Current concepts of thyroid function and laboratory evaluation

The role of triodothyronine (T(3) in regulating thyroid function is paramount in that at cellular level it interacts with receptors in the nucleus and thereby modulates gene expression. The multiple steps in the processing of lodide by the thyroid gland is under the influence of the thyroid stimulating hormone (TSH). In terms of laboratory evaluation of thyroid function the primary test is TSH. To discriminate between hypothalamic and pitutary dysfunction, the thyroid releasing hormone (TRH) stimulation test is useful. Currently used 2-site Immunometric procedures that employ mouse monoclonal antibodies can be subject to Interference by heterophlle antibodies in patient's serum. Drugs and other extraneous substances can influence the results obtained in some thyroid function tests. Thyroid dysfunction could also be due to autoimmune disease. The limitations of the usefulness of thyroid function tests in non-thyroidal illness should be kept in perspective. In conclusion, the proper interpretation of results of thyroid function tests depends on the sound understanding of concepts of thyroid function and variables affecting laboratory testing.