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TSH (Ultra Sensitive)

TEST: 000457
CPT: 84443
Cash Price: $100.00

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TSH stands for Thyroid Stimulating Hormone. It is a hormone produced by the pituitary gland in the brain that stimulates the thyroid gland to produce thyroid hormones.

The ultra-sensitive TSH test is a blood test that measures the level of TSH in the blood. It is more sensitive than the standard TSH test and can detect even small changes in TSH levels. The ultra-sensitive TSH test is often used to diagnose and monitor thyroid disorders, such as hypothyroidism (an underactive thyroid) and hyperthyroidism (an overactive thyroid).

Normal TSH levels can vary depending on the laboratory and the assay used for the test, but typically fall between 0.4 and 4.0 milli-international units per liter (mIU/L). However, in some cases, a TSH level slightly above or below this range may be considered normal, depending on the individual’s age, gender, and other factors.

If your ultra-sensitive TSH level is higher than normal, it may indicate an underactive thyroid gland, while a lower-than-normal level may indicate an overactive thyroid gland. Your healthcare provider will interpret your test results in the context of your medical history and symptoms to determine the appropriate next steps.

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

1 mL

Minimum Volume

0.7 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. Do not use oxalate, EDTA, or citrate plasma.

Collection

If a red-top tube or plasma is used, transfer separated serum or plasma to a plastic transport tube.

Storage Instructions

Room temperature

Stability Requirements

Temperature Period
Room temperature 14 days
Refrigerated 14 days
Frozen 14 days
Freeze/thaw cycles Stable x3

Causes for Rejection

Citrate plasma specimen; improper labeling

Test Details

Use

The ultra-sensitive TSH test is primarily used to diagnose and monitor thyroid disorders, particularly hypothyroidism (an underactive thyroid) and hyperthyroidism (an overactive thyroid). It is often used in conjunction with other thyroid function tests, such as free T4 (thyroxine) and T3 (triiodothyronine), to help determine the underlying cause of a thyroid disorder and to guide treatment decisions. The ultra-sensitive TSH test can also be used to monitor treatment for thyroid disorders, such as adjusting the dosage of thyroid hormone replacement therapy for hypothyroidism or monitoring the effectiveness of medications or radiation therapy for hyperthyroidism. In addition, the ultra-sensitive TSH test may be ordered as part of a routine checkup to screen for thyroid dysfunction in individuals who are at increased risk, such as those with a family history of thyroid disease or autoimmune disorders. Overall, the ultra-sensitive TSH test is a valuable tool in the diagnosis and management of thyroid disorders and can help healthcare providers ensure that their patients receive appropriate treatment and monitoring.

Limitations

While the ultra-sensitive TSH test is a valuable tool in the diagnosis and monitoring of thyroid disorders, there are several limitations to consider:

  1. False results: The ultra-sensitive TSH test may produce false results in certain situations. For example, certain medications, such as corticosteroids or dopamine, can interfere with the accuracy of the test. Additionally, conditions such as pregnancy or non-thyroidal illness may also affect TSH levels, leading to inaccurate results.
  2. Lack of specificity: While the ultra-sensitive TSH test is highly sensitive, it may not be as specific as other thyroid function tests in identifying the underlying cause of a thyroid disorder. In some cases, additional tests may be necessary to determine whether an individual has hypothyroidism or hyperthyroidism.
  3. Normal range variation: The normal range for TSH levels can vary depending on the laboratory and the specific assay used for the test. This means that an individual’s TSH level may be considered normal in one laboratory but abnormal in another, leading to confusion or misinterpretation of results.
  4. Limited utility in certain cases: The ultra-sensitive TSH test may not be as useful in certain situations, such as in the diagnosis of subclinical hypothyroidism, which is characterized by mildly elevated TSH levels but normal thyroid hormone levels. In these cases, other tests, such as measurement of thyroid antibodies, may be necessary to confirm the diagnosis.

In summary, while the ultra-sensitive TSH test is a valuable tool in the diagnosis and management of thyroid disorders, it is important to consider its limitations and interpret results in the context of an individual’s medical history and other thyroid function tests.

 

Methodology

The ultra-sensitive TSH test is a laboratory blood test that uses an immunoassay methodology to measure the level of TSH in the blood. Immunoassay is a technique that uses antibodies to detect and measure specific substances in the blood. The ultra-sensitive TSH test typically uses a two-site chemiluminescent immunoassay (CLIA) or an electrochemiluminescent immunoassay (ECLIA) methodology. These methods involve the use of antibodies that are specific to TSH and a chemical reaction that produces light when the antibody binds to TSH. In the CLIA method, two antibodies are used, one that is attached to a solid surface and the other that is labeled with a chemical that produces light. When TSH in the blood sample binds to the antibody on the solid surface, the labeled antibody binds to the TSH, producing light. The amount of light produced is proportional to the amount of TSH in the blood. The ECLIA method is similar to the CLIA method, but uses a different type of label that produces an electrical signal instead of light. In this method, a current is passed through the labeled antibody when it binds to TSH, producing an electrical signal that is measured and used to determine the level of TSH in the blood. Both the CLIA and ECLIA methods are highly sensitive and specific, allowing for accurate measurement of TSH levels even in very small quantities. The results of the ultra-sensitive TSH test are reported as the level of TSH in milli-international units per liter (mIU/L) of blood.

Reference Interval

See table.1

Age Range (μIU/mL)
0 to 6 d 0.700−15.200
7 d to 3 m 0.720−11.000
3 m 1 d to 12 m 0.730−8.350
1 to 5 y 0.700−5.970
6 to 10 y 0.600−4.840
>10 y 0.450−4.500

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Component Name
00457 TSH 11580-8 00457 Thyrotropin

© 2023 Brio Clinical, Inc. All Rights Reserved.

Copyright © 2022 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright © 1995-2023, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. See https://loinc.org/license for the full LOINC copyright and license.

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