Laboratory values

The most important laboratory values in thyroid diagnostics are the actual thyroid hormones fT3 and fT4, as well as the regulatory hormone TSH. TSH is produced in the brain and stimulates the thyroid gland to produce its hormones (fT3 and fT4). The thyroid hormones, on the other hand, have an inhibitory effect on the brain and reduce the secretion of TSH.

This creates a regulatory cycle in which the hormones can be maintained at a continuous level. If our thyroid gland now produces uncontrolled thyroid hormones, our laboratory values change: the concentration of fT3 and fT4 increases as they are produced in greater quantities. In addition, these hormones inhibit the release of TSH – consequently, this laboratory value decreases. Thus, the classic laboratory constellation for hyperthyroidism in the context of an autonomous adenoma: Schilddrüsenu, ↑fT3, ↑fT4.

These symptoms indicate an autonomic adenoma

An autonomous adenoma can manifest itself in two ways. On the one hand, the growth of the thyroid gland can lead to a lump feeling in the throat. This can be accompanied by swallowing difficulties.

On the other hand, and often much more pronounced, are the symptoms that can be attributed to hyperthyroidism. These include excessive sweating, trembling and hair loss. Heart palpitations and heart stumbling up to heart rhythm disturbances can occur.

Warm rooms are no longer well tolerated, patients are very irritable and restless, have sleep disorders and mood swings. Many patients also report diarrhoea and unwanted weight loss. The combined occurrence of many of these symptoms is very typical of hyperthyroidism, but the severity of the symptoms can vary greatly from individual to individual. If you report symptoms of this kind to your family doctor, a blood sample and an ultrasound can provide clarity.

Therapy of the autonomous adenoma

There are several treatment options for the therapy of autonomic adenoma. First of all, it should be noted that only symptomatic patients need to be treated at all. Many patients with an autonomic adenoma are often completely without symptoms for a long time and therefore do not need any therapy.

However, if symptoms such as palpitations or unintentional weight loss occur, it is advisable to curb the hyperthyroidism with therapy. As a rule, the treatment of first choice here is to take tablets. The so-called thyrostatics inhibit the iodine absorption in the thyroid gland and thus reduce the new build-up of thyroid hormones.

The common active ingredients are thiamazole, carbimazole or propylthiouracil. If the drug therapy is not sufficient or not desired by the patient, there is still the possibility of radioiodine therapy and surgical removal of the thyroid gland. Both options have in common that they usually lead to a permanent cure of hyperthyroidism by destroying or removing thyroid tissue.

However, often very little or no healthy thyroid tissue remains, which is why patients must take thyroid hormones in tablet form for the rest of their lives. Which form of therapy is chosen should be individually weighed up with a specialist. Radioiodine therapy is a common treatment option for an autonomous adenoma.

Here, we take advantage of the fact that only the thyroid gland can accumulate iodine in our body and any excess iodine is excreted in the urine. In this way, the patient is given radioactive iodine, which is absorbed by the thyroid gland and causes local destruction of the thyroid cells. In this way the autonomous adenoma can also be removed.

Whether a patient requires radioiodine therapy should be carefully considered with a specialist. The first choice of therapy is often the so-called thyrostatics, which are taken as tablets and reduce the thyroid hormone production. Only if this therapy cannot sufficiently suppress the symptoms of hyperthyroidism or if the patient is looking for a final therapy option, radioiodine therapy can be considered.