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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 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 first laboratory test to help assess thyroid status was the serum protein-bound iodine, which came into use around the 1950s. In 1971, the thyroid stimulating hormone (TSH) radioimmunoassay was developed, which was the most specific marker for assessing thyroid status in patients. [82]
TSH is the preferred initial test of thyroid function as it has a higher sensitivity to changes in thyroid status than free T 4. [60] 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, [61] with "a variation in TSH by a mean of between 0.95 mIU/mL to 2.0 mIU/mL". [62]
Screening for thyroid disease in patients without symptoms is a debated topic although commonly practiced in the United States. [8] If dysfunction of the thyroid is suspected, laboratory tests can help support or rule out thyroid disease. Initial blood tests often include thyroid-stimulating hormone (TSH) and free thyroxine (T4). [9]
Jostel's TSH index (TSHI or JTI), also referred to as Jostel's thyrotropin index or Thyroid Function index (TFI), is a method for estimating the thyrotropic (i.e. thyroid stimulating) function of the anterior pituitary lobe in a quantitative way. [1] [2] The equation has been derived from the logarithmic standard model of thyroid homeostasis.
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Because thyroid tissue usually contains a substantial reserve of thyroid hormone, thyrostatics can take weeks to become effective and the dose often needs to be carefully titrated over a period of months, with regular doctor visits and blood tests to monitor results. [11]
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