Thyroid-Stimulating Hormone (TSH) May 29, 2006 Join Now Sign In Bookmark This Page About the WebMD

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Test Overview Why It Is Done

How To Prepare How It Is Done How It Feels Risks Results What Affects the Test What To Think About Credits

Thyroid-Stimulating Hormone (TSH) Test Overview A thyroid-stimulating hormone (TSH) blood test is used to detect problems affecting the thyroid gland. TSH is produced when the hypothalamus releases a substance called thyrotropin-releasing hormone (TRH). TRH then triggers the pituitary gland to release TSH. See an illustration of the thyroid gland and the pituitary gland. TSH causes the thyroid gland to produce two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body's metabolism. Triiodothyronine (T3) and thyroxine (T4) are needed for normal development of the brain, especially during the first 3 years of life. An infant whose thyroid gland does not produce enough thyroid hormone (congenital hypothyroidism) may, in severe cases, become mentally retarded. Older children also need thyroid hormones to grow and develop normally. This test may be done at the same time as tests to measure T3 and T4. Why It Is Done A test for thyroid-stimulating hormone (TSH) is done to: Determine whether the thyroid gland is functioning properly. An underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods. An overactive thyroid (hyperthyroidism) can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods. Determine the cause of an underactive thyroid gland (hypothyroidism). TSH levels can help determine whether hypothyroidism is due to a damaged thyroid gland or some other cause (such as a problem with the pituitary gland or the hypothalamus). Monitor treatment with thyroid replacement medications for people who have hypothyroidism. Monitor thyroid gland function in people who are being treated for hyperthyroidism. This treatment may include antithyroid medications, surgery, or radiation therapy. Confirm the diagnosis of an underactive thyroid gland in a newborn (congenital hypothyroidism). How To Prepare Inform your doctor if you have recently (within 4 to 6 weeks) had any tests in which you were given radioactive materials or had X-rays that used iodine dye. Receiving iodine contrast material prior to a thyroid-stimulating hormone (TSH) test can affect the test results. How It Is Done

The health professional drawing blood will: Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein. Clean the needle site with alcohol. Put the needle into the vein. More than one needle stick may be needed. Attach a tube to the needle to fill it with blood. Remove the band from your arm when enough blood is collected. Apply a gauze pad or cotton ball over the needle site as the needle is removed. Apply pressure to the site and then a bandage. How It Feels You may feel nothing at all from the needle puncture, or you may feel a brief sting or pinch as the needle goes through the skin. Some people feel a stinging pain while the needle is in the vein. However, many people do not feel any pain (or have only minor discomfort) once the needle is positioned in the vein. The amount of pain you feel depends on the skill of the health professional drawing the blood, the condition of your veins, and your sensitivity to pain. Risks Risks of a blood test There is very little risk of complications from having blood drawn from a vein. You may develop a small bruise at the puncture site. You can reduce the risk of bruising by keeping pressure on the site for several minutes after the needle is withdrawn. Rarely, the vein may become inflamed after the blood sample is taken. This condition is called phlebitis and is usually treated with a warm compress applied several times daily. Continued bleeding can be a problem for people with bleeding disorders. Aspirin, warfarin (Coumadin), and other blood-thinning medications can also make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medication, tell your health professional before your blood is drawn. Results A thyroid-stimulating hormone (TSH) blood test is used to detect problems affecting the thyroid gland. Results of a thyroid-stimulating hormone (TSH) test are usually available within several days. Normal Thyroid-stimulating hormone (TSH) Newborns:3 20 milli-international units per liter (mIU/L) Adults:0.4 4.5 mIU/L The normal ranges for the results of this test may vary from laboratory to laboratory. High values A high thyroid-stimulating hormone (TSH) test result often indicates an underactive thyroid gland caused by failure of the thyroid gland (primary hypothyroidism). Hashimoto's thyroiditis is the most common cause of primary hypothyroidism. On rare occasions, a high TSH value can occur from a pituitary gland tumor that is producing excess amounts of TSH. In this case, the person usually has symptoms of hyperthyroidism such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods. Other thyroid hormone test results will likely be high as well. A high TSH value can also occur in people who have an underactive thyroid gland and are receiving too little thyroid hormone medication.

Low values A low thyroid-stimulating hormone (TSH) value can indicate an overactive thyroid gland (hyperthyroidism). Causes of hyperthyroidism include Graves' disease, a type of goiter (multinodular goiter), or a noncancerous (benign) tumor called a toxic nodule. A low TSH value can also indicate damage to the pituitary gland that prevents it from producing TSH (secondary hypothyroidism). In this case, the person usually has symptoms of hypothyroidism such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods. A low TSH value can occur in people who have an underactive thyroid gland and are receiving too much thyroid hormone medication. What Affects the Test Factors that can interfere with your test and the accuracy of the results include: Medications, such as corticosteroids, levodopa, aspirin, heparin, dopamine, lithium (such as Carbolith, Duralith, Lithane), methimazole (Tapazole), and propylthiouracil. Recent X-rays with iodine dye or tests using radioactive materials. Severe stress or long-term (chronic) illness. The first trimester of pregnancy. What To Think About The thyroid-stimulating hormone (TSH) test is the best screening test for conditions that can affect the thyroid gland. The results of a TSH test should be considered along with the results of thyroid hormone tests, especially thyroxine (T4) results. For more information about T3 and T4 testing, see the medical test Thyroid Hormone Tests. Another test that measures TSH levels in the blood is called the thyrotropin-releasing hormone (TRH) challenge test. TSH blood levels are measured before and after an injection of TRH. Normally the injection causes the pituitary gland to release TSH. TSH levels that do not rise after the injection can indicate the presence of conditions such as a damaged pituitary gland (secondary hypothyroidism), Graves' disease, or any condition that causes an overactive thyroid gland (hyperthyroidism). Credits Author Jan Nissl, RN, BS Editor Susan Van Houten, RN, BSN, MBA Associate Editor Tracy Landauer Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine Specialist Medical Reviewer David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism Last Updated August 27, 2004 To Health Guide A-Z back to the top Thyroid-Stimulating Hormone (TSH) Previous Last updated: August 27, 2004 Print-Friendly Version

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