Thyroid nodule laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laboratory findings in a patient with a thyroid nodule may reveal abnormalities in serum thyrotrophin, serum antithyroperoxidase, free T4, T3, serum thyroglobulin and plasma metanephrines. These findings may vary depending upon whether the nodule is hot or cold.

Laboratory Findings

Test Indication Finding
Serum thyrotropin
  • In all thyroid nodules
  • Increased in hot nodules that secrete TSH
  • Normal/Decreased in most of the cold/malignant nodules
Serum antithyroperoxidase level
  • Increased
Free T4
  • Increased
T3
  • Increased
Thyroglobulin
  • Routine measurement is not recommended by ATA
  • Increased
  • May be elevated in most thyroid diseases and are an insensitive and nonspecific test for thyroid cancer
Basal serum calcitonin
  • Increased
  • Routine measurement: Not recommended due to unresolved issues of sensitivity, specificity, and costeffectiveness
Plasma metanephrine testing
  • Increased
24-hour urinary collection

for catecholamines and metanephrines

Molecular markers

Thyroid specific molecular markers may be helpful in patients with intermediate cytology on FNA to decide on disease management:

References

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