Skip to main content
SpringerLink
Log in

Thyroid Testing

A Clinical Approach

  • Chapter
Diseases of the Thyroid

Part of the book series: Contemporary Endocrinology ((COE))

  • 236 Accesses

Abstract

Diseases of the thyroid are among the most common endocrine disorders encountered in clinical paractice. They are typically detected and managed on the basis of the results of thyroid-function tests, the diversity and multiplicity of which can be confusing to some clinicians. Ongoing changes and laboratory pitfalls in thyroid-related testing add to this complexity. Moreover, the recent introduction of sensitive laboratory tests has led to the early detection of thyroid disorders and to the detection of mild disorders. For these reasons, expertise is often needed to determine what tests to order and how to interpret them, bearing in mind that results can often be affected by concomitant diseases or medications. Beyond this, cost considerations dictate that physicians be selective and order specific laboratory tests for specific disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Spencer CA, Nicoloff JT. Serum TSH measurement—a 1990 status report. Thyroid Today 1990;13:1–4.

    Google Scholar 

  2. Nicoloff JT, Spencer CA. Clinical review 12: the use and misuse of the sensitive thyrotropin assays. J Clin Endocrinol Metab 1990;71:553–558.

    Article  PubMed  CAS  Google Scholar 

  3. Spencer CA, LoPresti JS, Patel A, et al. Applications of a new chemiluminometric thyrotropin assay to subnormal measurement. J Clin Endocrinol Metab 1990;70:453–460.

    Article  PubMed  CAS  Google Scholar 

  4. Klee GG, Hay ID. Biochemical thyroid function testing. Mayo Clin Proc 1994;69:469–470.

    PubMed  CAS  Google Scholar 

  5. Spencer CA, Takeuchi M, Kazarosyan M, MacKenzie F, Beckett GJ, Wilkinson E. Interlaboratory/intermethod differences in functional sensitivity of immunometric assays of thyrotropin (TSH) and impact on reliability of measurement of subnormal concentrations of TSH. Clin Chem 1995;41:367–374.

    PubMed  CAS  Google Scholar 

  6. Ekins R. Measurement of free hormones in blood. Endocr Rev 1990;11:5–46.

    Article  PubMed  CAS  Google Scholar 

  7. Stockigt JR. Serum thyrotropin and thyroid hormone measurements and assessment of thyroid hormone transport. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text, 7th ed. Lippincott-Raven, Philadelphia, 1996, pp. 377–396.

    Google Scholar 

  8. Kaptein EM. Clinical application of free thyroxine determinations. Clin Lab Med 1993;13:653–672.

    PubMed  CAS  Google Scholar 

  9. Kaye TB. Thyroid function tests. Application of newer methods. Postgrad Med 1993;94:81–83, 87–90.

    PubMed  CAS  Google Scholar 

  10. Braverman LW, Dawber NA, Ingbar SH. Observations concerning the binding of thyroid hormones in sera of normal subjects of varying ages. J Clin Invest 1966;45:1273–1279.

    Article  PubMed  CAS  Google Scholar 

  11. Kaiser FE. Variability of response to thyroid-releasing hormone in normal elderly. Age Ageing 1987; 16:345–354.

    Article  PubMed  CAS  Google Scholar 

  12. Sawin CT, Chopra D, Azizi F, Mannix JE, Bacharach P. The aging thyroid. Increased prevalence of elevated serum thyrotropin levels in the elderly. JAMA 1979;242:247–250.

    Article  PubMed  CAS  Google Scholar 

  13. Chopra IJ, Hershman JM, Pardridge WM, Nicoloff JT. Thyroid function in nonthyroidal illnesses. Ann Intern Med 1983;98:946–957.

    PubMed  CAS  Google Scholar 

  14. Hay ID. Euthyroid hyperthyroxinemia. Mayo Clin Proc 1985;60:61–63.

    PubMed  CAS  Google Scholar 

  15. Kaplan MM. Interactions between drugs and thyroid hormone. Thyroid Today 1981;4:1–6.

    Google Scholar 

  16. Moses AC, Lawlor J, Haddow J, Jackson IM. Familial euthyroid hyperthyroxinemia resulting from increased thyroxine binding to thyroxine-binding prealbumin. N Engl J Med 1982;306:966–969.

