Thyroid Function Testing
Thyroid function tests are performed by essentially all medical practitioners across every clinical setting. Significant insights have been gained into thyroid regulation and thyroid hormone metabolism that influence the selection and interpretation
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THYROID FUNCTION TESTING
ENDOCRINE UPDATES Shlomo Melmed, M.D., Series Editor For further volumes: http://www.springer.com/series/5917
THYROID FUNCTION TESTING Edited by Gregory A. Brent Professor of Medicine and Physiology David Geffen School of Medicine at UCLA Los Angeles, CA, USA
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Editor Gregory A. Brent Departments of Medicine and Physiology David Geffen School of Medicine at UCLA Los Angeles, CA, USA [email protected]
ISSN 1566-0729 ISBN 978-1-4419-1484-2 e-ISBN 978-1-4419-1485-9 DOI 10.1007/978-1-4419-1485-9 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2008939864 © Springer Science+Business Media, LLC 2010 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface Thyroid function tests are utilized by essentially all medical practitioners, across every clinical setting, in patients from newborns to the elderly. They are the most frequently measured endocrine tests. The sensitive thyrotropin (TSH) assay reflects thyroid hormone feedback to the pituitary, and is diagnostic of both thyroid hormone excess as well as deficiency. The log–linear relationship between serum TSH and thyroxine concentrations means that small changes in serum thyroxine are amplified by changes in serum TSH. The availability of the sensitive TSH assay in essentially all clinical laboratories has improved and simplified the assessment of thyroid function for the diagnosis of thyroid disease and to monitor treatment. Serum free thyroxine and thyrotropin concentrations, as well as other thyroid tests, can be measured utilizing an automated immunoassay platform that provides rapid and accurate results. This simplified approach to thyroid assessment, often requiring only a serum TSH measurement, and rapid availability of the thyroid function tests results, has expanded the scope of thyroid testing and clinicians ordering and interpreting thyroid tests. There remain, however, many c
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