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The TRH test involves administration of a small amount of TRH intravenously, [1] following which levels of TSH will be measured at several subsequent time points using samples of blood taken from a peripheral vein. [citation needed] The test is used in the differential diagnosis of secondary and tertiary hypothyroidism.
The TSH index is reduced in patients with secondary hypothyroidism resulting from thyrotropic insufficiency. [1] [9] [10] [11] For this indication, it has, however, up to now only been validated in adults. [12] JTI was also found reduced in cases of TACITUS syndrome (non-thyroidal illness syndrome) as an example of type 1 thyroid allostasis.
Hypothyroidism is the most frequent endocrine disorder. [43] Worldwide about one billion people are estimated to be iodine deficient; however, it is unknown how often this results in hypothyroidism. [11] In large population-based studies in Western countries with sufficient dietary iodine, 0.3–0.4% of the population have overt hypothyroidism.
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.
secondary hypothyroidism: Feedback loop interrupted on the level of pituitary, e.g. in anterior pituitary failure; tertiary hypothyroidism: Lacking stimulation by TRH, e.g. in hypothalamic failure, Pickardt–Fahlbusch syndrome or euthyroid sick syndrome. Hyperthyroidism: Inappropriately increased thyroid function
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.
Time of day can affect the results of this test; TSH peaks early in the morning and slumps in the late afternoon to early evening, [65] with "a variation in TSH by a mean of between 0.95 mIU/mL to 2.0 mIU/mL". [66] Hypothyroidism is diagnosed more often in samples taken soon after waking. [67]
This is done as diagnostic test of thyroid disorders such as secondary hypothyroidism and in acromegaly. TRH has anti-depressant and anti-suicidal properties, [ 8 ] and in 2012 the U.S. Army awarded a research grant to develop a TRH nasal spray in order to prevent suicide amongst its ranks.
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