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Journal Article
Whose normal thyroid function is better—yours or mine?
2002
Overview
The answer is, yes, to a limited extent (panel). A typical (statistical) reference range for thyroid-stimulating hormone (TSH) in many laboratories is around 0.2-5.5 mU/L. However, the 20-year longitudinal Whickham survey indicated that individuals with TSH values greater than 2.0 mU/L have an increased risk of developing overt hypothyroidism over the next 20 years.6 Subclinical autoimmune thyroid disease is so common in the population (up to 40% of women have lymphocytic infiltration of the thyroid and 10-15% have thyroid autoantibodies?) that laboratory reference ranges derived from testing apparently healthy subjects could easily be contaminated by diseased individuals. Indeed, if only individuals negative for antibodies against thyroid peroxidase and with no personal history of thyroid disease are tested, 95% of TSH values lie within 0.48-3.60,8 and the US National Academy of Clinical Biochemistry (NACB) recommends the use of such a revised normal range. Importantly, several studies have detected an increase in thyroid peroxidase antibody positivity with TSH concentrations outside the narrow range 0-2-1-9 mU/L,84 providing evidence that TSH in the upper reference range is often associated with abnormal pathology in the thyroid.
Publisher
Elsevier Ltd,Elsevier Limited
Subject
