Table 5. [Conditions which May be Associated with Abnormal Serum TSH Concentrations]. - Endotext

	Expected TSH (mU/L)	Thyroid Status	FT4
TSH reduced
1. Hyperthyroidism	<0.1	↑	↑, T3
2. “Euthyroid” Graves’ disease	0.2-0.5	N (↑)	N(T3↑)
3. Autonomous nodules	0.2-0.5	N (↑)	N(T3↑)
4. Excess thyroid hormone treatment	0.1-0.5	N,↑	N,↑
Other forms of subclinical hyperthyroidism (including thyroiditis variants)	0.1-0.5	N,↑	N,↑
6. Illness with or without dopamine	0.1-5.0	N	↑, N,↓
7. First trimester pregnancy	0.2-0.5	N (↑)	N (↑)
8. Hyperemesis gravidarum	0.2-0.5	N (↑)	↑(N)
9. Hydatidiform mole	0.1-0.4	↑	↑
10. Acute psychosis or depression (rare)	0.4-10	N	N (↑)
11. Elderly (small fraction)	0.2-0.5	N	N
Cushing’s syndrome and glucocorticoids excess (inconsistent)	0.1-0.5	N	N
13. Retinoid X receptor-selective ligands	0.01-0.2	↓	↓
14. Various forms of central hypothyroidism	<0.1-0.4	↓	↓
15. Congenital TSH deficiency a. Pit-1 mutations b. PROP1 mutations c. Mutations of TSHB gene in CAGYC region d. Skipping of TSHB gene exon 2 e. Inactivating mutation of TRH receptor gene	0 0 0 0 1-2 ↓ ↓	↓ ↓ ↓ ↓	↓ ↓ ↓ ↓
TSH Elevated
1. Primary hypothyroidism	6-500	↓	↓
2. Resistance to TSH	6->100	N,↓	N,↓
3. Recovery from severe illness	5-30	N	N,↓
4. Iodine deficiency	6-150	N,↓	↓
5. Thyroid hormone resistance	1-15	N (↓,↑)	↑
6. Thyrotroph tumor	3-30	↑	↑
7. Central (“tertiary”) hypothyroidism	1-19	↓	↓
8. Psychiatric illness (especially bipolar disorders)	0.4-10	N	N
9. Test artifacts (endogenous anti-mouse gamma-globulin antibodies as well as “macroTSH”)	10-500	N	N
10. Addison’s disease	5-30	N	N

Expected TSH (mU/L)

Thyroid
Status

FT4

TSH reduced

1.: Hyperthyroidism

<0.1

↑

↑, T3

2. “Euthyroid” Graves’ disease

0.2-0.5

N (↑)

N(T3↑)

3. Autonomous nodules

0.2-0.5

N (↑)

N(T3↑)

4. Excess thyroid hormone treatment

0.1-0.5

N,↑

Other forms of subclinical hyperthyroidism (including thyroiditis variants)

0.1-0.5

N,↑

6. Illness with or without dopamine

0.1-5.0

↑, N,↓

7. First trimester pregnancy

0.2-0.5

N (↑)

8. Hyperemesis gravidarum

0.2-0.5

N (↑)

↑(N)

9. Hydatidiform mole

0.1-0.4

↑

10. Acute psychosis or depression (rare)

0.4-10

N (↑)

11. Elderly (small fraction)

0.2-0.5

Cushing’s syndrome and glucocorticoids excess (inconsistent)

0.1-0.5

13. Retinoid X receptor-selective ligands

0.01-0.2

↓

14. Various forms of central hypothyroidism

<0.1-0.4

↓

15. Congenital TSH deficiency

a.: Pit-1 mutations
b.: PROP1 mutations
c.: Mutations of TSHB gene in CAGYC region
d.: Skipping of TSHB gene exon 2
e.: Inactivating mutation of TRH receptor gene

0
0
0
0
1-2 ↓ ↓

↓
↓
↓
↓

TSH Elevated

1.: Primary hypothyroidism

6-500

↓

2. Resistance to TSH

6->100

N,↓

3. Recovery from severe illness

5-30

N,↓

4. Iodine deficiency

6-150

N,↓

↓

5. Thyroid hormone resistance

1-15

N (↓,↑)

↑

6. Thyrotroph tumor

3-30

↑

7. Central (“tertiary”) hypothyroidism

1-19

↓

8. Psychiatric illness (especially bipolar disorders)

0.4-10

9. Test artifacts (endogenous anti-mouse gamma-globulin antibodies as well as “macroTSH”)

10-500

10. Addison’s disease

5-30

From: Physiology of the Hypothalamic-Pituitary-Thyroid Axis

Endotext [Internet].

Feingold KR, Anawalt B, Blackman MR, et al., editors.

South Dartmouth (MA): MDText.com, Inc.; 2000-.

This electronic version has been made freely available under a Creative Commons (CC-BY-NC-ND) license. A copy of the license can be viewed at http://creativecommons.org/licenses/by-nc-nd/2.0/.

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