Biochemical Testing in Thyroid Disorders

Esfandiari, Nazanene H.; Papaleontiou, Maria

doi:10.1016/j.ecl.2017.04.002

Cited by 39 publications

(31 citation statements)

References 131 publications

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“…With abnormal TSH results, FT4 should be examined, especially for hypothyroidism, and/or FT3, in the case of hyperthyroidism and thyrotoxicosis. TSH concentrations are modified even by minimal changes in the thyroid hormones (THs) levels and altered TSH concentrations occur during hyperthyroidism or hypothyroidism onset even before free THs changes [2]. However, serum TSH levels may be influenced by numerous factors, such as ethnicity, gender, age [1,2,22] and pregnancy; for the latter specific reference interval related to age of gestation are required [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…TSH concentrations are modified even by minimal changes in the thyroid hormones (THs) levels and altered TSH concentrations occur during hyperthyroidism or hypothyroidism onset even before free THs changes [2]. However, serum TSH levels may be influenced by numerous factors, such as ethnicity, gender, age [1,2,22] and pregnancy; for the latter specific reference interval related to age of gestation are required [23,24]. Diurnal and circannual variations in TSH levels have also been reported [22], and smoking, obesity and use of medications or dietary supplements (as a source of excessive iodine intake for some individuals) may affect TSH levels [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory tests, together with imaging methods, are fundamental for the diagnosis and management of these disorders in clinical practice [1]. Thyroid stimulating hormone (TSH) determination is recommended as a first screening test for the presence of overt and subclinical thyroid disorders, followed by free thyroxine (FT4), and free triiodothyronine (FT3) in patients who are suspected to have hyperthyroidism, as a second step [1,2]. Human calcitonin (CT) is mainly used as a marker for the presence and monitoring of medullary thyroid carcinoma (MTC), while thyroglobulin (TG) is mostly of value in the management of differentiated thyroid carcinoma (DTC) patients after treatment [1,2].…”

Section: Introductionmentioning

confidence: 99%

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European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates for serum thyroid biomarkers based on weekly samplings from 91 healthy participants

Bottani

Aarsand

Banfi

et al. 2021

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives Thyroid biomarkers are fundamental for the diagnosis of thyroid disorders and for the monitoring and treatment of patients with these diseases. The knowledge of biological variation (BV) is important to define analytical performance specifications (APS) and reference change values (RCV). The aim of this study was to deliver BV estimates for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroglobulin (TG), and calcitonin (CT). Methods Analyses were performed on serum samples obtained from the European Biological Variation Study population (91 healthy individuals from six European laboratories; 21–69 years) on the Roche Cobas e801 at the San Raffaele Hospital (Milan, Italy). All samples from each individual were evaluated in duplicate within a single run. The BV estimates with 95% CIs were obtained by CV-ANOVA, after analysis of variance homogeneity and outliers. Results The within-subject (CV I ) BV estimates were for TSH 17.7%, FT3 5.0%, FT4 4.8%, TG 10.3, and CT 13.0%, all significantly lower than those reported in the literature. No significant differences were observed for BV estimates between men and women. Conclusions The availability of updated, in the case of CT not previously published, BV estimates for thyroid markers based on the large scale EuBIVAS study allows for refined APS and associated RCV applicable in the diagnosis and management of thyroid and related diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates for serum thyroid biomarkers based on weekly samplings from 91 healthy participants

Bottani

Aarsand

Banfi

et al. 2021

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…TSH tests are recommended as first-line screening tests for thyroid dysfunction [1415]. Highly sensitive third-generation immunometric assays (sandwich or non-competitive assays), which are capable of detecting TSH levels <0.01 mIU/L, have been widely used since the late 1980s [16].…”

Section: Laboratory Testsmentioning

confidence: 99%

Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility

Soh

2019

Ann Lab Med

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Thyroid disorders are common, affecting more than 10% of people in the US, and laboratory tests are integral in the management of these conditions. The repertoire of thyroid tests includes blood tests for thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine, thyroglobulin (Tg), thyroglobulin antibodies (Tg-Ab), thyroid peroxidase antibodies (TPO-Ab), TSH receptor antibodies (TRAb), and calcitonin. TSH and free thyroid hormone tests are frequently used to assess the functional status of the thyroid. TPO-Ab and TRAb tests are used to diagnose Hashimoto's thyroiditis and Graves' disease, respectively. Tg and calcitonin are important tumor markers used in the management of differentiated thyroid carcinoma and medullary thyroid carcinoma (MTC), respectively. Procalcitonin may replace calcitonin as a biomarker for MTC. Apart from understanding normal thyroid physiology, it is important to be familiar with the possible pitfalls and caveats in the use of these tests so that they can be interpreted properly and accurately. When results are discordant, clinicians and laboratorians should be mindful of possible assay interferences and/or the effects of concurrent medications. In addition, thyroid function may appear abnormal in the absence of actual thyroid dysfunction during pregnancy and in critical illness. Hence, it is important to consider the clinical context when interpreting results. This review aims to describe the above-mentioned blood tests used in the diagnosis and management of thyroid disorders, as well as the pitfalls in their interpretation. With due knowledge and care, clinicians and laboratorians will be able to fully appreciate the clinical utility of these important laboratory tests.

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“…Референсные значения тиреотропного гормона -ещё одна широко обсуждаемая проблема. Существует множество исследований относительно того, каким должен быть нормаль-ный диапазон уровня ТТГ, и эта тема подробно освещена в некоторых обзорах и клинических руководствах по диагностике и лечению гипотиреоза [7,8]. Общепринятый установленный референсный диапазон для ТТГ составляет от 0,35 до 4,50 мкМЕ/мл.…”

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Subclinical hypothyroidism: treat or watch?

Tsanava

Bulgakova

Melikova³

2021

jour

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Manifest hypothyroidism occurs in more than 5 % of the population, while prevalence of subclinical hypothyroidism is much higher and reaches 15 %. In the practice of an endocrinologist, in most cases, the diagnosis and treatment of manifest hypothyroidism does not raise questions, while subclinical changes in thyroid hormones quite often generate a lot of discussions. The generally accepted reference range for TSH up to 4.50 μIU / ml is in conflict with data showing that more than 95 % of healthy people with euthyroidism have serum TSH levels up to 2.5 μIU / ml. At the same time, a lot of data has been accumulated on the effect of even slightly altered levels of thyroid hormones and TSH on various tissues, organs and systems of the body, especially on the cardiovascular, nervous and reproductive systems. This review analyzes the results of studies aimed at studying the relationship of subclinical hypothyroidism with cardiovascular and metabolic disorders, cognitive disorders, pathology of pregnant women.

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Biochemical Testing in Thyroid Disorders

Cited by 39 publications

References 131 publications

European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates for serum thyroid biomarkers based on weekly samplings from 91 healthy participants

European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates for serum thyroid biomarkers based on weekly samplings from 91 healthy participants

Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility

Subclinical hypothyroidism: treat or watch?

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