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Related Concept Videos

Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

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Related Experiment Video

Updated: May 8, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
10:19

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Published on: November 10, 2014

Variability in thyroid function test requests across general practices in south-west England.

Bijay Vaidya1, Obioha C Ukoumunne, Joanna Shuttleworth

  • 1Department of Endocrinology, Royal Devon & Exeter Hospital, Exeter, UK. b.vaidya@exeter.ac.uk

Quality in Primary Care
|August 24, 2013
PubMed
Summary

Thyroid function test (TFT) requests vary significantly between UK general practices. This study highlights the need to reduce unnecessary testing and standardize clinical practice for thyroid function tests.

Related Experiment Videos

Last Updated: May 8, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
10:19

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Published on: November 10, 2014

Area of Science:

  • Endocrinology
  • Clinical Practice Research

Background:

  • Thyroid function tests (TFTs) have seen a significant increase in utilization globally.
  • Inconsistent clinical practices and inappropriate test requests are suspected drivers of this rise.

Purpose of the Study:

  • To investigate the degree of variation in thyroid function test requests originating from general practices.
  • To identify potential areas for optimizing diagnostic test utilization in primary care.

Main Methods:

  • Analysis of routine data for all TFTs performed on patients aged 16 and over in two hospitals during 2010.
  • Inclusion of data from 107 general practices requesting the tests.

Main Results:

  • A total of 195,309 TFT requests were analyzed, with thyroid-stimulating hormone (TSH) being the most frequent test.
  • Significant variation in TSH test requests per 1000 list size was observed across general practices, ranging from 84 to 482.
  • Practice heterogeneity accounted for most of the variation, with hypothyroidism prevalence and socioeconomic deprivation explaining only 24% of the differences.

Conclusions:

  • Wide variability exists in thyroid function test ordering among general practices.
  • There is a clear opportunity to reduce both unnecessary TFTs and practice variation.
  • Further research is needed to elucidate the underlying causes of this testing variability.