Reference range of thyroid hormones in normal Indian school‐age children
Abstract
Summary: Objective There is an ongoing debate on narrowing the TSH reference range in adults. In view of the scarce data on normal values of thyroid function tests in children from India, we planned to establish a reference range for thyroid hormones in school‐age children. Design and subjects All children (N = 9527; 6–19 years) from six schools representing various zones of Delhi were evaluated for clinical evidence of goitre, thyroid ultrasound, serum free T3 (FT3), free T4 (FT4) and TSH and anti‐thyroid peroxidase (anti‐TPO) antibodies. From this sample, a reference population (N = 5122) was obtained by excluding those with a personal or family history of thyroid disease, use of thyroid medications, goitre, hypoechogenicity/nodularity on ultrasound or serum anti‐TPO antibodies. Measurements Thyroid hormone (FT3, FT4 and TSH) reference ranges were established for each year of life for the total and reference populations. Results In the reference population, mean serum FT3 was in the range 4·19–4·84 p m/l for boys and 4·03–4·47 p m/l for girls, mean serum FT4 14·69–17·36 p m/l for boys and 14·32–15·88 p m/l for girls, and mean serum TSH 2·57–3·6 mIU/l for boys and 1·83–3·58 mIU/l for girls. For TSH, the 97th percentile was in the range 6·01–8·4 mIU/l for boys and 5·28–8·04 mIU/l for girls, suggesting that at least in children there may not be a need to reduce the upper limit of normal for serum TSH. Conclusions This study provides mean reference intervals for FT3, FT4 and TSH for each year of life for both the sexes separately using strict exclusion criteria.
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In Indian children of a similar age group, FT3 and FT4 showed an inverse association with age, although this relationship was only significant in girls.
“In Indian children of a similar age group FT3 and FT4 also showed an inverse association with age, although this relationship was only significant in girls [47, 48].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [47]
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Taylor, P. N., Lansdown, A., Witczak, J., Khan, R., Rees, A., Dayan, C. M., & Okosieme, O. (2023) · Thyroid Research · doi:10.1186/s13044-023-00149-5 · Cited by 72 · see citing works
“In Indian children of a similar age group FT3 and FT4 also showed an inverse association with age, although this relationship was only significant in girls [47, 48].”
BackgroundTSH enhancement of FT4 to FT3 conversion is age dependent
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Self-citationReference range of thyroid function (FT3, FT4 and TSH) among Indian adults
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Self-citationReference range of thyroid hormones in healthy school-age children: Country-wide data from India
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Self-citation
- Authors
- Marwaha, R. K., Tandon, N., Desai, A., Kanwar, R., Grewal, K., Aggarwal, R., Sastry, A., Singh, S., Ganguly, S. K., & Mani, K.
- Affiliations
- Institute of Nuclear Medicine & Allied Sciences (IN)
- Corresponding author
- Marwaha, R. K.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2007-09-03
- Volume
- 68
- Issue
- 3
- Pages
- 369-374
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2148473610
- Cited by
- 31
- References
- 27
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 2 · 2012: 1
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (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 hormones, reference values, elementary school students, free T3, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, goiter, age-related reference values, sex differences, upper limit of normal, thyroid function tests, Delhi
- MeSH terms
- Adolescent, Child, Female, Humans, India, Male, Reference Values, Thyroid Hormones, Young Adult
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