Thyrotropic hormone: important influencing factors to consider. Part 2

Abstract

Thyroid pathology is one of the most common endocrinopathies, and it is the endocrinologist who diagnoses and determines the treatment. But it is characterized by a wide variety of clinical manifestations requiring specific treatment without which it is impossible to achieve the efficacy. For them, the patient addresses to other specialists in the first stage. This necessitates the exclusion of endocrinopathy by doctors of diffe­rent specialties: cardiologists, gynecologists, neurologists, family doctors and others, that is, the timely inclusion of thyrotropic hormone (TTH) evaluation, recognized in the world as screening test, into the algorithm for examining patients or referring a patient to endocrinologist. On the basis of TTH levels, further patient’s examination is determined. Today, sometimes situations occur when a patient is examined in different laboratories, and the results obtained, which determine the hormonal status of a patient, are slightly different. What are the possible causes of discordant results? What to consider? What factors should be taken into account when evaluating TTH levels and du­ring interpretation? Interpretation algorithms: benchmarks or diagnostic thresholds? Why do the laboratory results of TTH determination indicate that treatment is ineffective against the background of sufficient dosage and adherence? We will look at the answers to these questions in this article in terms of some factors that influence TTH levels.