Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

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Procedure, Side Effects, and Results

If a doctor is concerned about your thyroid function, they may recommend a series of blood tests. These tests are used to identify levels of hormones produced in the thyroid. You may also be able to use at-home blood tests.

Thyroid function tests are a series of blood tests used to measure how well your thyroid gland is working. Available tests include the T3, T3RU, T4, and TSH.

The thyroid is a small gland located in the lower-front part of your neck. It’s responsible for helping regulate many bodily processes, such as metabolism, energy generation, and mood.

The thyroid produces two major hormones: triiodothyronine (T3) and thyroxine (T4). If your thyroid gland doesn’t produce enough of these hormones, you may experience symptoms such as weight gain, lack of energy, and depression. This condition is called hypothyroidism.

If your thyroid gland produces too many hormones, you may experience weight loss, high levels of anxiety, tremors, and a sense of being on a “high.” This is called hyperthyroidism.

Typically, a doctor who is concerned about your thyroid hormone levels will order broad screening tests, such as the T4 or the thyroid-stimulating hormone (TSH) test. If those results come back abnormal, your doctor will order further tests to pinpoint the reason for the problem.

If you’re concerned about your thyroid function and don’t already have a primary care doctor, you can view doctors in your area through the Healthline FindCare tool.

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You don’t need to do anything special to prepare for the thyroid function tests.

If a healthcare professional has ordered other blood tests to be taken at the same time, you may need to fast for several hours before the test. They will let you know of any special instructions to follow.

Otherwise, you will not need to follow any specific directions before the test.

Before you get a blood draw to check your thyroid levels, talk with your doctor about any medications you’re taking. Also let them know if you’re pregnant. Certain medications and being pregnant may influence your test results.

A blood draw, also known as venipuncture, is a procedure performed at a lab or a doctor’s office. When you arrive for the test, you’ll be asked to sit in a comfortable chair or lie down on a cot or gurney. If you’re wearing long sleeves, you’ll be asked to roll up one sleeve or to remove your arm from the sleeve.

A healthcare professional, like a technician or nurse, will tie a band of rubber tightly around your upper arm to make the veins swell with blood. Once the healthcare professional has found an appropriate vein, they’ll insert a needle under the skin and into the vein.

You may feel a sharp prick when the needle punctures your skin. The healthcare professional will collect your blood in test tubes and send it to a laboratory for analysis.

When the healthcare professional has gathered the amount of blood needed for the tests, they’ll withdraw the needle and place pressure on the puncture wound until the bleeding stops. They will then place a small bandage over the wound.

You should be able to return to your typical daily activities immediately.

A blood draw is a routine, minimally invasive procedure and doesn’t have many side effects.

During the days immediately after the blood draw, you may notice slight bruising or soreness at the area where the needle was inserted. Placing an ice pack on the affected site or taking an over-the-counter pain reliever can help ease your discomfort.

If you experience a great deal of pain, or if the area around the puncture becomes red and swollen, follow up with your doctor immediately. These could be signs of an infection.

T4 and TSH results

The TSH test and the T4 test are the two most common thyroid function tests. The TSH test is often done first because it’s the best way to initially test thyroid function. It determines whether a person has hyperthyroidism or hypothyroidism.

The T4 test is known as the thyroxine test. A high level of T4 indicates an overactive thyroid (hyperthyroidism). Symptoms include:

• anxiety
• unplanned weight loss
• tremors
• diarrhea

Most of the T4 in your body is bound to protein. A small portion of T4 is not, and this is called free T4.

Free T4 is the form that is readily available for your body to use. Sometimes a free T4 level is also checked along with the T4 test.

The TSH test measures the level of thyroid-stimulating hormone in your blood. The TSH has a normal test range between 0.4 and 4.0 milli-international units of hormone per liter of blood (mIU/L).

If you show signs of hypothyroidism and have a TSH reading above 4.5 mIU/L, you’re at risk of progressing to hypothyroidism. Symptoms can include:

• weight gain
• fatigue
• depression
• brittle hair and fingernails

Your doctor may decide to begin treating your symptoms with medications, such as levothyroxine.

Both the T4 and TSH tests are routinely performed on newborn babies to identify a low functioning thyroid gland. If left untreated, this condition, called congenital hypothyroidism, can lead to developmental disabilities.

T3 results

The T3 test checks for levels of the hormone triiodothyronine. It’s usually ordered if T4 tests show elevation.

Abnormally high levels of T3 most commonly indicate a condition called Grave’s disease. It’s an autoimmune disorder associated with hyperthyroidism.

If your blood work suggests your thyroid gland is overactive, your doctor may order a thyroid uptake test or an ultrasound.

If scan results are normal, your doctor will likely prescribe medication to regulate your thyroid activity. They will follow up with additional thyroid function tests to make sure the medication is working. These tests will check for:

• structural problems with the thyroid gland
• thyroid gland activity
• any tumors that may be causing problems

Your doctor may also order an ultrasound if they discover abnormal findings during a physical exam of your neck. If ultrasound results are abnormal, your doctor may order a tissue sample of the thyroid.

