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Test Findings

Elevated TSH



  • 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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