCER is always a suspect or a consideration in the diagnosis. However, THYROID CANCER is NOT so common as BENIGN THYROID NODULE/S (80 to 20 or even 90 to 10 ratio – BENIGN: CANCER). Thyroid – When Do You Need Lab Tests?

21. i What are lab tests for thyroid? Lab tests means laboratory tests. Lab tests are diagnostic procedures done in a laboratory setting or a setting with equipment and special instruments (to differentiate them from physical examination by the physician which is also diagnostic in purpose). Examples of lab tests such as thyroid function tests (FT4, TSH) [blood tests], ultrasound, CT scan, MRI, nuclear scan and PET scan [imaging tests]. Thyroid – When Do You Need Lab Tests?

22. i THYROID – when do you need lab tests? Lab tests are done only when INDICATED. Not all persons should have lab tests for thyroid. INDICATIONS for lab tests: when a physician is NOT certain of the clinical diagnosis. needs to CONFIRM or BE CERTAIN of the clinical diagnosis because this will affect the type of treatment to be done. Thyroid – When Do You Need Lab Tests? Clinical diagnosis means diagnosis gotten from symptoms and signs data gotten from interview and physical examination by a physician on a patient. Thus, a lab test when done should have a clinical diagnosis first. A physician determines whether a lab test is needed or not.

23. i THYROID – when do you need lab tests? Before lab tests are considered, using the principles of PATIENT EMPOWERMENT, the following must be done: Self-examination by the patient No suspicion for GOITER, no lab tests needed Uncertain of findings, consult a physician (esp. a thyroid specialist) Physician or a thyroid specialist examination No suspicion for GOITER, no lab tests needed Uncertain of findings or need to be more certain, lab tests. Thyroid – When Do You Need Lab Tests?

24. i THYROID – when do you need lab tests? Before lab tests are considered, using the principles of PATIENT EMPOWERMENT, the following must be done: Self-examination of the patient No suspicion for GOITER, no lab tests needed Uncertain of findings, consult a physician (esp. a thyroid specialist) Thyroid – When Do You Need Lab Tests? Do SELF-EXAMINATION of the THYROID and NECK first before considering lab tests . Don’t go for lab tests right away without doing self-exam. Learn how to do self-exam of the THYROID and NECK. Lab tests may not be needed.

25. When to say you have a GOITER? A GOITER is said to be present if there is an ABNORMALITY in your thyroid gland. The ABNORMALITY usually comes in two forms: Functional abnormality Structural abnormality Functional abnormality – whether the thyroid gland is secreting too much or too little thyroid hormones (HYERTHYROIDISM or HYPOTHYROIDISM). Structural abnormality – whether the thyroid gland is diffusely enlarged or there are nodules or masses (either CANCER or NOT CANCER). DO A SELF-EXAMINATION TO CHECK IF ANY OF THESE ABNORMALITIES IS PRESENT! Thyroid – When Do You Need Lab Tests?

26. How to do self-examination to check if GOITER is present or not? Two essential things to do in SELF-EXAMINATION for POSSIBLE GOITER: Neck Self-Examination (NSE) Feeling for GOITER symptomatology [feel for symptoms that may suggest abnormality in the thyroid gland, especially the functional ones (symptoms of hyperthyroidism and hypothyroidism)] Start with NECK SELF-EXAMINATION (NSE)! NSE usually facilitates diagnosis or recognition in GOITER in one minute! Thyroid – When Do You Need Lab Tests?

27. NECK SELF-EXAMINATION for POSSIBLE GOITER https://www.verywellhealth.com/thyroid-disease-detection-neck-3233223 Thyroid – When Do You Need Lab Tests?

28. NECK SELF-EXAMINATION for POSSIBLE GOITER Self-palpation of the thyroid gland One hand and/or two hands Thyroid – When Do You Need Lab Tests?

