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Thyroid Function Test

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1. Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder

Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder Guidelines & Protocols Advisory Committee Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder Effective Date: October 24, 2018 Scope This guideline outlines testing for thyroid dysfunction in patients (pediatric and adult), including pregnant women or women planning pregnancy, and the monitoring of patients treated for primary thyroid function disorders. It does not apply (...) to the BC Newborn Screening Program. This guideline outlines testing for thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3) and anti-thyroid peroxidase (TPO). Information on other tests, including thyroglobulin/antithyroglobulin (Tg/anti Tg) and antibodies to the thyroid stimulating hormone receptor (TRAb), are covered in the associated BC Guideline Hormone Testing – Indications and Appropriate Use. Key Recommendations • Routine thyroid function testing

2018 Clinical Practice Guidelines and Protocols in British Columbia

2. Thyroid function testing

Thyroid function testing Thyroid function testing - Medical information | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Thyroid function testing Last reviewed: February 2019 Last updated: February 2018 Summary Thyroid hormones thyroxine (T4) and tri-iodothyronine (T3) are produced, stored, and secreted by the thyroid gland. These hormones, particularly T3, play a major role in multiple biological and metabolic processes. They act by binding to thyroid (...) receptors that are distributed in almost every organ. Typically, this process regulates gene transcription and the subsequent production of various proteins that are involved in development, growth, and cellular metabolism. Kronenberg HM, Melmed S, Polonsky KS, et al, eds. Williams textbook of endocrinology. 12th ed. Philadelphia, PA: Saunders/Elsevier; 2011. Thyroid function tests (TFTs) are the most commonly used endocrine test. Details Thyroid hormone production Thyroid hormone-binding proteins

2018 BMJ Best Practice

3. Repeat thyroid function tests for healthy older people are not needed

Repeat thyroid function tests for healthy older people are not needed Repeat thyroid function tests for healthy older people are not needed Discover Portal Discover Portal Repeat thyroid function tests for healthy older people are not needed Published on 2 January 2019 doi: Older adults with normal thyroid function or subclinical thyroid dysfunction show notable long-term stability of their thyroid hormone levels. This suggests that it is safe for GPs not to routinely retest older adults unless (...) they have risk factors or develop clinical symptoms of overt thyroid dysfunction. Over five years, about 0.2% older adults with normal thyroid function will develop overt hypothyroidism and about 3.5% will develop subclinical hypothyroidism. Amongst those with subclinical hypothyroidism, about 2% will develop overt hypothyroidism. The NIHR funded this study as there is a lack of consensus on the relevance of subclinical thyroid dysfunction and the need for repeat testing. This could both reduce

2019 NIHR Dissemination Centre

4. Repeat thyroid function tests for healthy older people are not needed. (PubMed)

Repeat thyroid function tests for healthy older people are not needed. The studyRoberts L, McCahon D, Johnson O, Haque MS, Parle J, Hobbs FR. Stability of thyroid function in older adults: the Birmingham Elderly Thyroid Study. Published on 28 August 2018 Br J Gen Pract 2018;68:e718-26.This study was funded by the National Institute for Health Research School for Primary Care Research (SPCR).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000703/repeat-thyroid (...) -function-tests-for-healthy-older-people-are-not-needed.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

2019 BMJ

5. Thyroid hormone treatment does not help adults with mildly abnormal thyroid tests

are drawn from the British Thyroid Association’s 2006 guideline for the use of thyroid function tests in the UK. The British Thyroid Association recommends levothyroxine if TSH is greater than 10mU/L. If TSH is higher than normal but below 10mU/L, treatment is not routinely recommended except in certain circumstances, such as patients with goitre (swelling of the thyroid gland) or women who are planning pregnancy. What are the implications? This review does not support the routine treatment (...) . Recommendations for treatment of subclinical hypothyroidism are drawn from the British Thyroid Association’s 2006 guideline for the use of thyroid function tests in the UK. The British Thyroid Association recommends levothyroxine if TSH is greater than 10mU/L. If TSH is higher than normal but below 10mU/L, treatment is not routinely recommended except in certain circumstances, such as patients with goitre (swelling of the thyroid gland) or women who are planning pregnancy. What are the implications

2019 NIHR Dissemination Centre

6. Thyroid function test evolution in children with Hashimoto’s thyroiditis is closely conditioned by the biochemical picture at diagnosis (PubMed)

