Get enhanced insights for diagnosing and managing thyroid disorders
Thyroid disorders have many etiologies, manifestations, and potential therapies. Quest Diagnostics offers solutions that can help you diagnose, treat, and monitor every type of thyroid disease.
Get guideline-based thyroid testing from the lab that knows endocrinology
Testing from Quest Diagnostics can help you diagnose, treat, monitor, and prevent complications related to every type and etiology of thyroid disease.
Quest’s broad range of endocrinology tests are aligned to the most recent clinical practice guidelines—including those from the American Thyroid Association (ATA) and American Association of Clinical Endocrinologists (AACE)—for better disease management.
Hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) are the most common thyroid disorders.
Common causes of these disorders include immune system disorders Graves’ disease, for hyperthyroidism, and Hashimoto’s disease, for hypothyroidism.
Hypo- and hyperthyroidism: symptoms, risk factors, and complications
Signs and symptoms2
Poor memory and concentration
Slow pulse rate
Delayed reflex relaxation
Cold extremities/feeling cold
Carpal tunnel syndrome Fatigue
Weight gain and poor appetite
Shortness of breath
Middle age (>50)
Family history of thyroid or other autoimmune diseases
Other autoimmune disorders
High levels of low-density lipoprotein
Mental health issues
Myxedema (in rare cases)
Nervousness or irritability
Frequent bowel movements/diarrhea
Goiter Graves’ ophthalmopathy
Age 20–40 years
Other autoimmune disorders
Heart rhythm disorders
Congestive heart failure
When to screen for hypo- and hyperthyroidism
ATA/AACE guidelines recommend screening for all patients with symptoms of hypothyroidism. For patients who are asymptomatic, recommendations vary widely. However, a thyroid-stimulating hormone (TSH) test is generally recommended for patients ≥50–60 years old, especially women.
Guidelines also state that there is compelling evidence to support screening in patients with:
Autoimmune disease (e.g., type 1 diabetes)
History of neck radiation
History of thyroid surgery
Abnormal thyroid examination
Psychiatric disorders, including patients taking amiodarone or lithium
Hypertension, cardiac dysrhythmia, or congestive heart failure
1. American Thyroid Association. General information/press room. Available at www.thyroid.org/media-main/about-hypothyroidism. Accessed March 30, 2018.
2. Nussey S, Whitehead S. Chapter 3: The thyroid gland. Endocrinology: An Integrated Approach. Oxford: BIOS Scientific Publishers; 2001.
3. Pramyothin P, Leung AM, Pearce EN, et al. Clinical problem-solving. A hidden solution. N Engl J Med. 2011;365(22):2123–2137.
4. Ginsberg J, Lewanczuk RZ, Honore LH. Hyperplacentosis: A novel cause of hyperthyroidism. Thyroid. 2001;11:393–396.
5. Patil-Sisodia K, Mestman JH. Graves hyperthyroidism and pregnancy: A clinical update. Endocr Pract. 2010;16(1):118–129.
6. Flynn RV, MacDonald TM, Morris AD, et al. The thyroid epidemiology, audit and research study; thyroid dysfunction in the general population. J Clin Endocrinol Metab, 2004;89:3879–3884.
7. Tamai H, Kasagi K, Takaichi Y. Development of spontaneous hypothyroidism in patients with Graves’ disease treated with antithyroidal drugs: clinical, immunological, and histological findings in 26 patients. J Clin Endocrinol Metab. 1989;69(1):49–53.
8. Hancock SL, Cox RS, McDougall IR. Thyroid diseases after treatment of Hodgkin’s disease. N Engl J Med. 1991;325(9):599–605.
9. Buisset E, Leclerc L, Lefebvre J-L, et al. Hypothyroidism following combined treatment for hypopharyngeal and laryngeal carcinoma. Am J Surg. 1991;162:345–347.
10. UCLA Endocrine Surgery Encyclopedia. Secondary hypothyroidism. Available at www.uclahealth.org/endocrine-center/hypothyroidism-secondary. Accessed March 30, 2018.
11. DeGroot LJ. Graves’ disease and the manifestations of thyrotoxicosis. 2015. Available at www.ncbi.nlm.nih.gov/books/NBK285567. Accessed March 30, 2018.
12. Ginsburg J. Diagnosis and management of Graves’ disease. CMAJ. 2003;168(5):575–585.
13. Stern RA, Robinson B, Thorner AR, et al. A survey study of neuropsychiatric complaints in patients with Graves’ disease. J Neuropsychiatry Clin Neurosci. 1996;8(2):181–185.
14. Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988–1028.
15. American Thyroid Association. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016:26(10):1343–1423.