Suivi des tests thyroïdiens - Directory has no index file.

Suivi des Tests Thyro
Suivi des Tests Thyroï ïdiens diens
en M
en Mé édecine G decine Gé én né érale rale
Chantal Daumerie
Chantal Daumerie
Endocrinologie
Endocrinologie
UCL, Clin.Univ. ST Luc
UCL, Clin.Univ. ST Luc

TSH
Pituitary
Thyroid Gland
Hypothalamus TRH
T4
T3
Hypothalamic-Pituitary-Thyroid Physiology
20%
TSH T3
–
–
–
–
T4
T4ÎT3
Peripheral Tissues
Heart
Liver
Bone
CNS
TR
Target Tissues
T3
80%
Blood Levels T3
T4

0
1
2
3
4
5
6
7
8
9
10
11
12
TSH
mIU/L
1970-85 1985-90 1990-00 2000-
TSH Reference Limits Over Three Decades
0.3-0.4
~ 5.0
2° IMA
0.3-0.4
~ 5.0
2° IMA
0.3-0.4
~ 5.0
2° IMA
~ 4.0
3° IMA
0.3-0.4
~ 2.5
0.3-0.4
~10.0
RIA
?
More sensitive thyroid
Antibody tests
Immunometric assay (IMA)
New Guidelines

Hyperthyroid
0.01
0.1
1.0
10
100
1000
TSH
mIU/L
Hypothyroid NORMAL HyperthyroidReference Range
undetectable
From: Spencer et al JCEM 70:453, 199
0
T4 (Free T4)
2
fold
100
fold
TSH is the Most Sensitive Test for Thyroid Status

Populatio
n
Referenc
e
Range
8 6 11 15 2 4 5 14 1 9 16 13 731210
160
140
120
100
80
60
40
20
0
Participants
Andersen et al JCEM 87: 1068, 2002
Free T4
Estimate
Individual FT4 Setpoints -Monthly Blood Draws x 1-Year
0
1
2
3
4
5
6
7
8
9
10
11
12
13