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Thyroid function tests frequently yield no evidence of thyroid disease

CHICAGO — In a cohort of adults who received a thyroid function test during hospitalization, most did not have a thyroid disease and those who did generally had mild conditions, according to findings presented at the annual meeting of the American Thyroid Association.

Ruaa Al-Ward

“Thyroid function tests are very frequently ordered in the hospitalized patients,” Ruaa Al-Ward, MD, a hospital medicine senior associate consultant at Mayo Clinic in Rochester, Minnesota, told Endocrine Today. “When abnormal, they are likely related to established diagnosis of thyroid disorders. However, in patients with no prior history of thyroid disorder, thyroid abnormalities resolved in two-thirds of the cases upon follow-up, therefore observation should be considered for the majority of these patients.”

Al-Ward and colleagues analyzed data from 116 adults (mean age, 63.8 years; 50% women) who received a thyroid function test between January 2018 and January 2019 at Mayo Clinic. An abnormal test was required for all participants as was a lack of thyroid disorder history, although the researchers noted that risk factors for such disorders were present in 32% of the cohort.

Researchers identified thyroid disease in 35 of patients, with 31 having hypothyroidism and 23 having minimally elevated thyroid-stimulating hormone. Among the total cohort, 82% had a TSH level between 4.3 mIU/L and 10 mIU/L, 9.4% had a TSH level of more than 10 mIU/L and 7.7% had a TSH level below 0.2 mIU/L. According to the researchers, an arrythmia accounted for 22% of the tests, whereas 39% of requests came from ED providers who the researchers labeled as the group that most commonly ordered tests.

“Although it is widely known that acute illness can affect thyroid function test, TSH is still commonly ordered. Physicians should keep in mind that, most of the time, thyroid testing is normal and not the explanation for the patient’s problem, and when the abnormalities are present they tend to be mild and they resolve during follow-up without any specific thyroid intervention,” Al-Ward said. “Thyroid testing should only be pursued when there is a high likelihood of thyroid disease.” – by Phil Neuffer

Reference:

Al-Ward R, et al. Poster 340. Presented at: 89th Annual Meeting of the American Thyroid Association; Oct. 30-Nov. 3, 2019; Chicago.

Disclosure: Al-Ward reports no relevant financial disclosures.

CHICAGO — In a cohort of adults who received a thyroid function test during hospitalization, most did not have a thyroid disease and those who did generally had mild conditions, according to findings presented at the annual meeting of the American Thyroid Association.

Ruaa Al-Ward

“Thyroid function tests are very frequently ordered in the hospitalized patients,” Ruaa Al-Ward, MD, a hospital medicine senior associate consultant at Mayo Clinic in Rochester, Minnesota, told Endocrine Today. “When abnormal, they are likely related to established diagnosis of thyroid disorders. However, in patients with no prior history of thyroid disorder, thyroid abnormalities resolved in two-thirds of the cases upon follow-up, therefore observation should be considered for the majority of these patients.”

Al-Ward and colleagues analyzed data from 116 adults (mean age, 63.8 years; 50% women) who received a thyroid function test between January 2018 and January 2019 at Mayo Clinic. An abnormal test was required for all participants as was a lack of thyroid disorder history, although the researchers noted that risk factors for such disorders were present in 32% of the cohort.

Researchers identified thyroid disease in 35 of patients, with 31 having hypothyroidism and 23 having minimally elevated thyroid-stimulating hormone. Among the total cohort, 82% had a TSH level between 4.3 mIU/L and 10 mIU/L, 9.4% had a TSH level of more than 10 mIU/L and 7.7% had a TSH level below 0.2 mIU/L. According to the researchers, an arrythmia accounted for 22% of the tests, whereas 39% of requests came from ED providers who the researchers labeled as the group that most commonly ordered tests.

“Although it is widely known that acute illness can affect thyroid function test, TSH is still commonly ordered. Physicians should keep in mind that, most of the time, thyroid testing is normal and not the explanation for the patient’s problem, and when the abnormalities are present they tend to be mild and they resolve during follow-up without any specific thyroid intervention,” Al-Ward said. “Thyroid testing should only be pursued when there is a high likelihood of thyroid disease.” – by Phil Neuffer

Reference:

Al-Ward R, et al. Poster 340. Presented at: 89th Annual Meeting of the American Thyroid Association; Oct. 30-Nov. 3, 2019; Chicago.

Disclosure: Al-Ward reports no relevant financial disclosures.

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