Southwestern internal medicine conference: The dilemma of abnormal thyroid function tests - is thyroid disease present or not?

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Abstract

Abnormal thyroid function tests are frequently encountered in the evaluation of patients without obvious thyroid disease. Only a fraction of these abnormal tests involve abnormalities in the well understood changes associated with altered levels of thyroid hormone binding globulin (TBG). In the remainder of patients it is necessary to decide whether subtle hypo- or hyperthyroidism exists or whether the abnormal values are somehow spurious. In spite of the ready availability of assays of serum triiodothyronine (T3) and thyrotropin (TSH), and of the ability to test the pituitary-thyroid axis by assessing the response of TSH to thyrotropin releasing hormone (TRH) stimulation, the diagnosis of subtle hypo- or hyperthyroidism is still a problem in clinical endocrinology. This review will consider the new insight into thyroid hormone physiology gained by studies of peripheral metabolism of thyroid hormones during the last ten years and discuss the problems of interpretation of thyroid function tests.

Original languageEnglish (US)
Pages (from-to)76-88
Number of pages13
JournalAmerican Journal of the Medical Sciences
Volume289
Issue number2
DOIs
StatePublished - Jan 1 1985

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Thyroid Function Tests
Thyroid Diseases
Internal Medicine
Thyroid Hormones
Hyperthyroidism
Hypothyroidism
Thyrotropin-Releasing Hormone
Endocrinology
Globulins
Triiodothyronine
Thyrotropin
Thyroid Gland
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "Abnormal thyroid function tests are frequently encountered in the evaluation of patients without obvious thyroid disease. Only a fraction of these abnormal tests involve abnormalities in the well understood changes associated with altered levels of thyroid hormone binding globulin (TBG). In the remainder of patients it is necessary to decide whether subtle hypo- or hyperthyroidism exists or whether the abnormal values are somehow spurious. In spite of the ready availability of assays of serum triiodothyronine (T3) and thyrotropin (TSH), and of the ability to test the pituitary-thyroid axis by assessing the response of TSH to thyrotropin releasing hormone (TRH) stimulation, the diagnosis of subtle hypo- or hyperthyroidism is still a problem in clinical endocrinology. This review will consider the new insight into thyroid hormone physiology gained by studies of peripheral metabolism of thyroid hormones during the last ten years and discuss the problems of interpretation of thyroid function tests.",
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