Is a TSH test to determine if you are hypothyroid necessary if you had T4 and T-uptake tests?
I was told by my 6 year old daughter's pediatrician that she was not hypothyroid after she ran tests. I called the nurse at the doctor's office a few minutes ago and she said that she thought it was odd that she did not have her TSH level tested. She did however test T4 level and did a T-uptake. Her T4 was 6 (normal is 5.5-11.0) and her T-uptake was .95 (normal .74-1.4). I'm not a doctor so I'm not certain but I have had doubts about the ability of our pediatrician. (the pediatrician that we had moved 5 states away and we recently started going to this new doctor.) I asked the nurse if the T4 and T-uptake tests were sufficient ways of diagnosing hypothyroidism. She replied... Not to my knowledge. Then she said she wasn't allowed to give her opinion and couldn't discuss it further. She was very kind and so I'm wondering if anyone else knows the answer to my question. Thank you for your help.
User Comments
- I have hypothyroidism, and the only test they did on me to check that was my TSH level. I'm not sure about those other tests, but I think the main thing that determines hypo- or hyper- thyroidism is the thyroid hormone itself...which is what the TSH tests....
I would get that checked... But your pediatrician may have just wanted to see if those 2 tests gave her enough information that she wouldnt have to test the TSH?
- Ideally, the diagnosis of thyroid function (normal, hypo, or hyperthyroidism) would be made with T3, T4, free T3, free T4, TSH, uptakes, and tests for antithyroid antibodies. However, physicians don't always do all of these tests.
While the child's tests are in the "normal range," they are low in the range, and thus there should be a suspicion of hypothyroidism, particularly if the child is having symptoms (depression, exhaustion, irritability, growth difficulties, hair loss, feeling cold all the time, dry skin, weight gain, etc.).
A TSH test is not required to make a positive diagnosis (I.e. that someone HAS hypothyroidism). That may be possibly determined by T3, T4, or uptake. However, a TSH should be done to come to a negative diagnosis (I.e., someone has normal thyroid function). Only a full panel of tests can fully reveal each and every person with problematic thyroid function.
However, given the results and ranges you've posted in your question, I would suspect that the child probably has subclinical hypothyroidism. That is, her levels fall in the low-normal range but she has symptoms. Many endocrinologists will treat a person with a subclinical presentation if they have symptoms.
You should demand the TSH test, as well as an antibody test and a thyroid ultrasound, if you have reason to suspect that your daughter has hypothyroidism.