Toxic Adenoma laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Laboratory Findings

• Measurement of serum TSH is considered as the initial test in the evaluation of thyroid disorders.
• It should be measured in all patients with a thyroid nodule or goiter.
• The serum free T 4 and free or total T 3 levels are elevated or in the upper part of the normal range.
• Toxic adenomas can be associated with overt or subclinical hyperthyroidism.
  • In overt hyperthyroidism, usually both serum (free) T4 and T3 are elevated.
  • Isolated T 3 toxicosis, in which the serum T 3 concentration is elevated but free T 4 is normal, occurs in approximately 1% of patients with hyperthyroidism.
• When the TSH is low, but both free T 4 and T 3 levels are normal, the patient has subclinical or mild hyperthyroidism, which is common in toxic multinodular goiter, especially in older patients.
• Findings of routine laboratory tests include:
  • elevated serum calcium
  • elevated alkaline phosphatase
  • elevated ferritin levels
  • low (LDL) cholesterol levels.