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[TSH determination in central hypothyroidism].

F Bakiri1

  • 1Service d'Endocrinologie, Hôpital Bologhine, Bains-Romains, Alger.

Annales D'Endocrinologie
|January 1, 2000
PubMed
Summary
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The thyrotropin-releasing hormone (TRH) test offers no advantage over basal thyroid-stimulating hormone (TSH) levels for diagnosing central hypothyroidism. Basal TSH assays are more cost-effective and provide fewer misleading results than the TRH test.

Area of Science:

  • Endocrinology
  • Thyroid Function Testing
  • Hormone Assays

Background:

  • Central hypothyroidism poses a diagnostic challenge, as sensitive TSH assays can be limited.
  • Existing studies on evaluating central hypothyroidism are scarce, necessitating further research.
  • The TSH assay's utility in conjunction with TRH stimulation warrants investigation.

Purpose of the Study:

  • To assess the diagnostic value of TSH assays before and after TRH administration in central hypothyroidism.
  • To compare the efficacy of the TRH test with basal TSH levels in diagnosing central hypothyroidism.

Main Methods:

  • Studied 52 patients with Sheehan's Syndrome (post-partum hypopituitarism), 32 hypothyroid patients, 20 euthyroid patients, and 21 healthy females.
  • Measured basal TSH levels (TSH0) and TSH levels 30 minutes after TRH administration (Delta TSH).

Related Experiment Videos

  • Analyzed TSH responses to TRH stimulation across different patient groups.

    • Main Results:

    • No significant difference in basal TSH levels (TSH0) was observed between hypothyroid, euthyroid, and control groups.
    • Delta TSH was significantly higher in controls compared to euthyroid patients, and higher in euthyroid patients compared to hypothyroid patients (p < 0.001).
    • The TRH test yielded misleading results, with 10 euthyroid patients showing impaired responses and 6 hypothyroid patients showing normal responses.

    Conclusions:

    • The TRH test provides no diagnostic advantage over basal TSH levels for central hypothyroidism.
    • Basal TSH assays, combined with thyroxine levels, are more reliable and cost-effective for diagnosing central hypothyroidism.
    • The TRH test demonstrates a poor cost-benefit ratio and generates numerous false positives/negatives.