{"id":1792993,"date":"2021-04-15T23:00:00","date_gmt":"2021-04-16T03:00:00","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=1792993"},"modified":"2023-03-16T06:16:40","modified_gmt":"2023-03-16T11:16:40","slug":"falsely-elevated-tsh","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/falsely-elevated-tsh\/","title":{"rendered":"Falsely Elevated TSH"},"content":{"rendered":"<p><strong>Can TSH be falsely elevated?\u00a0<\/strong>Thyroid function tests (immunoassays) are subject to errors. As such, when there is a disagreement between clinical and biochemical assessment of a patient\u2019s thyroid status, a laboratory error should be considered.\u00a0It is worthy to note that some immunoassays use a biotin-steptavidin signaling system. Thus patients on supraphysiological doses of biotin (upwards of 10mg daily instead of the physiological dose range of 30-100mcg) are likely to present with discordant laboratory and clinical features.<\/p>\n<h2>Causes of falsely elevated TSH<\/h2>\n<ul>\n<li>Macro TSH<\/li>\n<li>Anti-animal antibodies<\/li>\n<li>Heterophilic antibodies<\/li>\n<\/ul>\n<h2>Falsely elevated free T4<\/h2>\n<ul>\n<li>Nonesterified free fatty acids<\/li>\n<li>Heterophilic antibodies<\/li>\n<li>Iodothyronine antibodies<\/li>\n<\/ul>\n<h2>References<\/h2>\n<p>Favresse J, Burlacu MC, Maiter D, Gruson D. Interferences With Thyroid Function Immunoassays: Clinical Implications and Detection Algorithm. <a href=\"https:\/\/doi.org\/10.1210\/er.2018-00119\" target=\"_blank\" rel=\"noopener\">Endocr Rev. 2018 Oct 1;39(5):830-850.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Can TSH be falsely elevated?\u00a0Thyroid function tests (immunoassays) are subject to errors. As such, when there is a disagreement between clinical and biochemical assessment of a patient\u2019s thyroid status, a laboratory error should be considered.\u00a0It is worthy to note that some immunoassays use a biotin-steptavidin signaling system. Thus patients on supraphysiological doses of biotin (upwards [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[88],"tags":[],"class_list":["post-1792993","post","type-post","status-publish","format-standard","hentry","category-endocrinology-short-notes","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1792993","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=1792993"}],"version-history":[{"count":26,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1792993\/revisions"}],"predecessor-version":[{"id":4416056,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1792993\/revisions\/4416056"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=1792993"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=1792993"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=1792993"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}