Thyroid-stimulating hormone measurement
Measurement of thyroid-stimulating hormone from blood serum is regarded as the most important test for early detection of hyperthyroidism and hypothyroidism,[1] and is one of the thyroid function tests used to diagnose and treat thyroid disease.[2] The result of this assay is suggestive of the presence and cause of thyroid disease, since a measurement of elevated TSH generally indicates hypothyroidism, while a measurement of low TSH generally indicates hyperthyroidism.[3] 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.[2]
History
First-generation TSH assays were done by radioimmunoassay and were introduced in 1965.[1] There were variations and improvements upon TSH radioimmunoassay, but their use declined as a new immunometric assay technique became available in the middle of the 1980s.[1][2] The new techniques were more accurate, leading to the second, third, and even fourth generations of TSH assay, with each generation possessing ten times greater functional sensitivity than the last.[4] Third generation immunometric assay methods are typically automated.[1] Fourth generation TSH immunometric assay has been developed for use in research.[2]
Current status
Third generation TSH assay is the current requirement for modern standards of care. At present, TSH testing in the United States is typically carried out with automated platforms using advanced forms of immunometric assay.[1] Nonetheless, there is currently no international standard for measurement of thyroid-stimulating hormone.[2]
Interpretation
Accurate interpretation takes a variety of factors into account, such as the thyroid hormones i.e. thyroxine (T4) and triiodothyronine (T3),[2] certain medications like propylthiouracil,[2] temporal effects including circadian rhythm[5] and hysteresis,[6] and other medical history.[7]
See also
References
- 1 2 3 4 5 Spencer, Carole (1 January 2013). "Assay of Thyroid Hormones and Related Substances". Thyroid Disease Manager. Retrieved 5 November 2013.
- 1 2 3 4 5 6 7 Toft, Anthony; Beckett, Geoffrey (2005). Werner & Ingbar’s The Thyroid: A Fundamental & Clinical Text (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. pp. 329–344. ISBN 0-7817-5047-4.
- ↑ Military Obstetrics & Gynecology > Thyroid Function Tests In turn citing: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300
- ↑ Spencer, Carole; Takeuchi, Michael; Kazarosyan, Margarita (1996). "Current status and performance goals for serum thyrotropin (TSH) assays". Clinical Chemistry. Clinical Chemistry. 42 (1): 141–145. Retrieved 5 November 2013.
- ↑ Hoermann, Rudolf; Midgley, John E. M.; Larisch, Rolf; Dietrich, Johannes W. "Homeostatic Control of the Thyroid–Pituitary Axis: Perspectives for Diagnosis and Treatment". Frontiers in Endocrinology. 6. doi:10.3389/fendo.2015.00177. PMID 26635726.
- ↑ Leow, Melvin Khee-Shing. "A Review of the Phenomenon of Hysteresis in the Hypothalamus–Pituitary–Thyroid Axis". Frontiers in Endocrinology. 7: 64. doi:10.3389/fendo.2016.00064. PMID 27379016.
- ↑ Dayan, Colin (24 February 2001). "Interpretation of thyroid function tests" (PDF). The Lancet. Bristol: The Lancet Publishing Group. 357: 619–624. doi:10.1016/s0140-6736(00)04060-5. Retrieved 5 November 2013.
External links
- Interpretation of thyroid function tests by Dayan, Colin M. 2001. The Lancet, Vol. 357.
CDC laboratory procedure manuals
The Centers for Disease Control and Prevention has published the following laboratory procedure manuals for measuring thyroid-stimulating hormone:
- Thyroid Stimulating Hormone (TSH) (University of Washington Medical Center). September 2011. Method: Access 2 (Beckman Coulter).
- Thyroid Stimulating Hormone (TSH) (Collaborative Laboratory Services). September 2011. Method: Access 2 (Beckman Coulter).
- Thyroid Stimulating Hormone (TSH). September 2009. Method: Access 2 (Beckman Coulter).
- Lab 18 Thyroid Stimulating Hormone. 2001-2002. Method: Microparticle Enzyme Immunoassay.
- Lab 18 TSH - Thyroid Stimulating Hormone. 1999-2000. Method: Microparticle Enzyme Immunoassay.
Beckman Coulter procedure manuals
Beckman Coulter provides the equipment and reagents used in the 2009-2011 CDC manuals, and has published the following manuals for performing the procedure:
- HYPERsensitive hTSH - 3rd generation. 2010. Hosted by the University of California, San Francisco.
- Reference 33820 - HYPERsensitive hTSH 3rd generation and Fast hTSH 2nd generation
- http://www.tsh3rdgeneration.com. 2010. Hosted by manufacturer].