Thyroid function test evolution in children with Hashimoto’s thyroiditis is closely conditioned by the biochemical picture at diagnosis ᅟ: Aim of this commentary is to summarize the salient literature views on the relationships between presentation and evolution patterns of thyroid function in children with Hashimoto's thyroiditis (HT). According to the most recent reports, children with HT and subclinical hypothyroidism (SH) are more prone to the risk of developing severe thyroid (...) .1) a deterioration of thyroid status over time may be observed especially in the children presenting with SH, but also in those presenting with euthyroidism; 2) a definitive resolution of the hyperthyroid phase is generally observed in those presenting with either overt or subclinical hyperthyroidism.

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2018 Italian journal of pediatrics

7. Corrigendum to “Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease” (PubMed)

Corrigendum to “Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease” [This corrects the article DOI: 10.4061/2011/598712.].

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2017 Journal of thyroid research

8. Rationalizing thyroid function testing: which TSH cut-offs are optimal for testing free T4? (PubMed)

Rationalizing thyroid function testing: which TSH cut-offs are optimal for testing free T4? Thyroid function testing often uses thyrotropin (TSH) measurement first, followed by reflex testing for free thyroxine (T4) if TSH is outside the reference range. The utility of different TSH cutoffs for reflex testing is unknown.To examine different TSH cutoffs for reflex free T4 testing.We analyzed concurrent TSH and free T4 results from 120,403 individuals from a single laboratory in Western Australia (...) (clinical cohort) and 4568 Busselton Health Study participants (community cohort).In the clinical cohort, restricting free T4 measurement to individuals with TSH <0.3 or >5.0 mU/L resulted in a 22% reduction in free T4 testing compared with a TSH reference range of 0.4 to 4.0 mU/L; using TSH cutoffs of 0.2 and 6.0 mU/L resulted in a 34% reduction in free T4 testing. In the community cohort, the corresponding effect was less: 3.3% and 4.8% reduction in free T4 testing. In the clinical cohort, using TSH

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2017 Journal of Clinical Endocrinology and Metabolism

9. Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine Medication. (PubMed)

Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine Medication. Levothyroxine (LT4) and rifampin (RIF) are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose.We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association (ATA)/American (...) . Risk factor analysis showed that remaining thyroid gland (odds ratio [OR] 9.207, P = 0.002), the time interval between starting RIF and TSH measurement (OR 1.043, P = 0.019), and baseline LT4 dose per kg body weight (OR 0.364, P = 0.011) were clinically relevant variables.In patients receiving LT4, serum thyroid function test should be performed after starting RIF treatment. For patients with no remnant thyroid gland and those receiving a lower LT4 dose, close observation is needed when starting

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2017 PLoS ONE

10. Routine Prenatal Thyroid-Stimulating Hormone Testing: Evidence-Based Guidelines

of Abstracts Result type: Report Question What are the evidence-based guidelines for routine screening of thyroid-stimulating hormone in prenatal women? Key Message Four evidence-based guidelines were identified regarding routine screening of thyroid-stimulating hormone in prenatal women. Tags fear, fetus, pregnancy, pregnancy trimesters, pregnant women, thyroid diseases, thyroid function tests, thyrotropin, laboratory tests, Prenatal, foetus, iodine test, thyrotrophin, pregnant women, thyroid stimulating (...) Routine Prenatal Thyroid-Stimulating Hormone Testing: Evidence-Based Guidelines Routine Prenatal Thyroid-Stimulating Hormone Testing: Evidence-Based Guidelines | CADTH.ca Find the information you need Routine Prenatal Thyroid-Stimulating Hormone Testing: Evidence-Based Guidelines Routine Prenatal Thyroid-Stimulating Hormone Testing: Evidence-Based Guidelines Published on: November 14, 2016 Project Number: RB1038-000 Product Line: Research Type: Other Diagnostics Report Type: Summary

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

11. A Practical Approach for the Verification and Determination of Site and Trimester Specific Reference Intervals for Thyroid Function Tests in Pregnancy. (PubMed)

