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Cleve Clin J Med. 2010 Nov;77(11):803-11. doi: 10.3949/ccjm.77a.10056.

Approach to a low TSH level: patience is a virtue.

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1
Endocrinology and Metabolism Institute, F20, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. pantalk@ccf.org

Abstract

Confronted with a low serum level of thyrotropin (thyroid-stimulating hormone, TSH), physicians should not jump to the conclusion that it is due to a hyperthyroid state, as other conditions and some drugs can be associated with a TSH level that is slightly low (0.1-0.4 microIU/mL) or frankly suppressed (< 0.1 microIU/mL). This review discusses how to approach a low TSH, stressing the frequent need to reassess thyroid function before making a diagnosis, the underlying processes and the drugs that can be responsible, and the degree of TSH suppression and its role in the evaluation.

PMID:
21048053
DOI:
10.3949/ccjm.77a.10056
[Indexed for MEDLINE]
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