Waqar Azim, Asif Ali, Saad Azim.
Rational thyroid screening by Thyroid Stimulating Hormone assay.
Biomedica Jan ;24(2):89-91.

Serum thyroid stimulating hormone (TSH) estimation is an ideal investigation for thyroid disease. It gives most comprehensive information about whether a patient has a thyroid disease and what is the cause. It has been frequently observed in clinical settings that complete profile of thyroid function tests is advised for screening and vague symptoms. Aims and objectives of current study were to assess the usefulness of TSH alone as a screening tool of thyroid disease. It also evaluated the extra information generated by analysing ft3 and fT4 during screening. It was a prospective comparative cross sectional study. Adult patients referred for routine thyroid disease were selected for study. Their history was taken and detailed clinical examination was carried out. FT3, fT4 and TSH were analysed by chemiluminescence immunoassay. Results revealed that in 100% cases with normal TSH, fT3 and fT4 remained normal. Likewise in 107 cases with normal fT3 and fT4, TSH was abnormal leading to the diagnosis of sub-clinical hypothyroidism in 82 cases and sub-clinical hyperthyroidism in 25 cases. In a total of 213 abnormal TSH cases fT3 was abnormal 19 and fT4 was abnormal in 87. It was concluded that in cases with normal TSH levels there is no need of fT3 and fT4. Only patients with abnormal TSH merit detailed evaluation.

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