Thyroid Stimulating Hormone (TSH)
Medical Test

Diseases (205)
Screening/Initial Testing (37)
Diagnostic Testing (119)
Parkinson's disease
9
Note: Rule out thyroid disorders.
Seizure
8
Note:
Alcoholic fatty liver
7
Note: Evaluate for thyroid disorders
Alopecia
7
Note:
Amenorrhea
7
Note: Rule out thyroid disease.
Chronic fatigue syndrome (Fibromyalgia)
7
Note: Rule out thyroid disease.
Coma
7
Note:
Diabetes mellitus type 1
7
Note: Rule out thyroid disease.
Epilepsy
7
Note:
Familial hypercholesterolemia
7
Note: Rule out secondary cause of hypercholesterolemia.
Familial hypobetalipoproteinemia
7
Note: Evaluate for hypothyroidism
Gestational trophoblastic disease
7
Note: Evaluate for possible hyperthyroidism.
Hypercholesterolemia
7
Note: Rule out secondary cause of hypercholesterolemia.
Hypogammaglobulinemia
7
Note: Rule out autoimmune thyroid disease.
Idiopathic thrombocytopenic purpura
7
Note: If symptoms of hypo-or hyperthyroidism are present.
Jaundice
7
Note:
Multiple endocrine neoplasia, type II
7
Note: Rule out thyroid disorders.
Myasthenia gravis
7
Note: Rule out thyroid disease.
Obstructive sleep apnea
7
Note: Rule out hypothyroidism.
Osteoporosis
7
Note: Rule out thyroid disease as etiology of osteoporosis.
Polycystic ovary syndrome
7
Note: Rule out hypothyroidism.
Polymyalgia rheumatica
7
Note: Rule out Hypothyroidism.
Pregnancy without complications
7
Note: Rule out thyroid disease.
Primary fibromyalgia syndrome
7
Note: Rule out thyroid disease if symptoms of thyroid diseases are present.
Whipple's disease
7
Note: R/O hyperthyroidism
Adrenal hypofunction
6
Note: Rule out thyroid disease.
Anemia, NOS
6
Note: Rule out anemia due to hypothyroidism.
Atrophic gastritis
6
Note: Rule out thyroid related diseases.
Chronic gastritis
6
Note: Rule out thyroid related diseases.
Essential (primary) hypertension
6
Note: R/O hypothyroidism as a cause of secondary hypertension
Huntington disease
6
Note: If genetic testing for HD is negative test to rule out thyroid disorders.
Insomnia
6
Note:
Malabsorption
6
Note: Rule out thyroid disease.
Multifactorial encephalopathy
6
Note: Rule out thyroid diseases.
Protein losing enteropathy
6
Note: Rule out thyroid diseases.
Raynaud's disease
6
Note: R/O Hypothyroidism
Secondary hyperaldosteronism
6
Note: Rule out thyroid disease.
Autoimmune hemolytic anemia
5
Note: Rule out thyroid disease.
Myelodysplastic syndrome
5
Note: Rule out hypothyroidism.
Disease Management Testing (29)
Other Supportive/Alternative Tests (20)

Overview

Thyroid stimulating hormone (TSH) is a glycoprotein hormone produced by the anterior pituitary gland, which stimulates the thyroid gland to produce thyroid hormones. Secretion is stimulated by thyroid-releasing hormone from the hypothalamus. Free thyroid hormones (FT4 and FT3) work in a negative feedback loop to regulate the amount of TSH that is released from the pituitary gland. Dysregulation of TSH may either be a primary or secondary condition causing either hypo- or hyperthyroidism. Although thyroid issues are seen at all ages, onset is usually seen in the late 40s or early 50s, and affects females almost four times more often than males.

An elevated TSH result usually means an underactive thyroid (hypothyroidism), whereas a decreased result means an overactive thyroid gland (hyperthyroidism) or excessive amounts of thyroid medication in an individual being treated for hypothyroidism. Measurement of serum TSH is the best initial laboratory test of thyroid function. If TSH levels are abnormal, free thyroxine (FT3) should then be measured. Also, measurement of anti-thyroperoxidase antibody should be done if the TSH level is high.

