Dr. Friedman when diagnosing hypothyroidism, how valuable is medical history and an actual hands-on physical?
If your physician suspects hypothyroidism, he or she will first perform a medical examination to look for evidence that your thyroid level is low. The most important test in making a certain diagnosis of this condition is your TSH blood level. When your thyroid gland fails, your pituitary begins to produce increased amounts of TSH, in an effort to stimulate your thyroid more and return it to normal function. If your thyroid is damaged, it cannot increase its activity and your blood level of TSH rises and remains high. Detecting an increased level of TSH in your blood also provides solid evidence that your hypothyroidism is due to disease within your thyroid gland, and is not a result of inadequate stimulation of your thyroid by a diseased pituitary gland. A word should be said about a dangerous recent trend in the lay press to minimize the importance of thyroid blood tests in the diagnosis and management of hypothyroidism.