• Dorina Minxuri MD, MSc, Faculty of Pharmacy, Department of Pharmacy, Catholic University Our Lady of Good Counsel, Tirana, Albania
  • Anila Mitre Assoc. Prof., Intermedica Laboratory Center, Tirana, Albania
  • Silva Bino Assoc.Prof., Department of Epidemiology of Infectious Diseases, Institute of Public Health, Tirana, Albania
  • Entela Kostrista MSc, Department of Management, Faculty of Economics, University College, Tirana, Albania
  • Kejsi Hysaj MSc, Endomedika Clinic, Tirana, Albania



Thyroid, Ultrasound, TPO Antibodies, Hypothyroidism, TSH


There are different recommendations on how to screen for thyroid gland problems and TSH is the most ordered test. Anti TPO antibodies are usually tested when TSH is not within the normal range, but their presence before TSH changes has not been appreciated. This study aims to evaluate the role of anti-TPO and thyroid ultrasound for the early detection of thyroid pathologies, especially in the subclinical phase. This is a cross-sectional study in 458 individuals (80% females and 20% males). Thyroid laboratory tests and thyroid ultrasound was done. Statistical analysis was performed to assess the prevalence of thyroid dysfunction, thyroid antibodies and their correlation with thyroid ultrasound changes. 88.6 % (406) of subjects resulted in euthyroid. Subclinical hypothyroidism and hyperthyroidism were observed in 5.5% and 1.7% of the population, respectively. The prevalence of positive thyroid antibodies was 26.5% in females and 11.8 % in males. Hypoechoic structure, heterogenicity and micronodular pattern in ultrasound were associated with significantly higher TPO antibodies activity p<.001. Undiagnosed biochemical thyroid dysfunctions were common in our country. Measurement of anti-TPO in individuals with normal TSH is valuable in determining individuals at risk for thyroid pathologies.


Allan, W., Haddow, J., Palomaki, G., Williams, J., Mitchell, M., Hermos, R., Faix, J., & Klein, R. (2000). Maternal thyroid deficiency and pregnancy complications: implications for population screening. Journal of Medical Screening, 7 (3), 127–130.

Brochmann, H., Bjøoro, T., Gaarder, P. I., Hanson, F., & Frey, H. M. (1988). Prevalence of thyroid dysfunction in elderly subjects. Acta Endocrinologica, 117 (1), 7–12.

Canaris, G. J., Manowitz, N. R., Mayor, G., & Ridgway, E. C. (2000). The Colorado Thyroid Disease Prevalence Study. Archives of Internal Medicine, 160 (4), 526.

Ceylan, I., Yener, S., Bayraktar, F., & Secil, M. (2014). Roles of ultrasound and power Doppler ultrasound for the diagnosis of Hashimoto thyroiditis in anti-thyroid marker-positive euthyroid subjects. Quantitative imaging in medicine and surgery, 4 (4), 232–238.

Li, C., Zhou, J., Huang, Z., Pan, X., Leung, W., Chen, L., Zhang, Y., Wang, L., Sima, Y., Gober, H., Zhang, N., Qiu, X., Li, L., Guan, L. & Wang, L. (2020). "The Clinical Value and Variation of Antithyroid Antibodiesduring Pregnancy", Disease Markers, Vol. 2020,

Flynn, R. W. V., MacDonald, T. M., Morris, A. D., Jung, R. T., & Leese, G. P. (2004). The Thyroid Epidemiology, Audit, and Research Study: Thyroid Dysfunction in the General Population. The Journal of Clinical Endocrinology & Metabolism, 89 (8), 3879–3884.

Haddow, J. E., Palomaki, G. E., Allan, W. C., Williams, J. R., Knight, G. J., Gagnon, J., O’Heir, C. E., Mitchell, M. L., Hermos, R. J., Waisbren, S. E., Faix, J. D., & Klein, R. Z. (1999). Maternal Thyroid Deficiency During Pregnancy and Subsequent Neuropsychological Development of the Child. New England Journal of Medicine, 341 (8), 549–555.

