Borderline Underactive Thyroid Going Undetected

(Sub-Biochemical Hypothyroidism)

From “Clinical Medicine and Research” journal Oct 2007 comes an article questioning the adequacy of the commonly used TSH  and T4 test in detecting hypothyroidism(underactive thyroid).

Researchers documented that an exaggerated TRH response indeed occurs in many subjects with a normal biochemistry, the giveaway being a high-normal TSH and a low-normal or even low FT4. They also suggested that the notion of an early “sub-biochemical” state of hypothyroidism may be plausible and needs further study. Even though the TRH test is seldom used in clinical practice at present, a larger prospective study is in order. Until then, physicians may once again need access to TRH for diagnostic use.

Ref TRH Stimulation When Basal TSH is Within the Normal Range: Is There “Sub-Biochemical” Hypothyroidism?

Suhail A.R. Doi, PhD, FRCP, Daisy Issac, MSc, Sheikha Abalkhail, MRCP, Marwa M. Al-Qudhaiby, MBBS, Mohamad F. Hafez, MBBS, and Kamal A. S. Al-Shoumer, PhD, FRCP Clinical Medicine and Research October 2007