4
Clinical Thyrotropin Measurements
Table 2. Points to Consider for Clinical Thyrotropin Measure-
ments
Understanding TSH measurement and interpretation will lead to improvements in the
quality and efficiency of endocrine care.
• Serum TSH measurement is the best test to screen for primary hypothyroidism in all
age groups.
• TSH measurement alone is not sufficient for the diagnosis or treatment of patients
with central hypothyroidism and should be accompanied by f T4.
• Interpretation of TSH values in patients with acute and/or intercurrent illness, for
example, inpatients, is not straightforward and needs to take into account the marked
dynamic TSH changes during the course of 'non-thyoidal illness' which also affect serum
f T4 concentrations (see Fig. 1).
• Age, sex, reproductive status, medications, ethnicity, iodine intake, and biological
variation, but not circadian or circannual rhythms, are important variables to consider
when interpreting TSH values.
From: LoPresti, JS and Patil KP Assessing yroid Function in Hospitalized Patients. In: yroid
Function Testing (Brent[editor]) Springer, New York, pp 187-207, 2010.
Figure 1. Schematic Presentation of Dynamic Changes of
Serum TSH and Thyroid Hormone Concentrations
During the Course of 'Non-Thyoidal Illness'
