Dr. Friedman is it common to have both Hashimoto and Graves disease? Can hypothyroidism be due to a pituitary problem?
Diagnosis of Hyperthyroidism and Determination of the Type of Hyperthyroidism
There are many causes of hyperthyroidism and proper treatment requires both a diagnosis(usually done with history and laboratory tests) and a determination of the type of hyperthyroidism (usually done with history, thyroid examination and nuclear medicine tests). To diagnose hyperthyroidism, Dr. Friedman will measure TSH, free T4 and free T3. A suppressed TSH with an elevated free T4 and free T3 indicates frank hyperthyroidism, while a suppressed TSH with an upper-normal free T4 and free T3 indicates subclinical hyperthyroidism. A suppressed TSH with a low or low-normal free T4 and free T3 indicates hypothyroidism due to a pituitary problem. An elevated TSH indicates hypothyroidism due to a thyroid problem.
Once Dr. Friedman determines that a patient has hyperthyroidism, he then determines which type of hyperthyroidism the patient has.