Thyroid cancer is not related to hyperthyroid or hypothyroid. Keep in mind that blood tests are not used to find thyroid cancer.

TSH up to 50% off

Assay Description

Index

TSH is a hormone produced by the pituitary gland. It regulates the synthesis of the hormones T3 and T4 and the main clinical significance of the TSH analysis is the assessment of thyroid function.

Applications

Usually needed to rule out hyperthyroidism (low or undetectable TSH) or hypothyroidism (high TSH). For decoding, it is important to see the ratio of TSH, T3 and T4. That is why it is advisable to take an analysis “Thyroid hormones (advanced examination)”. This complex includes TSH, T3 and T4.

Specialist

It is prescribed both in the complex of analyzes of thyroid hormones, and separately, by a therapist or endocrinologist

Important

The norm of TSH differs depending on the gender and age of the person. In addition, the norm is affected by low-calorie nutrition and gestational age.

Research method – Chemiluminescent immunoassay (ICLA)

Research material
– Serum

Due date

Analysis will be ready in
within 1 day, excluding the day of collection.
The term can be extended by 1 day if necessary.
You will receive results by email. email as soon as it’s ready.

Deadline: within 1 day, excluding the day of sampling, excluding Saturday and Sunday (except for the day of taking the biomaterial)

How to prepare

In advance

It is recommended to take blood for hormones in the morning, unless otherwise specified by the attending physician. To check the dynamics of the indicator each time, select the same intervals for the delivery of the analysis.

Do not take a blood test immediately after X-ray, fluorography, ultrasound, physiotherapy.

Taking drugs containing thyroid hormones affects the results of tests for these hormones. Discuss with your doctor whether you need to take tests while taking medications or stop them 7 days before the test. Thyroid hormones are recommended to be taken 3 days after taking medications containing iodine.

The day before

24 hours before blood sampling:

• Limit fatty and fried foods, do not take alcohol.

• Avoid sports and emotional stress.

From 8 to 14 hours before donating blood, do not eat, drink only clean still water.

On the day of donation

Before blood sampling

• Do not smoke for 60 minutes,
• 15-30 minutes to be in a calm state.

Result

Analysis result example. pdf

Explanation of

Interpretation of test results is for informational purposes only and does not constitute a diagnosis or
replaces medical advice. Reference values ​​may differ from those indicated in
depending on the equipment used, the actual values ​​will be indicated on the form
results.

The TSH blood test is, in the vast majority of cases, sufficient to assess thyroid function. Determining the concentration of T4 (less often T3) exceeds the diagnostic value of determining the concentration of TSH only in the situation when it is necessary to assess the rapidly changing content of thyroid hormones in the body (monitoring thyrostatic therapy for toxic goiter, monitoring thyroid function in pregnant women).

When testing for TSH hormones, the lower concentration range is of most interest to the clinician. Evaluation of TSH concentration in low ranges of values ​​is necessary:

• For the diagnosis of thyrotoxicosis, especially subclinical.
• For adequate monitoring of suppressive therapy with thyroid hormone preparations of various forms of goiter.
• For the differential diagnosis of true thyrotoxicosis and TSH suppression occurring during pregnancy.

The most common reasons for the discrepancy between the results of determining TSH and free T4 with the clinical picture in case of a diffuse increase in the size of the thyroid gland:

• Over-treatment with thyroid hormones (low TSH, normal free T4).
• Recently adjusted thyroid hormone therapy (TSH elevated, free T4 normal).
• Taking drugs containing T3 (TSH is low, free T4 is normal).
• Insufficient thyroid hormone therapy (TSH elevated, free T4 normal)
• Extrathyroid pathology.
• Taking drugs that affect thyroid status (glucocorticoids, dopamine, etc. )
• Total resistance to thyroid hormones (TSH elevated, free T4 elevated, clinical euthyroidism).
• TSH-secreting tumors (TSH elevated, free T4 elevated, clinical thyrotoxicosis).

Unit: mIU/L

Reference values:

Increase:

• Primary hypothyroidism.
• Subacute thyroiditis.
• Hashimoto’s thyroiditis.
• Pituitary tumor.
• Ectopic secretion in tumors of the mammary gland, lung.
• Endemic goiter.
• Thyroid cancer.

Decrease:

• Primary hyperfunction of the thyroid gland.
• Hypothalamo-pituitary insufficiency.
• Itsenko-Cushing syndrome.
• Pituitary tumor.
• Pituitary injury.

Quality Assurance

Examination performed by Beckman Coulter UniCel DxI 800 Immunochemical Analyzer, USA

Time-tested, reliable technology that guarantees high quality and reliability of performed studies

TSH

Learn more about thyroid hormones:

The thyroid gland and its dysfunction

Fitness and the influence of hormones

Medical tests for overweight and obesity

Thyroid stimulating hormone (TSH) is produced by the anterior pituitary gland. In the body, TSH controls the processes of metabolism, growth and development of the body. In particular, TSH regulates the synthesis of thyroid hormones: T4 – thyroxine and T3 – triiodothyronine, where the concentration of TSH directly depends on the amount of these substances in the blood. The main clinical value of TSH analysis is the assessment of thyroid function. But, since it interacts very actively with hormones, it is important to see the ratio of TSH, T3 and T4 for decoding. The norm of TSH differs depending on the gender and age of the person. In addition, the norm is affected by low-calorie nutrition and gestational age.

