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Laboratory: Clinical Biochemistry
Test Name:
THYROID REFLEX TESTING - (P)
Test Code: TSH
Clinical Information:
Test Indications: This procedure is used for the detection of thyroid dysfunction in the general population or the monitoring of individuals with a known diagnosis of thyroid dysfunction under treatment.
It does not apply to neonates (infants <30 days).
Recommendations:  Determination of TSH level is the initial test used in the assessment of thyroid function. Very slight changes in circulating free T4 and free T3 levels result in much greater opposite changes in TSH level. Therefore, it is a very sensitive and specific marker for assessing thyroid disorders in patients with an intact pituitary-thyroid axis. If TSH is normal, no additional testing is necessary. When TSH is abnormal, appropriate follow-up testing is automatically performed to identify the nature of the thyroid disorder (subclinical or overt hypo- or hyperthyroidism).
Abnormal TSH will reflex to the addition of free T4 and free T3 as follows:
        Free T4 will be performed when TSH < 0.40 mU/L or ≥ 4.3 mU/L
        Free T3 will be performed when TSH < 0.09 mU/L
Patient Preparation Instructions:  TSH testing is unaffected by multivitamins (45–125 µg biotin) or biotin-only supplements.
For additional information see:
Collection Devices:
Specimen Required:
Plasma: 2.0 mL

Stability 14 days refrigerated, 2 years frozen
Referral:
Serum: 2.0 mL

Samples must be transferred to an aliquot tube and stored frozen if analysis will not be complete within 48 hours (#110-10-05 Serum / Plasma Separation Procedure & Transport)
Requisition:
Reference Values:
0 - 7d:                    1 - 39 mU/L
8 d - 4 wk:              1.7 - 9.1
5 wk - 12 mo:         0.8 - 8.2
13 mo - 20 y:          0.7 - 5.7
≥ 21 y:                    0.4 - 4.2
 
Availability:
Daily
See Also:
More Information: