Should ultrasound (US) of the thyroid be performed in cases of elevated Anti-Thyroglobulin (Anti-Tg) antibodies in patients with subclinical hypothyroidism?

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Last updated: February 11, 2025View editorial policy

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From the Research

Ultrasound of the Thyroid in Cases of Elevated Anti-Thyroglobulin Antibodies

  • The clinical usefulness of thyroid ultrasonography in patients with primary hypothyroidism has been evaluated in a prospective cross-sectional observational study 1.
  • The study found that ultrasonography is useful in the aetiological diagnosis of primary hypothyroidism and in the detection of coexisting, unsuspected, but clinically relevant nodular goitre.
  • Another study found that thyroid autoantibodies, including antithyroglobulin antibodies (TgAb), are common in the general population and are associated with abnormalities in thyroid function and structure 2.
  • The presence of TgAb has been found to interfere with serum thyroglobulin determination, and neck ultrasonography is recommended in patients with detectable TgAb and negative thyroglobulin-immunometric assay (Tg-IMA) results 3.

Association between Thyroid Autoantibodies and Thyroid Function

  • A cross-sectional survey found that the prevalence of TgAb positivity is significantly higher in female subjects and in those with subclinical hypothyroidism and clinical hyper- and hypothyroidism 2.
  • A study of infertile women with subclinical hypothyroidism found that thyroid autoimmunity may be present even in the absence of anti-thyroid antibodies and goiter 4.
  • Elevated TgAb levels have been found to be associated with symptom burden in patients with Hashimoto's thyroiditis, suggesting a role of thyroid autoimmunity in clinical manifestations of the disease 5.

Recommendations for Ultrasound of the Thyroid

  • Based on the available evidence, ultrasound of the thyroid may be considered in cases of elevated Anti-Tg antibodies in patients with subclinical hypothyroidism, particularly if there are symptoms or other indications of thyroid disease 1, 2, 3.
  • However, the decision to perform ultrasound should be individualized and based on a comprehensive evaluation of the patient's clinical presentation and laboratory results.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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