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TSH Ultra Sensitive

Thyroid
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Report in 4Hrs

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No Fasting Required

Details

Checks thyroid function

₹95₹440

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TSH Ultra Sensitive Test Information Guide

  • Why is it done?
    • Measures thyroid-stimulating hormone (TSH) levels with high sensitivity and specificity to detect subtle thyroid dysfunction
    • Screen for hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid)
    • Diagnose thyroid disorders in symptomatic patients presenting with fatigue, weight changes, temperature sensitivity, or mood disturbances
    • Monitor thyroid hormone replacement therapy in patients with known hypothyroidism receiving levothyroxine treatment
    • Screen for subclinical thyroid disease where TSH is abnormal but free T4 remains within normal limits
    • Routine screening during annual physical examinations, especially in women over 50, patients with family history of thyroid disease, or those with autoimmune conditions
    • Evaluate pituitary dysfunction and assess secondary hypothyroidism or hyperthyroidism
  • Normal Range
    • Standard Reference Range: 0.4 to 4.0 mIU/L (milliunits per liter)
    • Unit of Measurement: mIU/L (milliunits per liter) or mIU/mL
    • What Normal Means: TSH within the normal range indicates the pituitary gland is appropriately regulating thyroid hormone production, and thyroid function is likely normal
    • Low TSH (< 0.4 mIU/L): May indicate hyperthyroidism, overtreatment with thyroid hormone replacement, or pituitary insufficiency
    • High TSH (> 4.0 mIU/L): May indicate hypothyroidism, undertreatment with thyroid hormone, or early thyroid disease
    • Important Note: Reference ranges may vary slightly between laboratories. The ultra-sensitive assay can detect TSH levels as low as 0.01 mIU/L, making it particularly useful for screening subclinical thyroid disease and monitoring suppressive thyroid therapy in cancer patients
  • Interpretation
    • TSH Between 0.4-4.0 mIU/L (Normal): Thyroid function appears normal; thyroid is producing adequate hormones and pituitary feedback is appropriate. No thyroid disease is indicated.
    • TSH < 0.4 mIU/L (Low - Suggests Hyperthyroidism): Indicates elevated thyroid hormones (free T4/T3) are suppressing pituitary TSH secretion. Causes include Graves' disease, thyroiditis, toxic nodule, or excessive thyroid hormone medication. Follow-up with free T4 and free T3 testing is recommended.
    • TSH > 4.0 mIU/L (High - Suggests Hypothyroidism): Indicates the pituitary is attempting to stimulate an underactive thyroid gland. Thyroid hormones (free T4/T3) are low or insufficient. Common causes include Hashimoto's thyroiditis, iodine deficiency, or inadequate thyroid hormone replacement therapy.
    • TSH 0.1-0.4 mIU/L (Low-Normal/Subclinical Hyperthyroidism): Borderline low but may still be normal for some individuals. If free T4 is normal, this may represent subclinical hyperthyroidism requiring monitoring.
    • TSH 4.0-10.0 mIU/L (High-Normal/Subclinical Hypothyroidism): May indicate early or subclinical hypothyroidism, particularly if free T4 is still normal. Warrants further investigation and follow-up testing.
    • Factors Affecting TSH Levels: Time of day (TSH is higher in morning), pregnancy, medications (beta-blockers, corticosteroids, dopamine, lithium), acute illness, stress, recent iodine exposure, and pituitary or hypothalamic disorders
    • Clinical Significance: TSH is the most sensitive marker of thyroid dysfunction and serves as the first-line screening test. The ultra-sensitive assay improves detection of subclinical disease and enables precise thyroid hormone dose adjustment.
  • Associated Organs
    • Primary Organs Involved: Thyroid gland (produces thyroid hormones T4 and T3), anterior pituitary gland (produces TSH), and hypothalamus (produces thyrotropin-releasing hormone or TRH)
