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Thyroid function tests (TFTs) is a collective term for blood tests used to check the function of the thyroid. [1] TFTs may be requested if a patient is thought to suffer from hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroid-suppression or hormone replacement therapy.
The therapeutic target range TSH level for patients on treatment ranges between 0.3 and 3.0 μIU/mL. [18] For hypothyroid patients on thyroxine, measurement of TSH alone is generally considered sufficient. An increase in TSH above the normal range indicates under-replacement or poor compliance with therapy.
Some publications use a simpler form of this equation that doesn't correct for the reference range of free T4. It is calculated with T T S I = 100 ⋅ T S H ⋅ F T 4 {\displaystyle TTSI={100\cdot TSH\cdot FT4}} .
Jostel's TSH index can be calculated with = + from equilibrium serum concentrations of thyrotropin (TSH), free T4 (FT4) and a correction coefficient derived from the logarithmic standard model (β = 0.1345).
The first-trimester normal range is below 2.5 mIU/L and the second and third trimesters normal range is below 3.0 mIU/L. [16] [44] Treatment should be guided by total (rather than free) thyroxine or by the free T 4 index. Similarly to TSH, the thyroxine results should be interpreted according to the appropriate reference range for that stage of ...
TSH levels are determined by a classic negative feedback system in which high levels of T3 and T4 suppress the production of TSH, and low levels of T3 and T4 increase the production of TSH. TSH levels are thus often used by doctors as a screening test, where the first approach is to determine whether TSH is elevated, suppressed, or normal. [25]
In addition to testing the TSH levels, many doctors test for T 3, Free T 3, T 4, and/or Free T 4 for more detailed results. Free T 4 is unbound to any protein in the blood. Adult limits for these hormones are: TSH (units): 0.45 – 4.50 uIU/mL; T 4 Free/Direct (nanograms): 0.82 – 1.77 ng/dl; and T 3 (nanograms): 71 – 180 ng
In sub-clinical hyperthyroidism, serum TSH is abnormally low, but T4- and T3-levels fall within laboratory reference ranges. [47] It primarily affects the skeleton and the cardiovascular system (abnormalities in other systems have also been reported), in a similar but less severe and less frequent way than overt hyperthyroidism does.