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The Unreliable TSH Lab Test

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Jeffrey Dach
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References: Sawin CT, Geller A, Wolf PA, Belanger AJ, Baker E, Bacharach P, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994;331: 1249-52.[Abstract/Free Full Text]


Parle JV, Maisonneuve P, Sheppard MC, Boyle P, Franklyn JA. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study. Lancet 2001;358: 861-5.


Fatourechi V. Adverse effects of subclinical hyperthyroidism. Lancet 2001;358: 861-5.
Uzzan B, Campos J, Cucherat M, Nony P, Boissel JP, Perret GY. Effects on bone mass of long term treatment with thyroid hormones: a meta-analysis. J Clin Endocrinol Metab 1996;81: 4278-89.[Abstract]


Franklyn J, Betteridge J, Holder R, Daykin J, Lilley J, Sheppard M. Bone mineral density in thyroxine treated females with or without a previous history of thyrotoxicosis. Clin Endocrinol 1994;41: 425-32.[Medline]

http://www.ncbi.nlm.nih.gov/pubmed/4062219?dopt=Abstract
Ann Clin Biochem. 1985 Sep;22 ( Pt 5):506-8.Related Articles, Links
Clinical value of a sensitive immunoradiometric assay for TSH.
Allen KR, Scott RD, Hewitt JV, Watson D.

We have investigated a sensitive immunoradiometric assay for serum thyroid-stimulating hormone (TSH) in 45 thyrotoxic patients not on treatment, 464 euthyroid patients and 111 hypothyroid patients on replacement therapy. Forty-three thyrotoxic and seven euthyroid patients were found to have an undetectable TSH (less than 0.2 mIU/L). Previous work has shown a very clear separation of thyrotoxic and euthyroid patients using sensitive TSH assays. However, our extended study here has revealed that a significant number of euthyroid patients with undetectable TSH (1.5% in our study) are likely to be found if TSH becomes the initial test for thyroid function. Thirty of the hypothyroid patients on thyroxine were found to have undetectable TSH, but only one showed clinical signs of thyrotoxicosis. Most of the patients, although having raised serum free T4, had serum free T3 levels within the euthyroid range or just slightly elevated.

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Jeffrey Dach MD is a physician and author of three books, Natural Medicine 101, and Bioidentical Hormones 101, and Heart Book all available on Amazon, or as a free e-book on his web sites. Dr. Dach is founder and chief medical officer of (more...)
 

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