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Biochemical testing of thyroid function

G G Klee1, I D Hay

  • 1Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.

Endocrinology and Metabolism Clinics of North America
|January 16, 1998
PubMed
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Serum thyrotropin (TSH)-first thyroid testing is recommended by guidelines. This approach aids in diagnosing subclinical thyroid disorders and optimizing laboratory testing strategies.

Area of Science:

  • Clinical Biochemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Published guidelines advocate for a serum thyrotropin (TSH)-first approach in thyroid function testing.
  • Subclinical hypothyroidism and subclinical hyperthyroidism are defined by abnormal TSH levels with normal other thyroid tests.
  • Controversies exist regarding the follow-up and treatment of these subclinical thyroid conditions.

Purpose of the Study:

  • To outline guidelines for TSH-first thyroid testing.
  • To discuss the definition and management controversies of subclinical thyroid disorders.
  • To present laboratory experience and recommendations for optimizing thyroid testing.

Main Methods:

  • Review of published guidelines on TSH-first thyroid testing.

Related Experiment Videos

  • Definition of subclinical hypothyroidism and hyperthyroidism based on TSH and other thyroid tests.
  • Analysis of laboratory experience with TSH-first testing and implementation of a test ordering cascade.

    • Main Results:

    • Guidelines consistently recommend TSH-first thyroid testing.
    • Abnormal TSH with normal other tests define subclinical thyroid dysfunction.
    • Mayo Clinic Rochester's experience informed the development of a thyroid test ordering cascade.

    Conclusions:

    • TSH-first testing is a validated strategy for thyroid disorder evaluation.
    • Optimizing laboratory test ordering can improve diagnostic efficiency.
    • Further recommendations are provided for enhancing thyroid testing protocols.