Diseases of the thyroid gland rank second after diabetes mellitus among all endocrine disorders. Various factors can influence the development of thyroid pathology, the most significant of which are iodine deficiency and hereditary predisposition. In order to prevent problems or detect them at an early stage, you should regularly have your thyroid fully checked. ## When examination becomes a necessity? Thyroid issues can disguise themselves as many other conditions and depend on the malfunction of a wide variety of organs and systems. Do not hesitate to tell your doctor if you are feeling weak, get tired quickly, have constipation, or constantly feel extremely cold or hot. Watch out for weight fluctuations as well as lack of or increased appetite. It is important for women to pay attention to an irregular menstrual cycle or increased hair loss. Doctors will be able to notice swelling or dryness of the skin. Although one of these symptoms observed might not mean anything, a combination of several of them can be an alarming signal. For those who are at risk, the thyroid gland should be checked regularly. If your work is associated with exposure to radiation or toxic substances, or if there have been cases of thyroid cancer or a toxic goiter (Graves' disease) among close relatives, you must undergo an examination every year. ## What issues can the thyroid have? All thyroid diseases can be divided into three groups: *The first* is issues associated with increased production of thyroid hormones, called hyperthyroidism. *The second* is the reduced synthesis of thyroid hormones, called hypothyroidism. *The third* is issues where the gland’s functional activity doesn’t change but the structure of the organ (formation of nodes, increase in volume) does. ## What does a medical examination check? The first thing a doctor evaluates is the patient's appearance. A swollen face with a stingy facial expression or, on the contrary, emaciated, with a nervous look may be signs of illness. Next, the specialist assesses the size of the gland, the condition of the lymph nodes and their localization, and checks its movement when the patient swallows. If the doctor notices a potential issue during the examination, he or she will recommend taking tests to uncover the reason behind a lack or excess of certain hormones. __Important! You need to take a blood test strictly before 12 o'clock, on an empty stomach, and while in a relaxed mood. You should not have undergone any X-ray procedures or physical or emotional stress in the 24 hours before the procedure. Remember to tell your doctor if you are taking any medication.__ __TSH (thyroid-stimulating hormone)__ is a pituitary hormone that most effectively reflects the functional state of the thyroid gland. It rises with a lack of hormones and decreases with an excess. The normal range of TSH is almost the same for everyone — 0,3–4,2 μIU/ml. The exception to this is pregnant women, as their reference values are slightly different. As a rule, for the initial diagnosis of the state of the thyroid gland, a controlled TSH level is sufficient. But if the TSH is elevated or lowered, an additional examination will be required. __Free T4 (free thyroxine)__ is considered the norm when this indicator fits into the corridor 10,8–22,0 pmol/l. A decrease in Free T4 levels may indicate hypothyroidism. An increase occurs in thyrotoxicosis of various origins. __Free T3 (free triiodothyronine)__ is synthesized by the thyroid gland, but most of it is formed outside of it in the liver and kidneys. Reference interval: 3,08–6,78. The reasons for the increase may be hyperthyroidism, T3 thyrotoxicosis of various etiologies, thyroiditis, etc. __Thyroid ultrasound__ The examination will not be complete without an ultrasound, which allows the doctor to determine the size of the thyroid gland as well as calculate its volume and blood supply. The ultrasound also determines the presence of nodules or focal changes. Normally, the volume of the thyroid gland is up to 25 cm3 in men and up to 18 cm3 in women. If the doctor is not satisfied with the ultrasound results, X-ray diagnostic methods can be applied including computed tomography (CT), scintigraphy, magnetic resonance imaging (MRI) as well as fine-needle puncture biopsy of nodules.