Common Diagnostic Tests in Thyroid Disorders

Thyroid-stimulating hormone (TSH)

  • Most sensitive test to detect 1° hypo- and hyperthyroidism. Used as primary screening test for thyroid disease. ↓’d by dopamine, glucocorticoids, severe illness, excessive biotin. May not be helpful in central hypothyroidism.

Free T4 (fT4)

Unbound T4, not influenced by TBG. Checked in a variety of thyroid states including hyperthyroidism & central hypothyroidism

Total T3

Total serum concentrations of T3 (liothyronine). Useful when evaluating for hyperthyroidism.

Antithyroid peroxidase Ab (anti-TPO)

Antithyroid peroxidase (TPO) seen in Hashimoto’s (high titer), painless subacute thyroiditis and Graves’ disease (low titer)