Test Code Billings Clinic: 4987 Mayo: STSH Thyroid-Stimulating Hormone-Sensitive (s-TSH), Serum
Reporting Name
TSH, Sensitive, SPerforming Laboratory
Mayo Clinic Laboratories in RochesterUseful For
Screening for thyroid dysfunction and detecting mild (subclinical), as well as overt, primary hypo- or hyperthyroidism in ambulatory patients
Monitoring patients on thyroid replacement therapy
Confirmation of thyrotropin (TSH, formerly thyroid-stimulating hormone) suppression in thyroid cancer patients on thyroxine suppression therapy
Prediction of thyrotropin-releasing hormone-stimulated TSH response
Method Name
Electrochemiluminescent Immunoassay
Ordering Guidance
This is a standalone test for sensitive thyrotropin (s-TSH; formerly thyroid-stimulating hormone).
If a cascade approach is preferred, order THSCM / Thyroid Function Cascade, Serum, which utilizes a cascaded testing procedure to efficiently evaluate and monitor functional thyroid status. Serum s-TSH is the first-line test and when the s-TSH result is abnormal, appropriate follow-up tests will automatically be performed.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Specimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 30 days | ||
Ambient | 7 days |
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | OK |
Gross icterus | OK |
Reference Values
0-5 days: 0.7-15.2 mIU/L
6 days-2 months: 0.7-11.0 mIU/L
3-11 months: 0.7-8.4 mIU/L
1-5 years: 0.7-6.0 mIU/L
6-10 years: 0.6-4.8 mIU/L
11-19 years: 0.5-4.3 mIU/L
≥20 years: 0.3-4.2 mIU/L
For SI unit Reference Values, see https://www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Interpretation
In primary hypothyroidism, thyrotropin (TSH, formerly thyroid-stimulating hormone) levels will be elevated. In primary hyperthyroidism, TSH levels will be low.
The ability to quantitate circulating levels of TSH is important in evaluating thyroid function. It is especially useful in the differential diagnosis of primary (thyroid) from secondary (pituitary) and tertiary (hypothalamus) hypothyroidism. In primary hypothyroidism, TSH levels are significantly elevated, while in secondary and tertiary hypothyroidism, TSH levels are low or normal.
Elevated or low TSH in the context of normal free thyroxine is often referred to as subclinical hypo- or hyperthyroidism, respectively.
Thyrotropin-releasing hormone (TRH) stimulation differentiates all types of hypothyroidism by observing the change in patient TSH levels in response to TRH. Typically, the TSH response to TRH stimulation is exaggerated in cases of primary hypothyroidism, absent in secondary hypothyroidism, and delayed in tertiary hypothyroidism. Most individuals with primary hyperthyroidism have TSH suppression and do not respond to TRH stimulation with an increase in TSH over their basal value.
Sick, hospitalized patients may have falsely low or transiently elevated TSH.
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 to 2 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84443
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
STSH | TSH, Sensitive, S | 11579-0 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
STSH | TSH, Sensitive, S | 11579-0 |
Testing Algorithm
See Thyroid Function Ordering Algorithm in Special Instructions.