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More info - I have the lab tests descriptions at the end

SUBCLINICAL HYPOTHYROIDISM

Either no symptoms or minimal symptoms suggestive of

hypothyroidism with normal serum free T4 and T3 and elevated

serum TSH concentrations.

Subclinical thyroid dysfunction has become relatively common

over the past few years because sensitive serum TSH assays

are now readily available. Subclinical hypothyroidism is

especially common in elderly women, particularly in those with

underlying Hashimoto's thyroiditis, reaching up to 15% in some

series. Thyroid peroxidase antibodies should be measured in all

patients with subclinical hypothyroidism. L-Thyroxine therapy is

recommended in those patients with positive antibodies

because they are at greatest risk to progress to overt

hypothyroidism. In the absence of positive antibodies,

L-thyroxine therapy is more debatable but might be advisable in

the presence of even suggestive symptoms of hypothyroidism. At

the least, thyroid function should be closely monitored to

determine whether more severe hypothyroidism develops.

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Thyroid Antimicrosomal Antibody

Pronunciation: (THIY-royd AEN-tiy-MIY-kroe-SOEM-:l

AEN-ti-BAH-dee)

Synonyms: (anti-TPO; thyroid peroxidase antibody)

Test Description: Thyroid antimicrosomal antibody is a test to

detect thyroid microsomal antibodies and is used to confirm

diagnoses related to the thyroid gland. It is also used to monitor

disease activity. This test is more accurate when done in

conjunction with thyroid antibodies. The microsomal antibodies

are a reaction to the thyroid epithelium. The thyroid is an

endocrine gland located in the anterior neck region and partially

surrounds the thyroid cartilage and upper rings of the trachea.

The primary action of the thyroid gland is to control the basal

metabolic rate. The thyroid gland enlarges in hyperthyroidism

(goiter) and it may be removed surgically. In addition, a

hypothyroid state may exist (e.g., after a thyroidectomy) and the

therapy is to administer a synthetic form of thyroid hormones

(e.g., synthroid).

Clinical Implications and Indications:

1. Increased levels are found with autoimmune disease affecting

the thyroid, hypothyroidism, Hashimoto's disease, Graves'

disease, nontoxic goiter, and other autoimmune diseases.

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Thyroid Antibodies

Pronunciation: (THIY-royd AEN-ti-BAH-deez)

Synonyms: (antithyroglobulin)

Body Systems and Functions: Endocrine system

Test Description: This test detects thyroid antibodies and is

used to confirm diagnoses related to the thyroid gland. It is also

used to monitor disease activity. This test is more accurate when

done in conjunction with thyroid microsomal antibodies. The

thyroid is an endocrine gland located in the anterior neck region

and partially surrounds the thyroid cartilage and upper rings of

the trachea. The primary action of the thyroid gland is to control

the basal metabolic rate. The thyroid gland enlarges in

hyperthyroidism (goiter) and it may be removed surgically. In

addition, a hypothyroid state may exist (e.g., after a

thyroidectomy) and the therapy is to administer a synthetic form

of thyroid hormones (e.g., synthroid).

Clinical Implications and Indications:

1. Elevated levels are found with autoimmune disease affecting

the thyroid, hypothyroidism, Hashimoto's disease, Graves'

disease, nontoxic goiter, and other autoimmune diseases.

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Insulin

Pronunciation: (IN-suh-lin)

Body Systems and Functions: Endocrine system

Normal Findings:

Fasting:

Infants/children < 13 uU/mL

Adults 17 uU/mL

After 75 g glucose:

30 min 20-112 uU/mL

1 hr 29-88 uU/mL

2 hr 22-79 uU/mL

3 hr 4-62 uU/mL

Insulin-glucose ratio < 0.3:1

Note: Normal laboratory findings vary among laboratory settings.

CRITICAL VALUES:

> 30 uU/mL

Test Description: Insulin testing measures the rate of insulin

secreted by the cells of the islets of Langerhans in the pancreas.

Insulin is a hormone that is secreted normally in response to

elevated blood glucose. It promotes glucose utilization,

carbohydrate metabolism, and energy storage. Insulin

preparations are derived from beef or pork pancreas or

synthesized in the laboratory from either an alteration of pork

insulin or recombinant DNA technology to form a biosynthetic

human insulin. Insulin comes in rapid-acting (regular),

intermediate-acting (NPH), or long-acting (Ultralente)

preparations. Insulin therapy is mandatory for type I diabetics

and provides life-giving medication for clients with diabetes

mellitus.

Clinical Implications and Indications:

1. Diagnoses early noninsulin-dependent diabetes mellitus.

There will be an excessive production of insulin in relation to

blood glucose levels.

2. Confirms functional hypoglycemia.

3. Evaluates postprandial or reactive hypoglycemia of uncertain

etiology.

4. Diagnoses insulinoma and assists in the diagnosis of

pheochromocytoma.