Reference Intervals of Serum Thyroid Function Tests in a Previously Iodine-Deficient Area
Abstract
AIM: We undertook the present study to establish reference data for serum thyroid function tests in a previously iodine-deficient area. METHODS: Data from 4298 individuals, 20-79 years of age were available for the present analysis. Thyroid function (thyrotropin [TSH], free triiodothyronine [FT(3)], and free thyroxine [FT(4)]) and serum autoantibodies to thyroperoxidase (anti-TPOAb) were evaluated from blood samples. Thyroid structure and size were measured by ultrasound. RESULTS: A reference population was selected comprising 1488 persons (825 men) by excluding subjects with known thyroid diseases, and with yet unknown thyroid disorders such as goitre, inhomogeneous thyroid pattern, nodules, hypoechogenicity and anti-TPOAb seropositivity. Reference intervals for serum TSH, FT(3), and FT(4) were 0.25-2.12 mIU/L, 3.8-7.0 pmol/L, and 8.3-18.9 pmol/L, respectively. Reference serum TSH levels were not comparable to the reference values that were recently established for the U.S. population and most reference values slightly differed from the reference values provided by the manufacturers. CONCLUSIONS: The reference ranges of thyroid function tests in this formerly iodine-deficient region are distinct from the reference ranges that were established in areas with iodine sufficiency. Creating a reference population in the present setting should include thyroid ultrasound in order to exclude yet undiagnosed thyroid disorders.
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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 [91]
Studies in populations with iodine deficiency have failed to show an increase in TSH.
“Studies in populations with iodine deficiency have failed to show an increase in TSH [91, 93–95].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [91]
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- Authors
- Völzke, H., Alte, D., Kohlmann, T., Lüdemann, J., Nauck, M., John, U., & Meng, W.
- Affiliations
- Universität Greifswald (DE)
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2005-03
- Volume
- 15
- Issue
- 3
- Pages
- 279-285
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W2156565888
- Cited by
- 192
- References
- 23
- Citations by year
- 2025: 6 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 10 · 2020: 10 · 2019: 3 · 2018: 10 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 10 · 2013: 21 · 2012: 13
- FWCI
- 7.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung
- 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
- reference values, thyroid-stimulating hormone, free triiodothyronine, free thyroxine, iodine deficiency, thyroid peroxidase antibodies, thyroid ultrasound, thyroid dysfunction, reference population selection
- MeSH terms
- Adult, Aged, Autoantibodies, Female, Geography, Germany, Goiter, Humans, Iodide Peroxidase, Iodine, Male, Middle Aged, Reference Values, Thyroid Function Tests, Thyroid Gland, Thyrotropin, Thyroxine, Triiodothyronine, Ultrasonography, Thyroid Nodule
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