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The measurement of plasma TSH is the commonly accepted and most sensitive screening test for primary thyroid disorders, because the pituitary gland responds with great changes in its secretion, even to slight changes in the levels of free thyroid hormones.
A high TSH level indicates that the thyroid gland is not making enough thyroid hormone (primary hypothyroidism). The opposite situation, in which the TSH level is low, usually indicates that the thyroid is producing too much thyroid hormone (hyperthyroidism).
The introduction of sensitive thyrotropin assays and free thyroid hormone measurements has simplified the interpretation of thyroid function tests. However, important pitfalls and difficult cases still exist. In this review, thyroid function test results are grouped into six different patterns.
Key points. The results of thyroid function tests (TFTs) must always be interpreted in light of the clinical status of the patient: hypothyroid, euthyroid or hyperthyroid. Awareness of the conditions and/or disorders that can be associated with different patterns of TFTs guides further investigation and management.
the best screening test to determine if the thyroid is functioning normally. Thyroid hormone therapy: patients with hypothyroidism are most often treated with Levothyroxine in order to return their thyroid hormone levels to normal. Replacement therapy means the goal is a TSH in the normal range and is the usual therapy.
Tests Used to Detect Thyroid Dysfunction. Defining Ranges for Serum TSH. Individual’s range. • Much narrower than reference range. Lab reference range. • Defined by values in “normal” population. Target range. Goals for thyroxine treatment of specific conditions. Hypothyroidism: normalization of TSH within age-specific reference range.
TSH: Testing TSH is the best way to initially check thyroid function. A high TSH level indicates that the thyroid hormone level is low (usually hypothyroidism). A low TSH usually means that there is too much thyroid hormone.