TSH (thyroid-stimulating hormone, Thyrotropin, Thyroid-stimulating Hormone, TSH, Thyrotropin) is one of several pituitary glycoprotein hormones (LH, FSH, TSH) that consist of two non-covalently linked peptide chains: an α-chain, similar in structure to all these hormones, as well as the β-chain responsible for biological and immunological specificity. TSH, which is produced by the anterior pituitary gland, is the main regulator of thyroid function. The thyrotropin-releasing factor (TRF) of the hypothalamus controls the secretion of TSH, which in turn regulates the secretion of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). There is a negative feedback mechanism controlled by the hypothalamus, which is sensitive to the concentrations of T3 and T4 thyroid hormones circulating in the bloodstream. This whole complex belongs to the so-called hypothalamic-pituitary-thyroid system. Possible changes in the function of this system can affect the concentration of T3 and T4 in the blood.

TSH influences the main metabolic processes in the thyroid gland by binding to the cell membrane receptor and activating adenylate cyclase. In turn, adenylate cyclase triggers the production of cyclic AMP, the “second messenger” of TSH, which provides a cascade of metabolic reactions in the cell. Through this activation, the synthesis and secretion of T3 and T4 is enhanced, and the physical and functional integrity of the thyroid gland is maintained.

The main clinical value of determining the concentration of TSH in the blood (TSH analysis) is to assess the function of the thyroid gland. An analysis for the hormone TSH allows you to determine the concentration of TSH in the blood. TSH analysis is recommended in the following cases

• to rule out hyperthyroidism (low or undetectable TSH) or hypothyroidism (high TSH)
• for monitoring antithyroid therapy in hyperthyroidism or T4 replacement therapy in primary hypothyroidism
• to control T4 suppression – the trophic effect of TSH in “cold nodes” and non-toxic goiter
• to assess response to a stimulus test – thyrotropin-releasing factor (TRF)

Because accurate and sensitive thyroid-stimulating hormone tests are now available, TSH testing is used to diagnose latent or subclinical forms of hypothyroidism or hyperthyroidism.

Thyroid stimulating hormone (TSH) analysis can be taken at any Lab4U medical center.

Blood test for TSH in Zaporozhye | Analyzes

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(099) 309 03 03

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Get tested for TSH (thyroid-stimulating hormone) at St. Nicholas Clinic

Thyroid stimulating hormone (TSH) test is an important diagnostic indicator for the qualitative assessment of pituitary and thyroid function. The procedure is routine and not particularly difficult – a quick blood sampling from a vein, the work of the laboratory and the results of the analysis are already in your hands. Clinic of St. Nicholas – everything for your comfort and safety!

Study preparation

It is extremely important to carefully consider the preparation for obtaining the most accurate results of the TSH analysis:

TSH: normal in the blood

In a healthy body, TSH performs a number of important functions:

• Promotes the absorption of iodine by cells
• Controls the production of thyroid hormones
• Regulates metabolic processes, functioning of all body systems

TSH norm is a variable value and it changes along with circadian rhythms. The maximum concentration of the hormone in the blood is observed at 2-4 am, and at least at 5-7 pm.

On average, its norm is 0.4-4.0 mU/l.

Gender also influences the standardized indicators (for example, in women, the allowable fluctuations of the hormone are higher – it depends on the phase of the menstrual cycle, taking contraceptives, pregnancy, breastfeeding).

Possible causes of abnormality

Elevated TSH may indicate:

• Adrenal insufficiency
• Pituitary gland disease (adenoma)
• Hypothyroidism (lack of thyroid hormone production)
• Hormone-secreting tumors (eg, neoplasms of the breast , lung)
• Syndrome of unregulated secretion of TSH
• Syndrome of resistance (immunity) of the body to thyroid hormones
• Thyroiditis (inflammation of the thyroid gland)
• Pre-eclampsia or eclampsia in pregnant women
• Psychosomatic pathology tsom), when taking some drugs (especially hormones).

  Decreased concentration of thyroid-stimulating hormone in the blood may indicate:

  • Stress, mental disorders
  • Pituitary injury
  • Pituitary necrosis
  • Starvation, strict diets
  • Taking certain drugs (anabolic hormones, corticosteroids, cytostatics)
  • Thyroid hormone poisoning (with toxic goiter, autoimmune thyroiditis, oral administration)

  The analysis for the TSH hormone is performed by an experienced nurse, observing all the rules for the collection, storage and transportation of biomaterial. The results of the study are evaluated by a diagnostician, after which he formulates a competent conclusion. Remember that only a specially trained qualified person can interpret the data. Self-diagnosis and self-treatment can cause irreparable harm to your health!

  Analysis for TSH in the Clinic of St. Nicholas is performed on the basis of a modern laboratory, the cost of the study is 145 hryvnia.

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