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Levels of serum thyroid-stimulating hormone in hyperthyroidism.

S R Smith, D W Burton, J L Izenstark

Archives of Internal Medicine

|July 1, 1979

Summary

A new radioimmunoassay accurately measures low thyroid-stimulating hormone (TSH) levels. This enhanced assay effectively distinguishes hyperthyroidism from normal thyroid function and identifies specific cases of T3 toxicosis.

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Area of Science:

Endocrinology
Radioimmunoassay Development
Thyroid Function Testing

Background:

Accurate measurement of thyroid-stimulating hormone (TSH) is crucial for diagnosing thyroid disorders.
Existing assays may lack sensitivity at the lower end of the normal range, complicating differential diagnosis.
Distinguishing between hyperthyroidism and subclinical thyroid dysfunction requires sensitive TSH detection.

Purpose of the Study:

To develop a highly sensitive radioimmunoassay for measuring serum TSH.
To evaluate the assay's utility in differentiating hyperthyroid patients from normal individuals.
To assess TSH levels in patients with elevated triiodothyronine (T3) to identify 'T3 toxicosis'.

Main Methods:

A modified TSH radioimmunoassay was developed using dog serum, reduced 125I-labeled TSH, and antiserum.
Assay sensitivity was determined, with a standard deviation of B0 points at 1%, indicating <0.1 microU/mL sensitivity.
Serum TSH levels were measured in normal subjects, hyperthyroid patients, and individuals with elevated T3.

Main Results:

The modified TSH assay demonstrated sensitivity below 0.1 microU/mL.
Normal subjects had TSH values ranging from <0.1 to 4.1 microU/mL (97% > 0.2 microU/mL).
All hyperthyroid patients exhibited TSH levels ≤ 0.2 microU/mL, while those with elevated T3 showed variable TSH (<0.1 to 1.8 microU/mL).

Conclusions:

The modified TSH radioimmunoassay is effective in distinguishing hyperthyroid patients from normal subjects.
The assay's sensitivity allows for the identification of low TSH levels characteristic of hyperthyroidism.
Variable TSH levels in patients with elevated T3 suggest heterogeneity and aid in diagnosing specific 'T3 toxicosis' cases.

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