Hyperthyroxinemia with non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum

Timmons, J. (2020) Hyperthyroxinemia with non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum. Hormones, 19(3), pp. 311-315. (doi: 10.1007/s42000-020-00180-3) (PMID:32128699)

Abstract

Disorders of thyroid function are among the commonest referrals to endocrinology. While interpretation of thyroid function testing is usually straightforward, accurate interpretation becomes significantly more challenging when the parameters do not behave as would be expected in normal negative feedback. In such cases, uncertainty regarding further investigation and management arises. An important abnormal pattern encountered in clinical practice is that of high normal or raised free thyroxine (fT4) with inappropriately non-suppressed or elevated thyroid-stimulating hormone (TSH). In this short review using two clinical vignettes, we examine the diagnostic approach in such cases. A diagnostic algorithm is proposed to ensure that a definitive diagnosis is reached in these challenging cases.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Timmons, Dr Joseph
• Authors: Timmons, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Hormones
• Publisher: Springer
• ISSN: 1109-3099
• ISSN (Online): 2520-8721
• Published Online: 03 March 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Hormones 19(3): 311-315
• Publisher Policy: Reproduced under a Creative Commons license