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Test Findings
 
 

Elevated TSH

 
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Overview

An elevated TSH is suggestive of primary hypothyroidism.
  • Causes of Elevated TSH

  • Primary Hypothyroidism

  • Autoimmune thyroiditis - Hashimoto’s, atrophic
  • Hypothyroid phase of thyroiditis
  • Iatrogenic - radioiodine therapy, thyroidectomy, external irradiation of the neck
  • Drugs - amiodarone, lithium, interferons, interleukin-2, iodide
  • Iodine deficiency
  • Thyroid infiltration - amyloidosis, tumour
  • Congenital hypothyroidism
  • Other

  • Subclinical hypothyroidism
  • Nonthyroidal illness (recovery phase)
  • Central hyperthyroidism
  • TSH receptor defects
  • TSH resistance
  • Interpretation

  • Elevated TSH with reduced T4 - consistent with primary hypothyroidism
  • Elevated TSH with normal T4 - suggestive of subclinical hypothyroidism
  • Elevated TSH with elevated T4 - suggestive of central hyperthyroidism
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