29. NECK SELF-EXAMINATION for POSSIBLE GOITER Feel for bump or lump on swallowing Enlargement or nodule/s? YOU HAVE A GOITER! Thyroid – When Do You Need Lab Tests?

30. NECK SELF-EXAMINATION for POSSIBLE GOITER Self-palpation of the side of neck for possible lymph node enlargement Presence of a palpable lymph node may constitute a suspect for a THYROID CANCER! Thus, also a GOITER! Thyroid – When Do You Need Lab Tests?

31. Other findings that will make one further suspect THYROID CANCER: Palpation of the nodule/s by patients or thyroid specialists shows the following alert signs: The thyroid nodule/s is/are hard in consistency (approximating the feel of a bone). The thyroid nodule/s is/are fixed, immobile. There are palpable lymph nodes on the side of the neck. There is a distant mass suspected to be distant metastasis. Any one of these alert signs is enough to suspect thyroid cancer with high degree of certainty. Thyroid – When Do You Need Lab Tests?

32. How to do self-examination to check if GOITER is present or not? Aside from Neck Self-Examination to check if GOITER is present, particularly if NSE is normal, check if you have symptoms that may suggest abnormality in the thyroid gland, especially the functional ones such as HYPERTHYROIDISM and HYPOTHYROIDISM. Check if you have sudden weight loss despite good appetite palpitations chronic fatigue and tiredness If positive, you may have a GOITER. HYPERTHYROIDISM HYPOTHYROIDISM Thyroid – When Do You Need Lab Tests?

33. SO, when to say you have a GOITER? Upon NECK SELF-EXAMINATION plus feeling for GOITER symptomatology, you say you have a GOITER if Your thyroid is enlarged. Your thyroid contains nodule/s. There is a palpable neck node which can be a part of a thyroid cancer. There are symptoms suggestive of HYPERTHYROIDISM (particularly, sudden weight loss and palpitation). There are symptoms suggestive of HYPOTHYROIDISM (particularly, chronic fatigue and tiredness). Thyroid – When Do You Need Lab Tests?

34. Another situation in which you can say you have a GOITER is when a physician examines your neck for whatever reason and found Your thyroid is enlarged. Your thyroid contains nodule/s. There is a palpable neck node which can be a part of a thyroid cancer. There are symptoms suggestive of HYPERTHYROIDISM (particularly, sudden weight loss and palpitation). There are symptoms suggestive of HYPOTHYROIDISM (particularly, chronic fatigue and tiredness). Thyroid – When Do You Need Lab Tests?

35. Another situation in which you can say you have a GOITER is when diagnostic tests that were done for whatever reasons show abnormalities in the thyroid gland (in the realms of FUNCTION and STRUCTURE). The initial diagnostic tests are commonly the following: Thyroid function tests (such as FT3, FT4, TSH) Thyroid ultrasound Functional abnormality – whether the thyroid gland is secreting too much or too little thyroid hormones (HYERTHYROIDISM or HYPOTHYROIDISM). Structural abnormality – whether the thyroid gland is diffusely enlarged or there are nodules or masses (either CANCER or NOT CANCER). Thyroid – When Do You Need Lab Tests?

36. SO, what’s NEXT after you have discovered a possible or evident GOITER in your monthly NECK SELF-EXAMINATION? GO SEE A THYROID SPECIALIST RIGHT AWAY! A THYROID specialist in the Philippines at the present time can be an endocrinologist, a general surgeon or an ENT. DO NOT HAVE TESTS DONE WITHOUT SEEING A THYROID SPECIALIST FIRST WHO WILL EXAMINE and PALPATE YOUR NECK TO VERIFY YOUR FINDINGS . The TESTS may not be necessary after the THYROID specialist’s examination! Reminders: You should know how to do NECK SELF-EXAM. You should do MONTHLY NECK SELF-EXAM as a health habit. Thyroid – When Do You Need Lab Tests?