McDermott, M. T., & Ridgway, E. C. (2001). Subclinical Hypothyroidism Is Mild Thyroid Failure and Should be Treated. The Journal of Clinical Endocrinology & Metabolism, 86 (10), 4585–4590.

McGrogan, A., Seaman, H. E., Wright, J. W., & de Vries, C. S. (2008). The incidence of autoimmune thyroid disease: a systematic review of the literature. Clinical Endocrinology, 69 (5), 687–696.

Palmieri, E. A., Fazio, S., Lombardi, G., & Biondi, B. (2004). Subclinical Hypothyroidism and Cardiovascular Risk. Treatments in Endocrinology, 3 (4), 233–244.

Pedersen, I. B., Knudsen, N., Carlé, A., Vejbjerg, P., Jørgensen, T., Perrild, H., Ovesen, L., Rasmussen, L. B., & Laurberg, P. (2011). A cautious iodization program bringing iodine intake to a low recommended level is associated with an increase in the prevalence of thyroid autoantibodies in the population. Clinical Endocrinology, 75 (1), 120–126.

Prummel, M. F., & Wiersinga, W. M. (2005). Thyroid peroxidase autoantibodies in euthyroid subjects. Best Practice & Research Clinical Endocrinology & Metabolism, 19(1), 1–15.

Rugge, J. B., Bougatsos, C., & Chou, R. (2015). Screening and Treatment of Thyroid Dysfunction: An Evidence Review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 162 (1), 35.

Strickland, D. M., Whitted, W. A., & Wians, F. H. (1990). Screening infertile women for subclinical hypothyroidism. American Journal of Obstetrics and Gynecology, 163 (1), 262–263.

Strieder T. G. A, Tijssen J. G. P., Wenzel B. E., Endert E. & Wiersinga W. M. (2008). Prediction of Progression to Overt Hypothyroidism or Hyperthyroidism in Female Relatives of Patients with Autoimmune Thyroid Disease Using the Thyroid Events Amsterdam (THEA) score. Arch Intern Med. 2008;168 (15):1657–1663.

Thangaratinam, S., Tan, A., Knox, E., Kilby, M. D., Franklyn, J., & Coomarasamy, A. (2011). Association between thyroid autoantibodies and miscarriage and preterm birth: a meta-analysis of the evidence. BMJ, 342 (may09 1), d2616.

Siriwardhane, T. , Krishna, K., Ranganathan, V., Jayaraman, V., Wang, T., Bei, K., Ashman, S., Rajasekaran, K., Rajasekaran, J. J. & Krishnamurthy, H. (2019). Significance of Anti-TPO as an Early Predictive Marker in Thyroid Disease", vol. 2019,

Tunbridge, W. M. G., Evered, D. C., Hall, R., Appleton, D., Brewis, M., Clark, F., Evans, J. G., Young, E., Bird, T., & Smith, P. A. (1977). The Spectrum of Thyroid Disease in A Community: The Whickham Survey. Clinical Endocrinology, 7(6), 481–493.

Vanderpump M. P. J. (2019) Epidemiology of Thyroid Disorders. In: Luster M., Duntas L., Wartofsky L. (eds) The Thyroid and Its Diseases. Springer, Cham.

Vanderpump, M. P. J. (2011b). The Epidemiology Of Thyroid Disease. British Medical Bulletin, 99(1), 39–51.

Zimmermann, M. B., Connolly, K., Bozo, M., Bridson, J., Rohner, F., & Grimci, L. (2006). Iodine Supplementation Improves Cognition In Iodine-Deficient School Children In Albania: A Randomized, Controlled, Double-Blind Study. The American Journal of Clinical Nutrition, 83(1), 108–114.




How to Cite

Minxuri, D., Mitre, A., Bino, S., Kostrista, E., & Hysaj, K. (2021). SCREENING TESTS FOR THYROID DYSFUNCTION; IS TSH SUFFICIENT?. LIFE: International Journal of Health and Life-Sciences, 7(3), 01–12.