Pitfalls in the use of thyrotropin concentration as a first-line thyroid-function test
Abstract
Measurement of thyrotropin concentration alone as a first-line thyroid-function test fails to indicate hypopituitarism in a number of patients. Using a combination of thyrotropin and thyroxine assays, we analysed 56,000 tests for a population of 471,000 over 12 months. 15 patients with clinically unsuspected hypopituitarism were detected, indicating that the occurrence of hypopituitarism might be underestimated.
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Central hypothyroidism represents a major false negative result of the reflex TSH strategy, a widely accepted method for screening thyroid function by a first-line TSH measurement.
“Therefore, CeH represents a major false negative result of the 'reflex TSH strategy,' which is a widely accepted method for screening thyroid function by a first-line TSH measurement [4-7].”
From 2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism (2018) · cites this paper as [6]
Cites
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- Authors
- Wardle, C. A., Fraser, W. D., & Squire, C. R.
- Affiliations
- Royal Liverpool University Hospital (GB)
- ORCID
- Fraser, William D
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2001-03
- Volume
- 357
- Issue
- 9261
- Pages
- 1013-1014
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2009809472
- Cited by
- 67
- References
- 4
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 5 · 2014: 3 · 2013: 3 · 2012: 2
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- thyroid-stimulating hormone, TSH measurement, hypopituitarism, thyroid function tests
- MeSH terms
- Aged, Female, Humans, Hypopituitarism, Hypothyroidism, Male, Prospective Studies, Thyroid Function Tests, Thyrotropin, Thyroxine
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