Clinical Utility

  • Screening for Thyroid Dysfunction
  • Diagnosis of Hyperthyroidism (Decreased TSH)
  • Diagnosis of Hypothyroidism (Elevated TSH)
  • Monitoring thyroid hormone replacement therapy
  • Monitoring anti-thyroid therapy (in hyperthyroidism)
  • Monitoring thyroid cancer patients taking thyroxine

Interpretation

Increased in:

  • Primary Hypothyroidism
  • Mild increase in subclinical hypothyroidism, which is defined as a mild increase in serum TSH and normal free thyroxine and triiodothyronine levels
  • Hashimoto's thyroiditis patients who are euthyroid
  • Ectopic TSH secretion in certain cancers (lung, breast).
  • Recovery phase of subacute thyroiditis
  • Recovery phase of a non-thyroidal illness
  • Thyroid hormone resistance

Decreased in:

  • Primary Hyperthyroidism
  • Secondary (pituitary) hypothyroidism
  • Tertiary hypothyroidism
  • Graves disease
  • Thyroiditis
  • Toxic adenomas
  • Acute medical or surgical illness
  • Some drugs such as dopamine
  • High-dose corticosteroids
  • Mild decrease in subclinical hyperthyroidism (mild decrease in serum TSH and normal free thyroxine and triiodothyronine levels, as in treated Graves disease, toxic multinodular goiter, autonomous thyroid hormone secretion, exogenous thyroid hormone therapy)
  • Euthyroid sick syndrome

Reference Ranges

Group uU/mL or mU/L
Premature Infants / Children
Premature infants (28–36 wk gestation) 0.7–27
1–4 days 1.0–39
2–20 wk 1.7–9.1
5 mo–20 yr 0.7–6.4
Adults
21–54 yr 0.4–4.2
55–87 yr 0.5–8.9
Pregnancy
First trimester 0.3–4.5
Second trimester 0.5–4.6
Third trimester 0.8–5.2

Methodology

Chemiluminescent immunoassay, enzyme immunoassay, enzyme-linked immunosorbent assay (ELISA).

Specimen Collection

Serum (SST). 

Stability

  • Ambient: 3-5 days
  • Refrigerated: 5-7 days
  • Frozen: 2 months

Additional Testing

Free Thyroxine (Free T4), Total Thyroxine (T4 total), Thyroid stimulating immunoglobulin, Thyroid peroxidase antibody (TPO antibody), Thyroid Stimulating Hormone Receptor Antibody, Thyroglobulin Antibody.

CPT
84443$16.8

ICD10
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Showing results for all states.
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ICD10 CODE AND DESCRIPTIONLCD CODENCD CODE
A04.9 - Bacterial intestinal infection, unspecified——
A07.1 - Giardiasis [lambliasis]——
A08 - Viral and other specified intestinal infections——
A09 - Infectious gastroenteritis and colitis, unspecified——
A15 - Respiratory tuberculosis——
A15.0 - Tuberculosis of lung——
A18 - Tuberculosis of other organs——
A18.7 - Tuberculosis of adrenal glands——
A23 - Brucellosis——
A33 - Tetanus neonatorum——
A34 - Obstetrical tetanus——
A35 - Other tetanus——
A36.81 - Diphtheritic cardiomyopathy——
A37 - Whooping cough——
A37.0 - Whooping cough due to Bordetella pertussis——
A39.1 - Waterhouse-Friderichsen syndrome——
A41 - Other sepsis——
A41.8 - Other specified sepsis——
A41.9 - Sepsis, unspecified organism——
A49 - Bacterial infection of unspecified site——
A49.9 - Bacterial infection, unspecified——
A51.32 - Syphilitic alopecia——
A69.20 - Lyme disease, unspecified——
A69.22 - Other neurologic disorders in Lyme disease——
A81.0 - Creutzfeldt-Jakob disease——
A81.00 - Creutzfeldt-Jakob disease, unspecified——
A81.09 - Other Creutzfeldt-Jakob disease——
A87.9 - Viral meningitis, unspecified——
B00.9 - Herpesviral infection, unspecified——
B02.21 - Postherpetic geniculate ganglionitis——
B02.22 - Postherpetic trigeminal neuralgia——
B02.23 - Postherpetic polyneuropathy——
B15.0 - Hepatitis A with hepatic coma——
B16 - Acute hepatitis B——
B16.9 - Acute hepatitis B without delta-agent and without hepatic coma——
B17 - Other acute viral hepatitis——
B17.1 - Acute hepatitis C——
B17.10 - Acute hepatitis C without hepatic coma——
B17.11 - Acute hepatitis C with hepatic coma——
B18 - Chronic viral hepatitis——
B18.1 - Chronic viral hepatitis B without delta-agent——
B18.2 - Chronic viral hepatitis C——
B18.8 - Other chronic viral hepatitis——
B18.9 - Chronic viral hepatitis, unspecified——
B19 - Unspecified viral hepatitis——
B19.0 - Unspecified viral hepatitis with hepatic coma——
B19.11 - Unspecified viral hepatitis B with hepatic coma——
B19.2 - Unspecified viral hepatitis C——
B19.20 - Unspecified viral hepatitis C without hepatic coma——
B19.21 - Unspecified viral hepatitis C with hepatic coma——

Additional ICD10
  • AK - Alaska
  • AL - Alabama
  • AR - Arkansas
  • AS - American Samoa
  • AZ - Arizona
  • CA - California - Entire State
  • CO - Colorado
  • CT - Connecticut
  • DC - District of Columbia
  • DE - Delaware
  • FL - Florida
  • GA - Georgia
  • GU - Guam
  • HI - Hawaii
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  • ID - Idaho
  • IL - Illinois
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  • KY - Kentucky
  • LA - Louisiana
  • MA - Massachusetts
  • MD - Maryland
  • ME - Maine
  • MI - Michigan
  • MN - Minnesota
  • MO - Missouri - Entire State
  • MS - Mississippi
  • MT - Montana
  • NC - North Carolina
  • ND - North Dakota
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  • NY - New York - Entire State
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  • UT - Utah
  • VA - Virginia
  • VI - Virgin Islands
  • VT - Vermont
  • WA - Washington
  • WI - Wisconsin
  • WV - West Virginia
  • WY - Wyoming
  • CNMI - Northern Mariana Islands
  • EM - Missouri - Northeastern & Southern
  • WM - Missouri - Northwestern
  • DN - New York - Downstate
  • QN - New York - Queens
  • UN - New York - Upstate
  • NF - California - Northern
  • SF - California - Southern
Showing results for all states.
Filter:
ICD10 CODE AND DESCRIPTIONLCD CODENCD CODE
A06.5 - Amebic lung abscess——
A08.0 - Rotaviral enteritis——
A08.1 - Acute gastroenteropathy due to Norwalk agent and other small round viruses——
A08.11 - Acute gastroenteropathy due to Norwalk agent——
A08.19 - Acute gastroenteropathy due to other small round viruses——
A08.2 - Adenoviral enteritis——
A08.3 - Other viral enteritis——
A08.31 - Calicivirus enteritis——
A08.32 - Astrovirus enteritis——
A08.39 - Other viral enteritis——
A08.4 - Viral intestinal infection, unspecified——
A08.8 - Other specified intestinal infections——
A15.0 - Tuberculosis of lung——
A15.4 - Tuberculosis of intrathoracic lymph nodes——
A15.5 - Tuberculosis of larynx, trachea and bronchus——
A15.6 - Tuberculous pleurisy——
A15.7 - Primary respiratory tuberculosis——
A15.8 - Other respiratory tuberculosis——
A15.9 - Respiratory tuberculosis unspecified——
A18.0 - Tuberculosis of bones and joints——
A18.01 - Tuberculosis of spine——
A18.02 - Tuberculous arthritis of other joints——
A18.03 - Tuberculosis of other bones——
A18.09 - Other musculoskeletal tuberculosis——
A18.1 - Tuberculosis of genitourinary system——
A18.10 - Tuberculosis of genitourinary system, unspecified——
A18.11 - Tuberculosis of kidney and ureter——
A18.12 - Tuberculosis of bladder——
A18.13 - Tuberculosis of other urinary organs——
A18.14 - Tuberculosis of prostate——
A18.15 - Tuberculosis of other male genital organs——
A18.16 - Tuberculosis of cervix——
A18.17 - Tuberculous female pelvic inflammatory disease——
A18.18 - Tuberculosis of other female genital organs——
A18.2 - Tuberculous peripheral lymphadenopathy——
A18.3 - Tuberculosis of intestines, peritoneum and mesenteric glands——
A18.31 - Tuberculous peritonitis——
A18.32 - Tuberculous enteritis——
A18.39 - Retroperitoneal tuberculosis——
A18.4 - Tuberculosis of skin and subcutaneous tissue——
A18.5 - Tuberculosis of eye——
A18.50 - Tuberculosis of eye, unspecified——
A18.51 - Tuberculous episcleritis——
A18.52 - Tuberculous keratitis——
A18.53 - Tuberculous chorioretinitis——
A18.54 - Tuberculous iridocyclitis——
A18.59 - Other tuberculosis of eye——
A18.6 - Tuberculosis of (inner) (middle) ear——
A18.7 - Tuberculosis of adrenal glands——
A18.8 - Tuberculosis of other specified organs——

References

  • Am Fam Physician. 2005;72:623. [PMID: 16127951]
  • Lancet. 2003 Aug 9;362(9382):459-68. [PMID: 12927435]
  • Eur Rev Med Pharmacol Sci. 2009 Sep-Oct;13(5):341-9. [PMID: 19961039]
  • Exp Clin Endocrinol Diabetes. 1998;106 Suppl 4:S29-33. [PMID: 9867193]
  • Horm Res. 1996;45(3-5):142-7. [PMID: 8964573]
  • Am Fam Physician. 2005;72:1517. [PMID: 16273818]
  • Clin Chem. 2005;51:1480. [PMID: 15961550]
  • Eur J Endocrinol. 2006;154:633. [PMID: 16645008]
  • Alan Wu. Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders; 4 edition (June 13, 2006). ISBN-10: 0721679757