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
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.
Bloom syndrome
6
Note: Rule out hypothyroidism.
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$16.8

ICD10
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Showing results for all states.
Filter:
ICD10 CODE AND DESCRIPTIONLCD CODENCD CODE
A08 - Viral and other specified intestinal infections——
A18.7 - Tuberculosis of adrenal glands——
A23 - Brucellosis——
A35 - Other tetanus——
A36.81 - Diphtheritic cardiomyopathy——
A37 - Whooping cough——
A37.0 - Whooping cough due to Bordetella pertussis——
A41 - Other sepsis——
A41.9 - Sepsis, unspecified organism——
A49 - Bacterial infection of unspecified site——
A51.32 - Syphilitic alopecia——
A81.0 - Creutzfeldt-Jakob disease——
A81.00 - Creutzfeldt-Jakob disease, unspecified——
B00.9 - Herpesviral infection, unspecified——
B02 - Zoster [herpes zoster]——
B02.23 - Postherpetic polyneuropathy——
B15.0 - Hepatitis A with hepatic coma——
B17 - Other acute viral hepatitis——
B17.1 - Acute hepatitis C——
B17.11 - Acute hepatitis C with hepatic coma——
B18 - Chronic viral hepatitis——
B18.2 - Chronic viral hepatitis C——
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——
B33.24 - Viral cardiomyopathy——
B34 - Viral infection of unspecified site——
B34.9 - Viral infection, unspecified——
B37 - Candidiasis——
B37.1 - Pulmonary candidiasis——
B37.7 - Candidal sepsis——
B37.9 - Candidiasis, unspecified——
B59 - Pneumocystosis——
B82 - Unspecified intestinal parasitism——
B89 - Unspecified parasitic disease——
B96.81 - Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere——
C24 - Malignant neoplasm of other and unspecified parts of biliary tract——
C24.9 - Malignant neoplasm of biliary tract, unspecified——
C25 - Malignant neoplasm of pancreas——
C25.4 - Malignant neoplasm of endocrine pancreas——
C25.9 - Malignant neoplasm of pancreas, unspecified——
C26.0 - Malignant neoplasm of intestinal tract, part unspecified——
C26.9 - Malignant neoplasm of ill-defined sites within the digestive system——
C34 - Malignant neoplasm of bronchus and lung——
C44 - Other and unspecified malignant neoplasm of skin——
C48 - Malignant neoplasm of retroperitoneum and peritoneum——
C48.0 - Malignant neoplasm of retroperitoneum——

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
  • IA - Iowa
  • ID - Idaho
  • IL - Illinois
  • IN - Indiana
  • KS - Kansas
  • 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
  • NE - Nebraska
  • NH - New Hampshire
  • NJ - New Jersey
  • NM - New Mexico
  • NV - Nevada
  • NY - New York - Entire State
  • OH - Ohio
  • OK - Oklahoma
  • OR - Oregon
  • PA - Pennsylvania
  • PR - Puerto Rico
  • RI - Rhode Island
  • SC - South Carolina
  • SD - South Dakota
  • TN - Tennessee
  • TX - Texas
  • 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——
A23.0 - Brucellosis due to Brucella melitensis——
A23.1 - Brucellosis due to Brucella abortus——
A23.2 - Brucellosis due to Brucella suis——
A23.3 - Brucellosis due to Brucella canis——
A23.8 - Other brucellosis——
A23.9 - Brucellosis, unspecified——
A36.81 - Diphtheritic cardiomyopathy——
A37.0 - Whooping cough due to Bordetella pertussis——
A37.00 - Whooping cough due to Bordetella pertussis without pneumonia——
A37.01 - Whooping cough due to Bordetella pertussis with pneumonia——
A37.1 - Whooping cough due to Bordetella parapertussis——
A37.10 - Whooping cough due to Bordetella parapertussis without pneumonia——
A37.11 - Whooping cough due to Bordetella parapertussis with pneumonia——
A37.8 - Whooping cough due to other Bordetella species——
A37.80 - Whooping cough due to other Bordetella species without pneumonia——
A37.81 - Whooping cough due to other Bordetella species with pneumonia——
A37.9 - Whooping cough, unspecified species——
A37.90 - Whooping cough, unspecified species without pneumonia——
A37.91 - Whooping cough, unspecified species with pneumonia——
A41.0 - Sepsis due to Staphylococcus aureus——
A41.01 - Sepsis due to Methicillin susceptible Staphylococcus aureus——
A41.02 - Sepsis due to Methicillin resistant Staphylococcus aureus——
A41.1 - Sepsis due to other specified staphylococcus——
A41.2 - Sepsis due to unspecified staphylococcus——
A41.3 - Sepsis due to Hemophilus influenzae——
A41.4 - Sepsis due to anaerobes——
A41.5 - Sepsis due to other Gram-negative organisms——
A41.50 - Gram-negative sepsis, unspecified——
A41.51 - Sepsis due to Escherichia coli [E. coli]——
A41.52 - Sepsis due to Pseudomonas——
A41.53 - Sepsis due to Serratia——
A41.54 - ——
A41.59 - Other Gram-negative sepsis——
A41.8 - Other specified sepsis——
A41.81 - Sepsis due to Enterococcus——
A41.89 - Other specified sepsis——
A41.9 - Sepsis, unspecified organism——

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