    • Conditions Associated with Elevated TSH: Hashimoto's thyroiditis (autoimmune), primary hypothyroidism, iodine deficiency, thyroid removal or radioactive iodine treatment, medications (lithium, interferon-alpha), pituitary adenomas secreting TSH (secondary hyperthyroidism)
    • Conditions Associated with Suppressed TSH: Graves' disease, thyroiditis (silent, postpartum, or acute), toxic multinodular goiter, thyroid cancer on suppressive therapy, pituitary insufficiency, secondary hypothyroidism, hyperprolactinemia
    • Diseases Detected or Monitored: Hypothyroidism, hyperthyroidism, thyroid cancer, subclinical thyroid disease, thyroiditis, pituitary disorders, pregnancy-related thyroid dysfunction
    • Potential Complications of Abnormal Results: Untreated hypothyroidism can lead to myxedema, cognitive decline, heart disease, and depression. Untreated hyperthyroidism can cause thyroid storm, atrial fibrillation, osteoporosis, and cardiac complications. Improper hormone replacement can result in iatrogenic hyper- or hypothyroidism.
    • Impact on Affected Organ Systems: Thyroid hormones regulate metabolism, temperature, heart rate, cholesterol metabolism, and neurological function. Abnormal TSH indicates dysregulation affecting cardiovascular, metabolic, neurological, and reproductive systems.
  • Follow-up Tests
    • Free Thyroxine (Free T4): Recommended when TSH is abnormal to evaluate actual thyroid hormone levels and confirm diagnosis of hypo- or hyperthyroidism
    • Free Triiodothyronine (Free T3): May be ordered if hyperthyroidism is suspected or to evaluate T3 toxicosis
    • Anti-Thyroid Peroxidase (Anti-TPO) Antibodies: Ordered when elevated TSH is detected to diagnose autoimmune thyroiditis (Hashimoto's disease)
    • Anti-Thyroglobulin Antibodies: May be tested alongside anti-TPO to confirm autoimmune thyroid disease
    • TSH Receptor Antibodies (TRAb): Ordered when low TSH and hyperthyroid symptoms suggest Graves' disease
    • Thyroid Ultrasound: May be performed to evaluate thyroid structure, identify nodules, assess for thyroiditis, or investigate abnormal TSH findings
    • Radioactive Iodine Uptake (RAIU) Test: May be ordered to differentiate between causes of hyperthyroidism (Graves' vs. thyroiditis)
    • Monitoring Frequency for Treated Patients: Initial testing 6-8 weeks after starting levothyroxine therapy, then annually or as clinically indicated. During dose adjustments, retest 6-8 weeks after each change.
    • Complementary Tests: Lipid panel (thyroid disease affects cholesterol), comprehensive metabolic panel (assess overall health), pregnancy test in women of childbearing age (pregnancy affects TSH interpretation)
  • Fasting Required?
    • Fasting Required: No
    • Patient Preparation: Patient may eat and drink normally; no fasting period is required. Blood can be drawn at any time of day, though morning collection is preferred as TSH levels are typically highest in the morning.
    • Medications to Avoid or Report: Levothyroxine (thyroid hormone) should be taken at least 30-60 minutes before the blood draw to avoid falsely elevated TSH readings. Biotin supplements should be discontinued 48 hours before testing as they can interfere with assay results. Inform the healthcare provider of all medications including beta-blockers, corticosteroids, dopamine agonists, lithium, and amiodarone as they may affect TSH levels.
    • Additional Special Instructions: Consistency in timing is important when monitoring thyroid-treated patients. If possible, subsequent TSH tests should be drawn at the same time of day as baseline testing. Recent iodine contrast exposure (within 4 weeks) should be reported to the laboratory. Pregnancy status should be noted as normal TSH ranges are different during pregnancy.
    • Sample Collection: Routine venipuncture (blood draw from a vein). A single tube of blood is typically sufficient for TSH testing.

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