Should the TSH test be utilized in the diagnostic confirmation of suspected hypothyroidism?

Med Hypotheses. 2010 Nov;75(5):458-63. doi: 10.1016/j.mehy.2010.04.024. Epub 2010 May 14.


Hypothyroidism is an insidious disease that manifests a great number of non-specific symptoms. The prompt, accurate diagnosis of hypothyroidism will improve the quality of life for patients while controlling healthcare costs. Therefore, it is crucial that the protocol for diagnosing hypothyroidism has been properly evaluated. Its methods must be the best available to ensure that the resulting diagnoses will be as reliable as possible. When a patient presents with signs and symptoms of hypothyroidism and a medical history indicating hypothyroidism, a TSH test result is frequently utilized to assist in the diagnostic confirmation of hypothyroidism. In these circumstances, not only is performing the TSH test a waste of resources, utilizing the result will lead to a decrease in diagnostic certainty. The TSH test should not be utilized in the diagnostic confirmation of hypothyroidism because the diagnostic accuracy of the TSH test in confirming hypothyroidism is unknown, several aspects of the TSH test indicate its poor diagnostic utility and thyroid hormone trial therapy is the best method for achieving diagnostic certainty. Diagnostic confirmation of suspected hypothyroidism should be accomplished by evaluating the patient's response to a trial administration of thyroid hormone supplements. If the patient's chronic symptoms are relieved soon after beginning thyroid hormone supplements, it is very likely that the treatment is compensating for hypothyroidism.

MeSH terms

  • Humans
  • Hypothyroidism / diagnosis*
  • Sensitivity and Specificity
  • Thyrotropin / blood*


  • Thyrotropin