    Article  PubMed  CAS  Google Scholar 

  17. Tibaldi JM, Surks MI. Effects of nonthyroidal illness on thyroid function. Med Clin North Am 1985; 69:899–911.

    PubMed  CAS  Google Scholar 

  18. Stockigt JR. Free thyroid hormone measurement. A critical appraisal. Endocrinol Metab Clin North Am 2001;30:265–289.

    Article  PubMed  CAS  Google Scholar 

  19. Olsen T, Laurberg P, Weeke J. Low serum triiodothyronine and high serum reverse triiodothyronine in old age: an effect of disease not age. J Clin Endocrinol Metab 1978;47:1111–1115.

    Article  PubMed  CAS  Google Scholar 

  20. Spencer CA, Wang CC. Thyroglobulin measurement. Techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am 1995;24:841–863.

    PubMed  CAS  Google Scholar 

  21. Amino N, Hagen SR, Yamada N, Refetoff S. Measurement of circulating thyroid microsomal antibodies by the tanned red cell haemagglutination technique: its usefulness in the diagnosis of autoimmune thyroid diseases. Clin Endocrinol 1976:5:115–125.

    Article  CAS  Google Scholar 

  22. Cayzer I, Chalmers SR, Doniach D, Swana G. An evaluation of two new haemagglutination tests for the rapid diagnosis of autoimmune thyroid diseases. J Clin Pathol 1978;31:1147–1151.

    Article  PubMed  CAS  Google Scholar 

  23. Chiovato L, Bassi P, Santini F, et al. Antibodies producing complement-mediated thyroid cytotoxicity in patients with atrophic or goitrous autoimmune thyroiditis. J Clin Endocrinol Metab 1993;77:1700–1705.

    Article  PubMed  CAS  Google Scholar 

  24. Czarnocka B, Ruf J, Ferrand M, Carayon P, Lissitzky S. Purification of the human thyroid peroxidase and its identification as the microsomal antigen involved in autoimmune thyroid diseases. FEBS Lett 1985; 190:147–152.

    Article  PubMed  CAS  Google Scholar 

  25. Ekholm R. Biosynthesis of thyroid hormones. Int Rev Cytol 1990;120:243–288.

    Article  PubMed  CAS  Google Scholar 

  26. Seto P, Hirayu H, Magnusson RP, et al. Isolation of a complementary DNA clone for thyroid microsomal antigen. Homology with the gene for thyroid peroxidase. J Clin Invest 1987;80:1205–1208.

    Article  PubMed  CAS  Google Scholar 

  27. Salvi M, Fukazawa H, Bernard N, Hiromatsu Y, How J, Wall JR. Role of autoantibodies in the pathogenesis and association of endocrine autoimmune disorders. Endocr Rev 1988;9:450–466.

    Article  PubMed  CAS  Google Scholar 

  28. Beever K, Bradbury J, Phillips D, et al. Highly sensitive assays of autoantibodies to thyroglobulin and to thyroid peroxidase. Clin Chem 1989;35:1949–1954.

    PubMed  CAS  Google Scholar 

  29. Amino N, Iwatani Y, Tamaki H, et al. Post-partum autoimmune thyroid syndromes. In: Walfish PG, Wall JR, Volpé R, eds. Autoimmunity and the Thyroid. Academic Press, Orlando, FL, 1985, pp. 289–304.

    Google Scholar 

  30. Kraiem Z, Glaser B, Pauker J, Sadeh O, Sheinfeld M. Bioassay of thyroid-stimulating immunoglobulin in cryopreserved human thyroid cells: optimization and clinical evaluation. Clin Chem 1988;34:244–249.

