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Diagnostic Biomarker Profile

Thyroid Stimulating Hormone (TSH)

Concentration of Thyroid Stimulating Hormone (TSH) secreted by the anterior pituitary gland.

TSH stands for thyroid stimulating hormone . Another name for it is thyrotropin. A TSH test is a blood test that measures this hormone. A TSH level that is too high or too low may be a sign of a thyroid problem . The thyroid is a small, butterfly-shaped gland in the front of your neck. Your thyroid makes hormones that control how your body uses energy. Thyroid hormones affect nearly every organ and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and even your mood. If you don't have enough thyroid hormones in your blood, many of your body functions will slow down. But if you have too much, many body functions will speed up. Your thyroid is controlled by a gland in your brain called the pituitary gland. The pituitary gland makes thyroid-stimulating hormone (TSH). TSH tells your thyroid how much thyroid hormone it needs to make. If the thyroid hormone level in your blood is too low, your pituitary gland makes larger amounts of TSH to tell your thyroid to work harder. If your thyroid hormone level is too high, the pituitary gland makes little or no TSH. By measuring the TSH level in your blood, you can find out if your thyroid is making the right level of hormones. Other names: thyrotropin test, thyrotropic hormone

Why is this test ordered? You may need a TSH test if you have symptoms of too much or too little thyroid hormone in your blood. Hyperthyroidism is also called overactive thyroid. Having more thyroid hormones than you need speeds up your body functions and causes symptoms that can vary from person to person. The symptoms may include:: Weight loss, even though you may be eating more than usual Rapid or irregular heartbeat Feeling nervous or irritable Trouble sleeping Fatigue Shaky hands , muscle weakness Sweating or being very sensitive to heat Frequent bowel movements (pooping a lot) or diarrhea Goiter (enlarged thyroid that may cause your neck to look swollen) Adults over age 60 may have different symptoms than younger adults. For example, they may lose their appetite or withdraw from other people. Sometimes, this can be mistaken for depression or dementia . Hypothyroidism (too little thyroid hormone) is also called underactive thyroid. Not having enough thyroid hormone slows down your body functions and causes symptoms that can vary from person to person. The symptoms may include: Fatigue Weight gain Being very sensitive to cold Joint and muscle pain Dry skin Dry, thinning hair Heavy or irregular menstrual periods Fertility problems in women Depression Constipation Because hypothyroidism develops slowly, many people don't notice symptoms of the disease for months or even years. You may also have a TSH test and other tests to help diagnose unusual bumps or lumps on your thyroid. The tests will help your health care provider check for thyroid cancer or thyroid nodules (growths on your thyroid that aren't cancer).

Clinical Interpretation

Your TSH test results can tell you if your thyroid is making too much or too little hormones. But the test can't explain why your TSH levels may be too high or too low. If your test results aren't normal, your provider will probably order other thyroid blood tests to find out what's causing your thyroid problem. These blood tests may include: T4 thyroid hormone test T3 thyroid hormone test Thyroid antibodies test to help diagnose an autoimmune thyroid disorder, such as: Graves' disease, the most common cause of hyperthyroidism Hashimoto's disease, that the most common cause of hypothyroidism In certain cases, an abnormal TSH result may be a sign of a pituitary gland problem , but this doesn't happen often. Learn more about laboratory tests, reference ranges, and understanding results .

Medicare Coverage — diagnoses supporting medical necessity (NCD)

A18.81Tuberculosis of thyroid glandMedicare medical-necessity (NCD 190.22)C56.1Malignant neoplasm of right ovaryMedicare medical-necessity (NCD 190.22)C56.2Malignant neoplasm of left ovaryMedicare medical-necessity (NCD 190.22)C56.3Malignant neoplasm of bilateral ovariesMedicare medical-necessity (NCD 190.22)C56.9Malignant neoplasm of unspecified ovaryMedicare medical-necessity (NCD 190.22)C73Malignant neoplasm of thyroid glandMedicare medical-necessity (NCD 190.22)C75.8Malignant neoplasm with pluriglandular involvement, unspecifiedMedicare medical-necessity (NCD 190.22)C79.63Secondary malignant neoplasm of bilateral ovariesMedicare medical-necessity (NCD 190.22)C79.89Secondary malignant neoplasm of other specified sitesMedicare medical-necessity (NCD 190.22)C79.9Secondary malignant neoplasm of unspecified siteMedicare medical-necessity (NCD 190.22)D09.3Carcinoma in situ of thyroid and other endocrine glandsMedicare medical-necessity (NCD 190.22)D09.8Carcinoma in situ of other specified sitesMedicare medical-necessity (NCD 190.22)D27.0Benign neoplasm of right ovaryMedicare medical-necessity (NCD 190.22)D27.1Benign neoplasm of left ovaryMedicare medical-necessity (NCD 190.22)D27.9Benign neoplasm of unspecified ovaryMedicare medical-necessity (NCD 190.22)D34Benign neoplasm of thyroid glandMedicare medical-necessity (NCD 190.22)D35.2Benign neoplasm of pituitary glandMedicare medical-necessity (NCD 190.22)D35.3Benign neoplasm of craniopharyngeal ductMedicare medical-necessity (NCD 190.22)

Showing 18 of 1,404 diagnoses Medicare covers for this test under NCD 190.22. The complete list is in CMS's Lab NCD code list.

Clinical Protocol & Patient Advice

  • 1

    TSH levels exhibit diurnal variation, peak in the early morning, and are best measured early in the day.

  • 2

    Inform your clinician if you take biotin supplements, as biotin can interfere with thyroid lab assays.

  • 3

    You may need to stop taking certain medicines before this test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to. If your health care provider has ordered other blood tests, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions.

Usage Guidance

  • Different reference ranges apply to pregnant patients and the elderly.
  • Biotin doses above 5mg/day can lead to falsely low TSH results.
  • Reference ranges vary by laboratory. Always discuss your specific results with a qualified healthcare professional.

Source: MedlinePlus, National Library of Medicine. View the original.

Read from: MedlinePlus (NLM); reference ranges only where NIDDK, NIH ODS or NCI states the value, linked per page — Curated from federal sources. All data sources · How to read the labels