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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.
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 ...
TSH levels are determined by a classic negative feedback system in which high levels of T3 and T4 suppress the production of TSH, and low levels of T3 and T4 increase the production of TSH. TSH levels are thus often used by doctors as a screening test, where the first approach is to determine whether TSH is elevated, suppressed, or normal. [25]
Hypothyroidism is diagnosed by looking at the free thyroxine (T4) levels in people with elevated TSH levels, and comparing the ratio between them. People with high TSH and low T4 get a diagnosis ...
Subclinical hypothyroidism is a biochemical diagnosis characterized by an elevated serum TSH level, but with a normal serum free thyroxine level. [ 48 ] [ 49 ] [ 50 ] The incidence of subclinical hypothyroidism is estimated to be 3-15% and a higher incidence is seen in elderly people, females and those with lower iodine levels. [ 48 ]
Subclinical hyperthyroidism is a milder form of hyperthyroidism characterized by low or undetectable serum TSH level, but with a normal serum free thyroxine level. [32] Although the evidence for doing so is not definitive, treatment of elderly persons having subclinical hyperthyroidism could reduce the number of cases of atrial fibrillation. [33]