    PubMed  CAS  Google Scholar 

  31. Zakarija M, McKenzie JM, Banovac K. Clinical significance of assay of thyroid-stimulating antibody in Graves’ disease. Ann Intern Med 1980;93:28–32.

    PubMed  CAS  Google Scholar 

  32. Zakarija M, McKenzie JM, Hoffman WH. Prediction and therapy of intrauterine and late-onset neonatal hyperthyroidism. J Clin Endocrinol Metab 1986;62:368–371.

    Article  PubMed  CAS  Google Scholar 

  33. Van Herle AJ, Rich P, Ljung B-ME, Ashcraft MW, Solomon DH, Keeler EB. The thyroid nodule. Ann Intern Med 1982;96:221–232.

    Google Scholar 

  34. Rojeski MT, Gharib H. Nodular thyroid disease. Evaluation and management. N Engl J Med 1985; 313:428–436.

    Article  PubMed  CAS  Google Scholar 

  35. Gharib H. Current evaluation of thyroid nodules. TEM 1994;5:365–369.

    PubMed  CAS  Google Scholar 

  36. Ashcraft MW, Van Herle AJ. Management of thyroid nodules. I: History and physical examination, blood tests, X-ray tests, and ultrasonography. Head Neck Surg 1981;3:216–230.

    Article  PubMed  CAS  Google Scholar 

  37. Cersosimo E, Gharib H, Suman VJ, Goellner JR. “Suspicious” thyroid cytologic findings: outcome in patients without immediate surgical treatment. Mayo Clin Proc 1993;68:343–348.

    PubMed  CAS  Google Scholar 

  38. Reading CC, Gorman CA. Thyroid imaging techniques. Clin Lab Med 1993;13:711–724.

    PubMed  CAS  Google Scholar 

  39. Gharib H, Goellner JR, Johnson DA. Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. Clin Lab Med 1993;13:699–709.

    PubMed  CAS  Google Scholar 

  40. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med 1993;118:282–289.

    PubMed  CAS  Google Scholar 

  41. Gharib H, Goellner JR, Zinsmeister AR, Grant CS, Van Heerden JA. Fine-needle aspiration biopsy of the thyroid. The problem of suspicious cytologic findings. Ann Intern Med 1984;101:25–28.

    PubMed  CAS  Google Scholar 

  42. Nystrom E, Bengtsson C, Lindquist O, Noppa H, Lindstedt G, Lundberg PA. Thyroid disease and high concentration of serum thyrotrophin in a population sample of women. A 4-year follow-up. Acta Med Scand 1981;210:39–46.

    Article  PubMed  CAS  Google Scholar 

  43. Tunbridge WM, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977;7:481–493.

    Article  CAS  Google Scholar 

  44. Rosenthal MJ, Hunt WC, Garry PJ, Goodwin JS. Thyroid failure in the elderly. Microsomal antibodies as discriminant for therapy. JAMA 1987;258:209–213.

    Article  PubMed  CAS  Google Scholar 

  45. Spencer C, Eigen A, Shen D, et al. Specificity of sensitive assays of thyrotropin (TSH) used to screen for thyroid disease in hospitalized patients. Clin Chem 1987;33:1391–1396.

    PubMed  CAS  Google Scholar 

  46. Glinoer D, de Nayer P, Bourdoux P, et al. Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab 1990;71:276–287.

    Article  PubMed  CAS  Google Scholar 

  47. Lazarus JH. Silent thyroiditis and subacute thyroiditis. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text. 7th ed. Lippincott-Raven, Philadelphia, 1996, pp. 577–591.

    Google Scholar 

Download references

Authors
  1. Laurie A. Kane MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hossein Gharib MD, FACP, FACE
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Section of Endocrinology, Diabetes, and Nutrition, Boston Medical Center, Boston, MA, USA

    Lewis E. Braverman MD (Chief) (Chief)

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kane, L.A., Gharib, H. (2003). Thyroid Testing. In: Braverman, L.E. (eds) Diseases of the Thyroid. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-352-1_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-352-1_3

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-405-0

  • Online ISBN: 978-1-59259-352-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation