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Various diseases can be diagnosed with regular blood tests usually performed in internal medicine clinics. Additionally, specific tests are available as needed, particularly focusing on endocrine system examinations crucial for modern individuals. Such examinations include Hemoglobin A1C tests for diabetes diagnosis, Thyroid Stimulating Hormone (TSH) tests for thyroid diseases, and bone density tests for diagnosing osteoporosis.
By Dr. Christian Kim, MD
The Hemoglobin A1C test measures how much hemoglobin in the red blood cells is glycated by glucose, reflecting the average blood sugar over the past three months, considering the 120-day lifespan of red blood cells. A Hemoglobin A1C level of 7% indicates an average blood sugar of 154 mg/dL over three months. Normal A1C levels are below 5.6%; 5.7% to 6.4% suggests prediabetes, and 6.5% or above indicates diabetes.
Diabetes diagnosis can also be made if fasting blood sugar is over 126 mg/dL or post-75 gram glucose consumption blood sugar exceeds 200 mg/dL. However, these methods may miss some diagnoses since fasting levels can be normal while post-meal levels are high or vice versa. Hemoglobin A1C provides an effective diagnosis as it reflects the average of fasting and post-meal blood sugar levels.
Adults over 45 should ideally undergo this test every three years for prevention or early diagnosis, even without symptoms. If there is a family history of diabetes, obesity, or cardiovascular conditions, earlier testing is advised. If the Hemoglobin A1C indicates diabetes or a near-diabetic condition, management under a physician's guidance is recommended.
TSH tests are extensively used for diagnosing thyroid diseases. Often misunderstood as a thyroid hormone, TSH is secreted by the pituitary gland in the brain, stimulating the thyroid to produce thyroxine (T4) and triiodothyronine (T3), which regulate body metabolism and energy production.
Why not directly measure thyroid hormones (T4, T3)? The stability of TSH, as opposed to the fluctuation of thyroid hormones, makes TSH a reliable indicator. Abnormal TSH levels often reveal thyroid issues even when thyroid hormone levels are normal. If TSH is abnormal, T4 and T3 levels are tested.
Is TSH screening needed even without symptoms? Many physicians believe it is necessary, especially since hypothyroidism symptoms, like fatigue, lethargy, or mild depression, are often mild and overlooked. Overlapping with menopausal symptoms adds difficulty in early detection. Simple blood tests suffice for functional assessments, but for structural issues like thyroid cancer or nodules, an ultrasound is necessary.
A natural decline in bone density occurs with aging. However, post-menopausal women may experience rapid reductions. When should bone density testing begin? Opinions vary across countries and organizations, but most recommend testing for women over 65 and men over 70. Factors like low weight, smoking, and excessive drinking, which heighten osteoporosis risk, warrant earlier testing.
A bone density score of -2.5 or lower indicates osteoporosis; scores between -1 and -2.5 suggest osteopenia. Treatments include oral and injectable medications, prescribed based on a specialist's diagnosis.
In summary, beyond basic blood tests, one can easily undergo tests for endocrine diseases during routine medical examinations. It is imperative to receive appropriate tests and treatments based on personal history, family background, and present symptoms.
Dr. Christian Kim, MD
Ck Endo
Endocrinology, Diabetes & Metabolism
1608 Lemoine Ave, Ste 203
Fort Lee, NJ 07024
(201) 944-8400
