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Eine Erhöhung des Calcium-Spiegels im Blut ist auf Dauer sehr schädlich und kann sogar lebensgefährliche Herzrhythmusstörungen auslösen. Die häufigste ist eine Überfunktion der Nebenschilddrüsen (Hyperparathyreoidismus, HPT). In den kleinen Nebenschilddrüsen wird das Parathormon produziert, das u. Den Calciumabbau aus dem Knochen fördert und so zu einer Erhöhung des Blutcalcium-Spiegels führt.
Nach Beginn oder nach Änderung der Dosis einer Hormontherapie mit Thyroxin z. Bei einer Schilddrüsenunterfunktion (Hypothyreose), nach einer Schilddrüsen-OP oder nach einer Radiojodtherapie wird in der Regel eine erste Blutkontrolle etwa nach 4 bis 6 Wochen durchgeführt. Bei einer guten Einstellung und unauffälligem Verlauf sind dann häufig Kontrollen alle 6 – 12 Monate ausreichend. Bei allen Blutuntersuchungen ist es grundsätzlich wichtig zu wissen, dass nicht die reinen Testergebnisse an sich, sondern eine medizinisch fundierte Bewertung in Zusammenschau aller Befunde entscheidend ist. Bei diesem Verfahren wird vor allem die Funktion des Regelkreises zwischen Gehirn und Schilddrüse kontrolliert. TRH ist ein im Gehirn produzierter Botenstoff, der auf die Hirnanhangdrüse einwirkt, die wiederum die Schilddrüse steuert.
Dann nimmt man sich selbst ein wenig Blut aus der Fingerbeere ab, gibt ein paar Blutstropfen auf ein mitgeliefertes Medium und sendet dieses mit einem meist vorgefertigten Umschlag an ein medizinisches Labor. Manche Labore liefern neben den reinen Daten auch Erklärungen und Empfehlungen zum weiteren Vorgehen mit. Die Selbst-Tests werden in der Regel nicht von den Krankenkassen bezahlt. Wenn der Gehalt an freiem T4 außerhalb des normalen Bereichs liegt, kann dies auf eine Unter• oder Überfunktion der Schilddrüse hinweisen. Niedrige Werte können auf eine Schilddrüsenunterfunktion (Hypothyreose) hindeuten, die zu Symptomen wie Müdigkeit, Gewichtszunahme und Kälteempfindlichkeit führen kann. Hohe Werte wiederum können auf eine Schilddrüsenüberfunktion (Hyperthyreose) hinweisen, die sich durch Symptome wie Gewichtsabnahme, Nervosität und übermäßiges Schwitzen äußern kann.
Ist TSH erhöht, deutet das oft auf eine Unterfunktion hin, da der Körper mehr Hormone anfordert. FT4 (freies Thyroxin) ist die Vorstufe von fT3 (freies Trijodthyronin), dem aktiven Hormon, das direkt Deinen Stoffwechsel beeinflusst. Niedrige Werte können Symptome wie Müdigkeit, Gewichtszunahme oder Kälteempfindlichkeit verursachen, hohe Werte eher Herzrasen, Unruhe oder Schwitzen. Ein Check lohnt sich, wenn Du Dich oft müde fühlst, Gewichtsschwankungen hast oder hormonelle Probleme vermutest.
Manchmal ist der T4-Wert regular, aber der T3-Wert ist hoch, so dass die Messung der Thyroxin- und der Trijodthyronin-Werte bei der Diagnose einer Schilddrüsenüberfunktion hilfreich sein kann. Mit den Schilddrüsenhormonen wird gesteuert, wie der Körper Energie verbraucht, weshalb sie sich auf nahezu jedes Organ im Körper auswirken, sogar auf das Herz. Daher sind weitere regelmäßige Untersuchungen erforderlich, um die genaue Ursache für einen Überschuss oder Mangel an Schilddrüsenhormonen festzustellen. Mit einem Progesteron Check wird der Progesteronspiegel im Blut gemessen. Ein TSH-Test ist ein Bluttest, der den Wert dieses Hormons bestimmt. Ihre Ergebnisse können in Kind von einem Gesamt-T4- oder freiem T4-Wert vorliegen oder es wird ein freier T4-Index angegeben.
Schilddrüsenantikörper werden gebildet, wenn das Immunsystem die Schilddrüse versehentlich angreift. Wenn der Arzt der Meinung ist, dass eine Schilddrüsenüberfunktion vorliegt, obwohl der T-Wert regular ist, kann man einen T 3- und einen T4-Test machen, um die Diagnose zu bestätigen. Ein hoher TSH-Wert bedeutet in den meisten Fällen, dass man an einer Schilddrüsenunterfunktion (Hypothyreose) leidet. Das bedeutet, dass die Schilddrüse nicht genügend Hormone produziert. Infolgedessen produziert die Hypophyse ständig TSH und gibt es in das Blut ab. Störfaktoren und Hinweise auf Besonderheiten Als immunologischer Test sind Störfaktoren sehr selten.
Schilddrüsenantikörper sind entsprechend Antikörper gegen bestimmte Strukturen in der Schilddrüse. Diese Antikörper gegen eigentlich gesunde Schilddrüsenstrukturen werden fälschlicherweise aus letztlich nicht bekannter Ursache gebildet und können an der Schilddrüse zu ganz unterschiedlichen Schäden führen. Die entsprechenden Erkrankungen bezeichnet man als Autoimmunerkrankungen.
Erhöhte Blutspiegel von TPO-Antikörpern gehen häufig mit Autoimmunerkrankungen der Schilddrüse einher. Hohe TPO-AK sind charakteristisch für die Hashimoto-Thyreoiditis, sie kommen aber auch beim Morbus Basedow vor und können in bis zu etwa 5 % auch bei Schilddrüsengesunden nachgewiesen werden. Die TPO-AK sind ein wichtiger Baustein für die moderne Schilddrüsendiagnostik, ihr Spiegel alleine beweist allerdings noch keine Diagnose.
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