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Journal of Thyroid Research
Volume 2013, Article ID 148157, 8 pages
http://dx.doi.org/10.1155/2013/148157
Review Article

The Use of TSH in Determining Thyroid Disease: How Does It Impact the Practice of Medicine in Pregnancy?

1Georgetown University School of Medicine, Georgetown University Medical Center, Washington, DC 20057, USA
2Departments of Oncology, Medicine, Pharmacology, and Physiology, Georgetown University Medical Center, Washington, DC 20057, USA
3Departments of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC 20057, USA
4Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, LL, S-166, 3800 Reservoir Road NW, Washington, DC 20057, USA

Received 15 October 2012; Accepted 9 April 2013

Academic Editor: Fereidoun Azizi

Copyright © 2013 Offie P. Soldin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

During the last four decades, there have been considerable advances in the efficacy and precision of serum thyroid function testing. The development of the third generation assays for the measurement of serum thyroid stimulating hormone (TSH, thyrotropin) and the log-linear relationship with free thyroxine (T4) established TSH as the hallmark of thyroid function testing. While it is widely accepted that TSH outside of the normal range is consistent with thyroid dysfunction, a vast multitude of additional factors must be considered before an accurate clinical diagnosis can be made. This is especially important during pregnancy, when the thyroid is under considerable additional pregnancy-related demands requiring significant maternal physiological changes. This paper examines serum TSH measurement in pregnancy and some associated potential confounding factors.