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Interpretation Of Thyroid Function Tests

by Colin M. Dayan

THE LANCET Vol 357 February 24, 2001

The introduction of sensitive thyrotropin assays and free thyroid hormone measurements has simplified the interpretation of thyroid function tests. However, important pitfalls and difficult cases still exist. In this review, thyroid function test results are grouped into six different patterns. We propose that if assays for thyrotropin, free T3, and free T4 are all done, knowledge of these patterns coupled with clinical details and simple additional tests allow a diagnosis to be made in almost all cases.

There have been considerable improvements in assays for thyrotropin (TSH), free T4, and free T3 over the past 20 years. As a result, interpretation of thyroid function tests is now generally straightforward, and more than 90% of people investigated are diagnosed with normal thyroid gland function. However, there remain a few situations in which the results of TSH, free T4, and free T3 assays tend to point in different directions, as well as cases in whom thyroid function test results seem clear cut but are in fact misleading. Additionally, over the past 6 years, an increasing number of genetic defects has been identified in the pituitary-thyroid axis. These defects are easily misdiagnosed by the unwary and, although rare, can present for the first time in adulthood, with implications for both the patient and their family. My aim is to guide the general physician around these pitfalls with a practical approach.

Continued here…

Retrieved on : 16 January 2014
From : Resident/Articles/Endocrinology/TFTs.pdf


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