Nye retningslinjer for TSH verdier...

[Shanita]

TSH level is very important to determine the function of thyroid gland.
The normal range has been changed racently to more accurate figures.
I chose this article for refreshing of knowledge to the thyroid treating doctors.


New Criteria for Diagnosis and Management


By Stephanie L. Lee, MD


Recommendation for a new normal TSH reference range.

The TSH reference range of 0.4 to 4.0 mIU/L is considered normal based on the results of general cross-sectional population studies lacking well-defined reference populations.1 In contrast, the third National Health and Nutrition Examination Survey (NHANES III) screened 17 353 subjects and excluded those with a history of thyroid disease, goiter, pregnancy, or biochemical hypo- or hyperthyroidism, and those taking thyroid medication, androgens or estrogens.2 In the resulting “normal� reference population of 13 344 subjects, 95% had TSH levels that fell between 0.3 and 2.5 mIU/L . Though TSH levels increased slightly with age, the highest mean TSH level of the normal population was slightly higher than 2 mIU/L, and the average level across all ages was only 1.49 mIU/L (Figure 2). These data were consistent with those of the smaller Andersen study, in which TSH levels measured in 16 normal men fell between 0.16 and 2.4 mIU/L with a mean of 1.27 mIU/L .Taken together, these findings support the establishment of a new normal reference TSH range from 0.5 to 2.5 mIU/L, with subclinical
hypothyroidism defined as a TSH level between 2.5 and 10 mIU/L with a normal free thyroxine (FT4) level, and overt hypothyroidism as TSH greater than 10 mIU/L with a suppressed FT4 level.


Synes dette var ganske interessant, men fikk dessverre ikke opp kilden, men denne er hentet fra et diskusjonsforum til noen leger i statene...

Shanita...

[Anisa]

Synes dette var ganske interessant, men fikk dessverre ikke opp kilden, men denne er hentet fra et diskusjonsforum til noen leger i statene...

Shanita...

http://www.doctor.vg/showthread.php?t=352

[Anisa]

http://www.doctor.vg/showthread.php?t=352

Linket virker ikke mere, men hele artiklen kan læses på ThyroidToday.com

SUMMARY

• Laboratoriet TSH referenceområde skal revurderes og sættes ned til 0,5 til 2,5 mIU/L for at afspejle TSH-niveauet i den (anset for) raske befolkning.
• Den TSH terapeutiske værdi på 0,5 til 2,0 mIU/L bør genindføres, og thyroxin-behandling bør skræddersyes til patienterne, baseret på deres individuel helbredstilstand og ved hyppig overvågning af TSH-niveauer.
• Ifølge den nye reference-standard, bør TSH niveau over 3,0 mIU/L ikke betragtes som normalt.
• Patienter med TSH niveauet 5,0 til 10 mIU/L vil sandsynligvis have gavn af thyroxin-behandling.
• Patienter med depression bør rutinemæssigt testes for hypothyreose.
• Da bioækvivalens af forskellige syntetiske thyroxin-præparater
  ikke nødvendigvis lig terapeutisk ækvivalens. Patienter bør konsekvent behandles med samme thyroxin-præparat.

Nå da da... TSH's normalområde på 0,5 til 2,0 mIU/L? Anbefaling vedtaget i 2003 af American Association of Clinical Endocrinologists (AACE) in San Diego, California, USA?

Hos os (i Skandinavien) kan vi forgæves kravle i støvet med TSH på 2,0 og langt derudover, og... få at vide af lægerne at vi er friske som havørne, hypokondere?

Relateret: Clinical Implications of the New TSH Reference Range (pdf)