TSH Test – Thyroid Stimulating Hormone

What is TSH?

TSH or thyroid-stimulating hormone is a hormone which is made in the pituitary gland. This hormone’s level changes if there are any thyroid disorders. If the thyroid gland is underactive, aka, the thyroid hormones are low; the pituitary gland produces higher levels of TSH and vice versa. The thyroid hormones regulate important functions in the body such as growth and metabolism. If TSH values are abnormal, it indicates a malfunction of the thyroid gland.

What does TSH test measure?

A TSH test is a blood test that measures the level of thyroid secreting hormone circulating in the bloodstream. TSH level is an indicator of whether the thyroid gland is functioning properly or it is either overactive (hyperthyroidism) or underactive (hypothyroidism). High TSH indicates low thyroid activity or hypothyroid condition. Similarly, low TSH means the person has an overactive thyroid or hyperthyroidism.

Who needs to undergo a TSH test?

The thyroid is an all-important endocrine gland in your body that secretes hormones which regulate metabolism and growth. This butterfly-shaped gland is present in the throat region. Any disturbance in the thyroid levels can affect multiple organ systems in the body starting from digestion to energy levels to mood. If you have experienced unexplained weight changes, appetite changes, increase/decrease of energy levels, poor concentration, sleep disorders, or menstrual disorders, there are high chances that your doctor will suggest you a TSH test.

How common are thyroid problems in India?

Thyroid problems are quite common among Indian adults. In India, thyroid disorders are more prevalent in women than in men.  11.4% women in India show symptoms of sub-clinical hypothyroidism compared to 6.2% men. The incidence of thyroid disorders also increases with age.

What symptoms does a thyroid patient show?

A person with hypothyroidism will show unexplained weight gain, constant fatigue, hair thinning, cold sensitivity, constipation, and irregular menses. Hyperthyroid patients experience high levels of anxiety, unexplained weight loss, tremors, puffiness in the face, increased heartbeat, and sleep problems such as insomnia.

What could cause abnormal levels of TSH?

There are several factors that can cause an imbalance in the thyroid levels. The most common cause is an autoimmune disorder known as Hashimoto’s thyroiditis. Thyroid surgery, exposure to harmful radiation, and certain medications can also lead to abnormal thyroid levels. At times, over-response to thyroid treatment can also be counterproductive and lead to either excess or too less production of thyroid hormones. Iodine deficiency can also trigger thyroid disorders.

What is the cost of TSH test in India?

The cost of TSH test in India generally lies between Rs. 200-300. However, in most cases T4 and T3 thyroid level tests are also prescribed along with TSH test and the entire package may cost close to Rs. 500.

Does TSH level change during pregnancy?

Studies reveal that TSH and entire thyroid profile changes a lot during the gestation period and is much different from what is considered normal reading during the non-pregnant state. Pregnancy hormones tend to have a direct impact on thyroid physiology. That is why most pregnant women develop a thyroid imbalance during pregnancy, which usually gets corrected after childbirth.

How is the TSH test performed?

TSH test is a simple blood test where a small amount of blood is drawn from the inner elbow region.
– The area is cleaned with an antiseptic solution
– An elastic band is tied around the arms to increase the pressure on the veins.
– Once the vein is detected, a needle is inserted to draw blood.
– The blood is collected in a small vial attached to the needle.
– After the blood is drawn, the area is covered with a bandage.
– The entire procedure takes less than a minute.

What important points do I need to remember before undergoing the TSH test?

Do I need to fast before the TSH test?

Fasting before the TSH test is not required. But you should aim to get the test done during the morning hours.

What medications can affect the TSH level in the body?

Psychiatric drugs and cholesterol-lowering drugs tend to affect TSH levels. Drugs that contain amiodarone, lithium, prednisone, potassium iodide, and lithium are the ones you should be careful about and inform your doctor before you undergo the test.

What are the normal TSH levels?

The TSH levels are measured in milli-international units per liter. They can be roughly categorized as –

Are there any risks associated with a TSH test?

This is a relatively simple and painless procedure and carries almost zero risks. There might be some redness and swelling at the site of syringe injection. If at all you are experiencing more pain and swelling at that point, you must refer to doctor.

What is the importance of the TSH level in the blood?

– Shows whether the thyroid gland is functioning properly or not. High TSH indicates underactive thyroid and low TSH indicates an overactive thyroid.
– It can also be used to screen and detect thyroid cancer.
– It has been observed that abnormal TSH, in the long run, can cause osteoporosis and complications in the heart.
– However, only the TSH level is not a complete indicator of the health of thyroid gland.- T3 -T4 levels are also required to get a clear picture of your thyroid activity.

How often should one get a TSH test?

Once the thyroid treatment begins via levothyroxine drugs, the next TSH test should ideally be scheduled 6-8 weeks after the 1^st TSH test. If the body is responding well to the thyroid treatment, beyond this TSH should ideally be tested once every 4-6 months.

My TSH levels are abnormal. What does it mean?

– TSH readings are usually studied with T3 and T4 levels to determine thyroid gland activity.
-High TSH and low T4 indicates hypothyroidism that needs treatment.
– Low TSH and high T4 indicates hyperthyroidism that needs treatment.
– TSH slightly high and T4 normal indicates sub-clinical hypothyroidism. Additional tests may be needed here to determine the exact problem.
– TSH low with low T4 indicates a problem with the pituitary gland and is treated as a non-thyroid illness.
 

How are abnormal TSH levels treated?

As mentioned above, only TSH levels cannot be used to determine the presence of a thyroid disorder. You will need to undergo additional tests such as T3, T4, and thyroid antibodies to get a clear picture. If you have an underactive/overactive thyroid, your doctor will prescribe you medication (levothyroxine or Synthroid) which need to be taken strictly as per the doctor’s advice. Going ahead, you will need to undergo further TSH tests in gaps of 3-4 months to test the efficacy of the treatment.

How to maintain a healthy thyroid gland?

– Eat fewer cruciferous vegetable such as broccoli, cauliflower, Brussels sprouts, etc
– Drink less alcohol or refrain from drinking completely
– Consume iodine-rich foods such as seafood.
– Don’t drink green tea in excess
– Indulge in low-impact aerobic exercises
– Increase your vitamin b12 intake