Current normal values for TSH and FT3 in children are too low: evidence from over 11,000 samples
Abstract
BACKGROUND: Current pediatric normal values for thyroid function tests are based on data from relatively few patients. OBJECTIVE: To develop new normal pediatric values based on a large sample of children. PATIENTS AND METHODS: Data were collected from a computerized database in Jerusalem, Israel, of thyroid function tests taken in community pediatric clinics. Samples from patients with antithyroid peroxidase antibodies and/or antithyroglobulin antibodies and from those treated with levothyroxine, methimazole, propylthiouracil, thyrotropin, lithium, phenobarbital, or glucocorticoids were excluded. The analysis included over 11,000 samples tested for TSH, free triiodothyronine (FT3), and free thyroxine (FT4) with the ADVIA Centaur system. RESULTS: The upper normal limit (UNL) for TSH increased by about 1 mIU/L and the lower normal limit (LNL) for FT3 increased by 0.5-2 pmol/L in different age groups. There was no significant change in FT4 values. CONCLUSIONS: These reference data should replace current normal values.
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Free triiodothyronine (FT3) levels fall with age.
“Free triiodothyronine (FT3) levels fall with age and appear to play a role in pubertal development, during which it shows a strong relationship with fat mass.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [45]
Previous cross-sectional studies have indicated that FT3 falls and FT4 rises from age 4 years.
“Previous cross-sectional studies have indicated that free triiodothyronine (FT3) falls and FT4 rises from age 4 years [43–45].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [45]
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Ft3 is Higher in Males than in Females and Decreases Over the Lifespan
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- Authors
- Strich, D., Edri, S., & Gillis, D.
- Affiliations
- Clalit Health Services (IL)
- Hebrew University of Jerusalem (IL)
- Corresponding author
- Gillis, David
- ORCID
- Strich, David
- Venue
- Journal of Pediatric Endocrinology and Metabolism
- Publisher
- Walter de Gruyter GmbH
- Published
- 2012-01-01
- Volume
- 25
- Issue
- 3-4
- Pages
- 245-8
- ISSN
- 0334-018X (ISSN-L)
- 2191-0251
- OpenAlex
- W2029267389
- Semantic Scholar
- 544c0c3a251c754c68c96a9d48d29dde659dc1d8
- Cited by
- 20
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 1 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Endocrinology and Metabolism (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
- pediatric reference values, thyroid-stimulating hormone, free triiodothyronine, free thyroxine, age-specific reference ranges, thyroid function tests, children
- MeSH terms
- Adolescent, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Reference Values, Thyroid Function Tests, Thyrotropin, Triiodothyronine
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