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2630 pages added, reviewed or updated during the last month (last updated: 17/4/2021)


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raised TSH, normal free thyroid hormones

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The large majority of patient with raised TSH and normal free thyroid hormones are suffering from subclinical autoimmune hypothyroidism.

These results occur more rarely in the following circumstances:

  • the presence of heterophile antibodies
    • mouse antibodies are used in many TSH assays
    • patients may have antibodies to mouse immunoglobulins
    • heterphile antibodies result in a false TSH elevation
    • alternative assays should be used for these patients

  • in patients taking a regular dose of thyroxine an increase in the TSH concentration may indicate thyroxine malabsorption, due to:
    • small bowel disease
    • cholestyramine
    • iron therapy

  • amiodarone therapy

  • recovery from severe non-thyroidal disease

  • congenital abnormalities of thyroid function:
    • some cases of Pendred's syndrome

Last reviewed 01/2018

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