Thyroid Stimulating Hormone

TSH produced by the pituitary. Thyroid Stimulating Hormone Test stimulates the release of thyroid hormone from thyroglobulin. It also stimulates the growth of thyroid follicular cells. An abnormal level of TSH Test can mean that the thyroid hormone regulation system is out of whack, usually as a result of a benign condition (Hyperthyroidismor Hypothyroidism).

Also Known asTSH, Thyrotropin Test, Thyrotropin, Thyroid Stimulating Hormone, Thyrotropic Hormone,
Test PurposeDiagnose and Monitor the treatment of a Thyroid Disorder
Test PreparationsNo Need any Preparation for this Test
Test ComponentsThyroid Stimulating Hormone (TSH)
Specimen2 ML (1 ML Min.) Blood From 1 SST
Stability Room2 Hours
Stability Refrigerated48 Hours
Stability Frozen4 Weeks
MethodChemiluminescent Immunoassay (CLIA)
Download Report Download Report
TSH Test

TSH stands for thyroid stimulating hormone. A TSH test is a blood test that measures this hormone. TSH levels that are too high or too low can be a sign of a thyroid problem.


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Why To Get Tested:

The TSH test may be used for the following reasons:

  • To diagnose an underactive or overactive thyroid gland
  • To detect thyroid disease before it causes symptoms, especially in newborns
  • To evaluate a thyroid nodule, which is a lump in the thyroid gland
  • To evaluate a goiter, which is an enlarged thyroid gland
  • To diagnose or rule out thyroid diseases, such as Hashimoto’s thyroiditis, Graves’ disease, and thyroid cancer
  • To monitor a patient’s response to treatment for Hypothyroidism, Hyperthyroidism, or another thyroid condition

When to Get Tested:

If you have symptoms of these disorders, your doctor may order a TSH test or thyroid panel. Symptoms of Hypothyroidism include:

  • Fatigue
  • Depression
  • Weight gain
  • I am cold
  • Painful joints and muscles
  • Dry Skin
  • Fine and/or dry hair
  • slow heart rate
  • Constipation
  • irregular menstrual periods
  • fertility problems

Symptoms of hyperthyroidism include:

  • Weightloss
  • Irritability
  • Anxiety
  • Insomnia
  • Difficulty tolerating heat
  • Humor changes
  • Fast or irregular heartbeat
  • Loose and frequent bowel movements


Thyroid disorder = T4 decreased + TSH normal or raised

Pituitary disorder = T4 decreased + TSH decreased

What other tests might I have along with this test?

You may also need these tests:

Sample Required:

  • The serum of a patient is needed.
  • 2 ML (1 ML Min.) Blood From 1 SST

Sample Precations:

  • Sample with hemolysis or lipemia is rejected.
  • Centrifuge the turbid sample before performing the test.

Normal Values:

Source 1

  • Male: 0.3 – 5.0 uIU/ml
  • Non Pregnant: 0.3 – 5.0 uIU/ml
  • Pregnant:
    • First trimester: 0.1 to 2.5 mIU/ml
    • Second trimester: 0.2 to 3.0 mIU/ml
    • Third timester: 0.3 to 3.0 mIU/ml

Source 2:

  • Adult = 0.4 to 5.6 mIU/L
  • Newborn = 3 to 20 mIU/L
  • Cord blood = 3 to 12 µU/mL
    • Values vary between laboratories.

Source 3:

  • Adult
  • 21 to 54 years = 0.4 to 4.2 mU/L
  • 55 to 87 years = 0.5 to 8.9 mU/L
  • Newborn = 1.7  to 9.1 mU/L
    • 0.3 to 3.04 mIU/L  (another reference)
  • Pregnancy
    • First trimester = 0.3 to 4.5 mU/L
    • Second trimester = 0.5 to 4.6 mU/L
    • Third trimester = 0.8 to 5.2 mU/L
HyperthyroidismNormalMild hypothyroidismHypothyroidism
0.0–0.4 mU/L0.4–4.0 mU/L4.0–10.0 mU/L10.0 mU/L

Thyroid Function Tests Summary:                       

DiseaseT3T4 (total)T4 freeTSHCholesterol
Hyperthyroidismincreasedincreasedincreaseddecreased or absentdecreased
Excess Thyroid binding globulin (TBG)increasedincreasedNormaldecreased
Decreased thyroglobulin (TBG)LowLowNormal
TSHTotal and Free T4Total and Free T3MOST LIKELY DIAGNOSIS
NormalNormalNormalNormal thyroid function (e.g., “euthyroid”)
Normal or decreasedNormal or decreasedDecreasedNormal adjustment in thyroid function due to illness (nonthyroidal illness or sick euthyroid syndrome)
IncreasedNormalNormalSubclinical hypothyroidism; in a person with hypothyroidism on treatment, not enough thyroid hormone is being given
IncreasedDecreasedNormal of decreasedHypothyroidism resulting from a problem with the thyroid gland itself (primary hypothyroidism)
Normal or increasedIncreasedIncreasedHyperthyroidism resulting from a problem with the pituitary gland signals (central hyperthyroidism) or from a problem with the thyroid hormone receptor (thyroid hormone resistance)
DecreasedNormalNormalSubclinical Hyperthyroidism; in a person with Hypothyroidism, too much thyroid hormone is being given
DecreasedNormalIncreasedHyperthyroidism resulting from the thyroid gland making too much active thyroid hormone T3 (uncommon, also known as T3 toxicosis)
DecreasedIncreasedIncreasedHyperthyroidism resulting from the gland making too much thyroid hormones (primary hyperthyroidism)
DecreasedDecreasedDecreasedHypothyroidism resulting from a problem with the hypothalamus or pituitary signals that govern the thyroid gland (central hypothyroidism)

Increase Level of TSH is seen in

  • Hypothyroidism
  • Pituitary resistance
  • Thyrotropin Releasing Hormone (TRH) Secreting Tumor
  • Adults and neonates with primary hypothyroidism.
  • Congenital Cretinism.
  • Hashimoto’s thyroiditis.
  • Thyrotoxicosis due to pituitary tumors.
  • TSH antibodies.
  • Large doses of iodine.
  • Chronic and severe illness.
  • Drugs
    • Amiodarone
    • Lithium
    • Haloperidol
    • Chlorpromazine
    • Metoclopramide
    • Metyrapone
    • Domperidone

Decrease Level of TSH is seen in

  • Primary Hyperthyroidism.
  • Secondary and tertiary Hypothyroidism.
  • Overtreatment in a Hypothyroid patient.
  • Treated Grave’s disease patient.
  • Hyperthyroidism
  • Euthyroid Sick Syndrome (associated with acute illness)
  • Central Hypothyroidism
    • Hypothyroidism or Pituitary Ademoma causing TSH deficiency and low T4 and T3
  • Hyponatremia
  • Malnutrition
  • Mood Disorders
  • Medications
    • Amiodarone
    • Interferon
    • Interleukin-2
    • Opiates
    • Corticosteroids
    • Levothyroxine
    • Levodopa
    • Dopamine Agonists
    • Pyridoxine
    • Bromocriptine
    • Somatostatin analogs
    • Carbemazepine
    • Metformin
    • Biotin (High dose, >5000 mcg/day)

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