title: Does thyroid gland examination by palpation alter serum hormone levels?
abstract: OBJECTIVE
  The goal of this study was to investigate the effects of routine thyroid gland palpation on serum thyroid hormone levels.
  
  
  METHODS
  Prospective study at Haydarpaşa Numune Research and Education Hospital, Istanbul, Turkey.
  
  
  METHODS
  This study was carried out in two groups with a total of 50 consecutive adults. Group I consisted of 20 patients (12 female and 8 male, aged 20-48 years) with a diagnosis of nodular thyroid disease confirmed by ultrasound imaging techniques. The second group consisted of 30 otherwise healthy subjects (17 female and 13 male, aged 18-50 years) referred for neck and thyroid ultrasound and with no thyroid pathology detected. Thyroid gland palpations were performed by the same physician. Blood samples were obtained before and 2 hours after thyroid gland palpation. Serum total T3 (TT3), total T4 (TT4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH), and thyroglobulin (TG) measurements were made.
  
  
  RESULTS
  We found that routine palpation in the first group caused a significant increase in serum TT3 (P < .05), FT3 (P < .01), FT4 (P < .05), and TG (P < .05) levels. In the second group, TT3 (P < .01), FT3 (P < .05), FT4 (P < .05), and TG (P < .05) levels also increased significantly after palpation. Differences in TSH and TT4 levels were not significant in any of the groups (P > .05).
  
  
  CONCLUSIONS
  Preliminary data proposing a possible effect of routine thyroid gland palpation on serum thyroid hormone levels suggest that serum thyroid hormone measurements should be performed before any manipulation of the gland, including palpation, to avoid misdiagnosis.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Educational and Research Hospital, Istanbul, Turkey. semazertoros@yahoo.com
authors.forename: Sema Zer
authors.initials: SZ
authors.lastname: Toros
authors.forename: Leyla
authors.initials: L
authors.lastname: Ozel
authors.forename: Mehmet Murat
authors.initials: MM
authors.lastname: Yekrek
authors.forename: Ahmet Burak
authors.initials: AB
authors.lastname: Toros
authors.forename: Baris
authors.initials: B
authors.lastname: Naiboglu
authors.forename: Melih
authors.initials: M
authors.lastname: Kara
authors.forename: Erdal
authors.initials: E
authors.lastname: Erdoğdu
authors.forename: Erol
authors.initials: E
authors.lastname: Egeli
authors.forename: Izzet
authors.initials: I
authors.lastname: Titiz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010173:Palpation; D013959:Thyroid Diseases / Q000175:diagnosis; D013961:Thyroid Gland / Q000502:physiology*; D013963:Thyroid Hormones / Q000097:blood*; D055815:Young Adult
chemical_list: D013963:Thyroid Hormones