37. What will a THYROID SPECIALIST do to you upon consultation? The thyroid specialist will make a DIAGNOSIS statement based on physical examination and symptom data. Then, he/she will make recommendations on what to do next. You should expect the following: explanation of findings & diagnosis; allayance of fear and anxiety; queries answered; informed consent obtained for decided treatment. Depending on the DIAGNOSIS, the following recommendations may ensue: Observe and do further self-monitoring and specialist’s monitoring; diagnostic tests; medications; operation; etc. Thyroid – When Do You Need Lab Tests?

38. i THYROID – when do you need lab tests? When there is a need to be certain if there is HYPERTHYROIDISM or HYPOTHYROIDISM, FT4 and TSH are requested. Where there is a need to be certain if the nodule /s are MALIGNANT or NON-MALIGNANT, OPTIONS include ultrasound and needle aspiration biopsy (two most common lab tests for nodules). At times, CT scan, MRI, PET scan and other tests may be needed. Thyroid – When Do You Need Lab Tests?

39. i When do you not have to do lab tests for thyroid? NO ABNORMALITY is found in the thyroid on self-examination by a patient and physical examination by a physician. The physician is quite certain that there is NO GOITER present during clinical examination. Thyroid – When Do You Need Lab Tests?

40. i Do you need screening lab tests for thyroid? Screening lab tests means those (FT4, TSH and ultrasound and other tests) done just to check if a GOITER is present or not even when there is NO ABNORMALITY found in the thyroid on self-examination by a patient and physical examination by a physician. Screening lab tests are considered NOT to be cost-effective in the general population except in those with high-risk for GOITER but which are very few if not rare in incidence. Thyroid – When Do You Need Lab Tests?

41. i Common scenario in the community – WHICH IS A NO-NO! I feel I have a goiter (for whatever reason – somebody says so; I have tightness of the neck; etc.) I will have an ultrasound of the thyroid and thyroid function tests (FT4, FT3, TSH) done even when I have NOT consulted a physician or I will request my physician to give me a prescription for these tests even if he has not seen me. Thyroid – When Do You Need Lab Tests? NO-NO because the physician needs to do clinical examination first then he / she decides when lab tests are needed or not. BEWARE: There are a lot of false-negatives and false-positives in the lab tests which create anxiety, more harm, more problem.

42. Thyroid – When Do You Need Lab Tests? Summary Take Away Contents What is the thyroid? Where is the thyroid gland located? What is the anatomy of the thyroid gland? What are the diseases that may occur in the thyroid gland? What are lab tests for thyroid? When do you need lab tests for thyroid? When do you not have to do lab tests for thyroid?

43. Thyroid – When Do You Need Lab Tests? Take Away in relation to Patient Empowerment Be always in touch with reliable medical information on Thyroid – When Do You Need Lab Tests? Knowledge is power; it gives power. Use the 4Ks of Patient Empowerment: Kaalaman , Kakayanan , Karapatan and Kapangyarihan to gain greater control over decisions / make better decisions on Thyroid – When Do You Need Lab Tests? as part of your health management.

44. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. This ends m y PEP TALK today on: Thyroid – When Do You Need Lab Tests?

45. Reminder after the PEP Talk: Take the Online Learning cum Evaluation Test Exercise (OLETE) for mastery of learning and have a perfect score to get a Certificate. Link is in Chat Box.

46. Reminder: 25 OLETE Certificates = 1 Voucher for ROJoson Medical Consultation either Face-to-Face or Telemedical.

47. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. ROJOSON’S REQUEST: FEEDBACK TO THIS PEP TALK! Pls. type in your feedback in the chat box during the open forum and before we adjourn! Thank you!

48. Thyroid – When Do You Need Lab Tests? Empowerment objective - for laypeople to have an essential  understanding on THYROID – WHEN DO YOU NEED LAB TESTS as part of their health management. LET’S NOW HAVE A GROUP PICTURE TAKING BEFORE WE START Q&A AND INTERACTIONS! Pls. turn on your video! Show your face!