A Practical Approach for the Verification and Determination of Site and Trimester Specific Reference Intervals for Thyroid Function Tests in Pregnancy. Population-, assay-, and trimester-specific reference intervals for thyroid function tests are necessary to assess thyroid status accurately and manage thyroid disease throughout pregnancy. This study's objective was to verify if the manufacturer's recommended trimester-specific reference intervals for thyroid tests and the American Thyroid (...) and delivery ward (third-trimester samples, n = 35). Exclusions included thyroid medication or disease and positive thyroid peroxidase antibodies (anti-TPO). Samples were analyzed for thyrotropin (TSH), free T4 (fT4), free triiodothyronine (fT3), TT4, and anti-TPO using the Roche Cobas 8000 Modular e602 electrochemiluminescence immunoassay.Nine percent of the aneuploidy screening samples were excluded prior to thyroid testing due to maternal use of thyroid medication. Six percent of analyzed samples were

2018 Thyroid

12. Implementation of thyroid function tests algorithms by clinical laboratories: A four-year experience of good clinical and diagnostic practice in a tertiary hospital in Greece. (PubMed)

Implementation of thyroid function tests algorithms by clinical laboratories: A four-year experience of good clinical and diagnostic practice in a tertiary hospital in Greece. Thyroid Function Tests (TFTs) are among the most commontly ordered tests. Significant overuse of TFTs can occur when instead of using a single TSH test to screen for thyroid disease a full panel (TSH plus FT4 and FT3) is ordered. The aim of our study was to evaluate the effectiveness of the application of a scientifically (...) -established laboratory-controlled algorithm for TFTs to physician's orders for inpatients and to address potential pitfalls of such an approach.We collected and analyzed Laboratory Information System data of the TFTs performed between April 2009 and March 2016 in a 739-bed tertiary teaching hospital. Between April 2013 and March 2016, we applied a laboratory controlled algorithm for inpatient TFT assays after TSH and did not perform further tests, unless a justified bypass was requested by the treating

2018 European journal of internal medicine

13. A Systematic Review on Normative Values of Trimester-specific Thyroid Function Tests in Indian Women. (PubMed)

A Systematic Review on Normative Values of Trimester-specific Thyroid Function Tests in Indian Women. Small cross-sectional studies are published on the trimester-specific normal ranges of thyrotropin and thyroxine levels in Indian women from various parts of the country.We sought to review the published literature on thyroid function tests in normal pregnant Indian women to see if the pooled data from various studies can define normative data and hypothyroidism in pregnancy.We retrieved 56 (...) /clinical evidence of thyroid dysfunction, those with family history of thyroid dysfunction, infertility and those with history of recurrent miscarriages (usually >3). Ultrasound evidence of thyroid disease, urinary iodine assessment, and thyroid antibodies were included as additional exclusion criteria in two, three, and four studies, respectively. None of the studies included the outcome of pregnancy as part of follow-up. As part of the pooled data analysis, the 5th-95th centile values of normal TSH

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2018 Indian journal of endocrinology and metabolism

14. Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU (PubMed)

Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU Prognostic value of cortisol and thyroid function tests (TFTs) has previously been evaluated in medical ICUs. We aimed to evaluate prognostic efficacy of cortisol and TFTs in critically ill poisoned patients admitted to toxicology intensive care unit (ICU).In a prospective study of consecutively enrolled subjects admitted to the toxicology ICU, lab analyses included TFTs (total T3 and T4

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2018 World journal of emergency medicine

15. Effect of High-dose Biotin on Thyroid Function Tests: Case Report and Literature Review (PubMed)

Effect of High-dose Biotin on Thyroid Function Tests: Case Report and Literature Review Biotin is a readily available supplement that is part of the B-complex vitamins. It is an essential co-factor for five carboxylases involved in fatty acid synthesis and energy production. The recommended daily intake (RDI) of biotin ranges from 30 to 70 mcg per day. At high doses (10,000 times RDI), biotin improves clinical outcomes and quality of life in patients with progressive multiple sclerosis (MS (...) ). It has been reported to cause interference in immunoassays resulting in abnormal thyroid function tests. Hereby we are describing the case of a patient having MS who was on high-dose biotin, seen in the clinic for a follow-up visit with thyroid function tests suggestive of Graves' disease with no signs and symptoms of hyperthyroidism and completely normal physical examination. In the case we have described, the laboratory measurements suggestive of thyrotoxicosis were attributed to interference

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2018 Cureus

16. Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study (PubMed)

