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If the TSH level is normal or low and serum free T 4 levels are low, this is suggestive of central hypothyroidism (not enough TSH or TRH secretion by the pituitary gland or hypothalamus). There may be other features of hypopituitarism , such as menstrual cycle abnormalities and adrenal insufficiency .
Stress suppresses TSH, [5] and alterations in thyroid hormone levels may arise in psychiatric illness. In major depressive disorder, an NTIS-like phenotype may be observed, with reduced T3 and increased rT3. T4 may be elevated, and TSH is usually normal, although TSH's normal circadian rhythm may be disrupted. [2]
Any inappropriateness of measured values, for instance a low-normal TSH together with a low-normal T 4 may signal tertiary (central) disease and a TSH to TRH pathology. Elevated reverse T 3 (RT 3 ) together with low-normal TSH and low-normal T 3 , T 4 values, which is regarded as indicative for euthyroid sick syndrome, may also have to be ...
Free T4, total T3 or both are elevated and serum TSH is below normal in hyperthyroidism. If the hyperthyroidism is mild, only serum T3 may be elevated and serum TSH can be low or may not be detected in the blood. [14] Free T4 levels may also be tested in patients who have convincing symptoms of hyper- and hypothyroidism, despite a normal TSH.
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]
Thyroid stimulating hormone (TSH) is produced by the pituitary gland, another hormone-producing organ in the head. This in turn causes the thyroid to produce T3 and T4, which play a role in the ...
In children, late blood sampling at 60 to 120 minutes is necessary. An increase in the serum TSH level following TRH administration means that the cause of the hypothyroidism is in the hypothalamus (tertiary hypothyroidism), i.e. the hypothalamus is not producing TRH. Therefore, when TRH is given exogenously, TSH levels increase.
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.