Reference range of thyroid function (FT3, FT4 and TSH) among Indian adults
Abstract
Objectives To generate thyroid hormone reference norms using electro-chemiluminescence technique.Design and methods Cross sectional study on apparently normal 4349 Delhi adults (18-86 years). Predetermined exclusion criteria (goiter, hypoechogenicity or nodularity on ultrasound, elevated anti-thyroid peroxidase antibody, hypo or hyperthyroidism and family history of thyroid dysfunction) excluded 2433 subjects leaving 1916 (916 males and 1000 females) as the reference population.Results Mean age and BMI of the reference population were 41.2 ± 18.1 years and 24.5 ± 4.4 kg/m(2) respectively. Median urinary iodine excretion was 233.6 μg/L (79-458;3rd-97th centile). The population was categorized into various age groups (18-30, 31-40, 41-50, 51-60, 61-70 and ≥ 70 years). Overall FT3 and FT4 values in the reference population irrespective of age, ranged from 2.4-8.8 (mean 4.6 ± 0.9) pmol/L and 10.1-24.8 (mean 15.40 ± 2.0) pmol/L, respectively. Mean TSH value in the reference population was 2.2 ± 0.9 mIU/L which was significantly lower than that of total population (3.8 ± 6.1; p<0.001).Conclusion FT3 values were observed to be significantly higher in men than women (p=0.001). The centiles (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th) of FT3, FT4 and TSH were derived for reference purposes in Indian adults. This community based study in Indian adults has established mean reference intervals for FT3, FT4 and TSH for different age groups for both sexes separately using strict exclusion criteria. These can be used as reference norms for Indian adults.
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Not all studies have confirmed age-related TSH elevations; studies from Holland, India, Germany, China, Italy, and the UK Whickham community survey failed to show TSH elevations with age.
“However, not all studies have confirmed these changes. Studies from Holland [89], India [90], Germany [91], China [92] as well as older data from Italy [93] and the UK Whickham community survey failed to show TSH elevations with age.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [90]
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- Authors
- Marwaha, R. K., Tandon, N., Ganie, M. A., Mehan, N., Sastry, A., Garg, M. K., Bhadra, K., & Singh, S.
- Affiliations
- Institute of Nuclear Medicine & Allied Sciences (IN)
- All India Institute of Medical Sciences (IN)
- Sher-i-Kashmir Institute of Medical Sciences (IN)
- Army Hospital Research and Referral (IN)
- Corresponding author
- Marwaha, Raman Kumar
- Venue
- Clinical Biochemistry
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 46
- Issue
- 4-5
- Pages
- 341-345
- ISSN
- 0009-9120 (ISSN-L)
- OpenAlex
- W2008805242
- Cited by
- 35
- References
- 33
- Citations by year
- 2026: 5 · 2024: 5 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 1 · 2014: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Biochemistry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- thyroid function, reference values, free thyroxine, free triiodothyronine, thyroid-stimulating hormone, age-related reference values, sex differences, urinary iodine excretion, Indian adults, Delhi
- MeSH terms
- Adolescent, Adult, Aged, Cross-Sectional Studies, Female, Humans, India, Male, Middle Aged, Reference Values, Thyroid Gland, Thyrotropin, Thyroxine, Triiodothyronine, Young Adult
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