What is What Is the best and most sensitive Investigation for hypothyroidism ? and explain in detail?
The thyroid-stimulating hormone (TSH) assay is the most reliable test for diagnosing primary hypo- and hypehyroidismTSH secretion is pulsatile and follows a circadian rhythm. Major secretory pulses occur between 10 p.m. and 4 a.m., and the mean levels are approximately 1.3-1.4 mIU/L, with a lower limit of 0.3-0.5 mIU/L and an upper limit of 3.9-5.5 mIU/L (10)Changes in serum TSH levels can be attributed to its pulsatile and nocturnal secretion Currently, the normal reference range of serum TSH for adults is 0.4-4.5 mIU/L . Consistent studies confirm that serum TSH levels are age-dependent and that adult reference values do not correspond to those observed in pediatric patients; TSH levels continuously decrease from the neonatal period until the end of adolescence . Ref - pubmed.com