Depending on what indications the first examination steps have provided, further tests follow. These can be used, for example, to check synthesis performance or blood flow, identify genetic causes, and determine surgical measures (or verify the success of surgery).
Various special examinations of the thyroid gland
- Dynamic function tests: to assess hyperthyroidism or hypothyroidism in more detail, substances that stimulate (stimulation test) or inhibit (suppression test) hormone release from the thyroid gland are injected, and thyroid hormones in the blood are checked beforehand and several times afterwards at specific intervals. Depending on how the thyroid gland reacts, conclusions can be drawn about the nature of the disorder.
- Scintigraphy: in this procedure, the patient is injected with radioactively labeled substances and their deposition in the thyroid or epithelial tissue is recorded with special cameras and displayed in color. In this way, metabolic activity and function can be assessed, although this is often not so easy with the small parathyroid glands. If a functional disorder of the parathyroid gland is suspected, a bone scintigraphy of the whole body may also be indicated, namely if it is suspected that a tumor with daughter tumors in the bone is the cause.
- Other imaging modalities: If one suspects hyperthyroidism or hypothyroidism of the parathyroid gland, conventional X-rays are often taken, since the skeletal changes caused by the hormone disorder can be seen well on them. Computed tomography and magnetic resonance imaging are used especially in the assessment of tumors and to find metastases.
- Other blood tests: In certain thyroid diseases (for example, Hashimoto’s thyroiditis, Graves’ disease), antibodies are formed against the body’s own tissue, which can be detected in the blood. In inflammation, certain blood values are also changed.
- Laryngoscopy: this allows the condition of the vocal cords to be assessed, which is particularly important for the planning and follow-up of thyroid surgery for cancer.
- Genetic diagnostics: there are diseases of the thyroid and parathyroid glands that are hereditary; some often occur together with diseases of other organs of the endocrine system (multiple endocrine neoplasia = MEN). DNA alterations can be detected using various genetic diagnostic methods. This may be indicated, for example, for genetic counseling of parents who wish to have children.
