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However, when TSH is measured by itself, it can yield misleading results, so additional thyroid function tests must be compared with the result of this test for accurate diagnosis. [4] [5] [6] TSH is produced in the pituitary gland. The production of TSH is controlled by thyrotropin-releasing hormone (TRH), which is produced in the hypothalamus ...
TSH concentrations are measured as part of a thyroid function test in patients suspected of having an excess (hyperthyroidism) or deficiency (hypothyroidism) of thyroid hormones. Interpretation of the results depends on both the TSH and T 4 concentrations. In some situations measurement of T 3 may also be useful.
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.
Prior to the availability of sensitive TSH assays, thyrotropin releasing hormone or TRH stimulation tests were relied upon for confirming and assessing the degree of suppression in suspected hyperthyroidism. Typically, this stimulation test involves determining basal TSH levels and levels 15 to 30 minutes after an intravenous bolus of TRH ...
Thyroid function tests include a battery of blood tests, including the measurement of the thyroid hormones, as well as the measurement of thyroid stimulating hormone (TSH). [84] They may reveal hyperthyroidism (high T 3 and T 4), hypothyroidism (low T 3, T 4), or subclinical hyperthyroidism (normal T 3 and T 4 with a low TSH). [84]
The first laboratory test to be helpful in assessing 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. [81]
The results came from a small study comprising 81 participants who had typical thyrotropin levels, which are used to indicate thyroid function, and who were taking levothyroxine.
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]
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