• include:
  • Women > 60 years old
  • Patients with symptoms suggestive of thyroid disease (fatigue, weight changes, cold intolerance, palpitations, depression)
  • History of autoimmune diseases (e.g., type 1 diabetes, rheumatoid arthritis)
  • Family history of thyroid disease
  • Patients with neck irradiation or goiter
  • Pregnant women or those planning pregnancy
    (American Thyroid Association Guidelines)

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2. Screening Tests

• TSH (Thyroid Stimulating Hormone) is the preferred initial screening test due to its sensitivity.
• If TSH is abnormal:
  • Check Free T4 (to distinguish hypo- vs hyperthyroidism)
  • Consider thyroid antibodies (e.g., anti-TPO) if autoimmune thyroiditis suspected.

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3. Interpreting Results

TSH Level	Interpretation	Next Steps
Normal (0.4–4.0 mIU/L)	Euthyroid (normal)	No action unless symptomatic
Elevated (>4.0 mIU/L)	Possible hypothyroidism	Check Free T4; consider treatment if low or symptomatic
Suppressed (<0.4 mIU/L)	Possible hyperthyroidism	Check Free T4; refer for further evaluation

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4. When to Refer

• Confirmed overt hypo- or hyperthyroidism
• Presence of thyroid nodules or goiter on examination
• Pregnant women with abnormal thyroid tests
• Patients with severe symptoms or complications

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5. Patient Education & Follow-Up

• Educate patients on symptoms and importance of follow-up
• Repeat testing as per clinical context (e.g., 6–12 months for subclinical disease)
• Encourage adherence to prescribed therapy and lifestyle modifications

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Summary Table: Thyroid Dysfunction Screening

Step	Key Points
Target Population	High-risk groups, symptomatic patients
Initial Test	Serum TSH
Follow-up Testing	Free T4, antibodies if indicated
Referral Criteria	Overt disease, nodules, pregnancy
Patient Education	Symptoms, importance of follow-up

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If you want, I can help you design easy-to-use screening checklists, patient leaflets, or training presentations for Neftaly!