Clinical Chemistry
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Clinical Chemistry 33: 1213-1214, 1987;
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Clinical Chemistry, Vol 33, 1213-1214, Copyright © 1987 by American Association for Clinical Chemistry

Anomalous thyrotropin values

S Ratnaike, M Goodwin and D Deam

We studied problems associated with use of an "ultrasensitive" thyrotropin (TSH, thyroid-stimulating hormone) assay for diagnosis of hyperthyroidism. Of 955 TSH assays performed in our laboratory during four months, 135 gave TSH values less than 0.1 milli-int. unit/L. We noted low TSH values at all concentrations of free thyroxin (FT4) in plasma. Nine of 13 patients with a normal or low FT4 and no obvious endocrine explanation for a low TSH were elderly and ill. This raises questions about the pituitary function in such patients. Twenty-seven patients who had high FT4 and non-suppressed TSH were clinically euthyroid, 20 of them being on treatment with thyroxin or amiodarone. Low TSH values in a hospital environment do not always indicate hyperthyroidism, although a normal value for TSH probably indicates euthyroidism.


The following articles in journals at HighWire Press have cited this article:


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 Arch Intern MedHome page
C. T. Sawin, A. Geller, M. M. Kaplan, P. Bacharach, P. W. F. Wilson, and J. M. Hershman
Low Serum Thyrotropin (Thyroid-Stimulating Hormone) in Older Persons Without Hyperthyroidism
Arch Intern Med, January 1, 1991; 151(1): 165 - 168.
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Copyright © 1987 by the American Association for Clinical Chemistry.