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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Major Hormones and Their Functions01:27

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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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Tachycardia is a condition marked by an abnormally fast or irregular heart rate, surpassing the typical resting rate. In adults, tachycardia is characterized by a pulse rate ranging from 100 to 180 beats per minute. The increased heart rate can result in inadequate blood flow to various body parts, ultimately diminishing the oxygen supply to organs and tissues.
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Updated: Mar 21, 2026

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Real or Not Real? An Elevated TSH.

Marla E Sevilla-Alsina1, Allison O Dumitriu Carcoana1,2, Jane Y Yang3

  • 1University of South Florida, Tampa, FL, USA.

Journal of Investigative Medicine High Impact Case Reports
|March 19, 2026
PubMed
Summary
This summary is machine-generated.

Macro-TSH, a rare condition, can cause elevated thyroid-stimulating hormone (TSH) levels despite normal thyroid function. Diagnosis involves TSH antibody testing or gel filtration chromatography to confirm this unusual cause of hypothyroidism.

Keywords:
Macro-TSHclinical misdiagnosisimmunoassay interferencethyroid function teststhyroid-stimulating hormone

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Area of Science:

  • Endocrinology
  • Clinical Chemistry

Background:

  • Elevated thyroid-stimulating hormone (TSH) levels typically indicate hypothyroidism.
  • Discordant thyroid function tests (normal free thyroxine and triiodothyronine with elevated TSH) warrant further investigation.

Purpose of the Study:

  • To report a rare case of Macro-TSH.
  • To highlight the importance of investigating incongruent thyroid function test results.

Main Methods:

  • Case presentation of a 19-year-old male with fatigue and constipation.
  • Laboratory evaluation including TSH, free thyroxine, and total triiodothyronine levels.
  • Diagnostic confirmation using TSH antibody testing and gel filtration chromatography.

Main Results:

  • The patient presented with a TSH level of 85 mIU/L, normal free thyroxine, and normal total triiodothyronine.
  • Macro-TSH was diagnosed, confirmed by positive TSH antibody testing and gel filtration chromatography.
  • This confirmed Macro-TSH as the cause of the elevated TSH.

Conclusions:

  • Macro-TSH is a rare condition that can mimic hypothyroidism.
  • Investigating TSH antibody levels or utilizing gel filtration chromatography is crucial when thyroid function tests do not align with clinical presentation.