Thyroid function tests before prescribing anti-dementia drugs: a retrospective observational study Treatable causes of cognitive dysfunction, such as hypothyroidism, should be excluded by physicians before prescribing anti-dementia drugs. Many clinical guidelines for dementia recommend a thyroid function test (TFT) as one of the standard screening tests for cognitive dysfunction. This study aimed to investigate the national implementation rate of TFTs during the 365 days before the initiation

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2018 Clinical interventions in aging

17. Therapeutic challenges in the application of serum thyroid stimulating hormone testing in the management of patients with hypothyroidism on replacement thyroid hormone therapy: a review. (PubMed)

Therapeutic challenges in the application of serum thyroid stimulating hormone testing in the management of patients with hypothyroidism on replacement thyroid hormone therapy: a review. Normalizing serum thyroid stimulating hormone (TSH) levels by lifelong treatment with levothyroxine (LT4) remains the primary goal of therapy for patients with hypothyroidism. The reference ranges for TSH are derived from populations with (supposedly) normal thyroid function. But, TSH results are affected (...) by a number of factors including alterations in TSH levels with age, concurrent illnesses, circadian rhythm, inter- and intra-assay differences, and some commonly used medications that interfere with thyroid function or the TSH test. Furthermore, some patients are complex to manage and bringing serum TSH to within its reference range does not always resolve their symptoms of hypothyroidism. Furthermore, changes in TSH within the reference range may provoke symptoms in some sensitive patients, and others

2019 Current medical research and opinion

18. Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's thyroiditis presenting with either euthyroidism or subclinical hypothyroidism. (PubMed)

Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's thyroiditis presenting with either euthyroidism or subclinical hypothyroidism. Whether the course of thyroid function in Hashimoto's thyroiditis (HT) differs in children who present with either euthyroidism or subclinical hypothyroidism (SH) has been incompletely investigated.Using a five-year prospective evaluation of 234 children with HT and no prognostic risk factors, this study investigated (...) with a mild biochemical picture (either SH or euthyroidism). A total of 57.1% of initially euthyroid children remain euthyroid, and 40.6% of patients with initial SH normalize thyroid function within five years after HT diagnosis. The patients presenting with SH are more prone to the risk of developing severe thyroid dysfunction over time.

2016 Thyroid

19. A single 10mg oral dose of biotin interferes with thyroid function tests. (PubMed)

A single 10mg oral dose of biotin interferes with thyroid function tests. 28614993 2018 10 18 2018 10 18 1557-9077 27 8 2017 08 Thyroid : official journal of the American Thyroid Association Thyroid A Single 10 mg Oral Dose of Biotin Interferes with Thyroid Function Tests. 1099-1100 10.1089/thy.2016.0623 Biscolla Rosa Paula M RPM Fleury Group , Sao Paulo, Brazil . Chiamolera Maria Izabel MI Fleury Group , Sao Paulo, Brazil . Kanashiro Ina I Fleury Group , Sao Paulo, Brazil . Maciel Rui M B RMB (...) Fleury Group , Sao Paulo, Brazil . Vieira Jose G H JGH Fleury Group , Sao Paulo, Brazil . eng Letter 2017 07 21 United States Thyroid 9104317 1050-7256 6SO6U10H04 Biotin IM Biotin administration & dosage Humans Thyroid Function Tests Thyroid Gland drug effects 2017 6 16 6 0 2018 10 20 6 0 2017 6 16 6 0 ppublish 28614993 10.1089/thy.2016.0623

2017 Thyroid

20. Thyroid function tests in the reference range and fracture: individual participant analysis of prospective cohorts. (PubMed)

Thyroid function tests in the reference range and fracture: individual participant analysis of prospective cohorts. Hyperthyroidism is associated with increased fracture risk, but it is not clear if lower thyroid-stimulating hormone (TSH) and higher free thyroxine (FT4) in euthyroid individuals are associated with fracture risk.To evaluate the association of TSH and FT4 with incident fractures in euthyroid individuals.Individual participant data analysis.Thirteen prospective cohort studies (...) associated with FT4 [HR (95% CI) 1.22 (1.11 to 1.35) per one standard deviation increase in FT4]. FT4 only was associated with any and nonvertebral fractures. Results remained similar in sensitivity analyses.Among euthyroid adults, lower TSH and higher FT4 are associated with an increased risk of hip fracture. These findings may help refine the definition of optimal ranges of thyroid function tests.Copyright © 2017 Endocrine Society

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2017 Journal of Clinical Endocrinology and Metabolism

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