Review article: Harmonization of Thyroid Hormone Testing; A Complex Challenge to Improve Patient Outcomes


David Hamilton, Demetra Castillo and Patricia Tille



Thyroid diseases are extraordinarily complex endocrine conditions. Hyperthyroidism, hypothyroidism, and thyroid cancer is diagnosed and monitored using thyroid hormone (TH) laboratory testing. Treatment decisions adhere to published clinical practice guidelines that rely heavily upon laboratory measurements such as thyroid stimulating hormone (TSH), thyroxine (T4), free thyroxine (FT4), and thyroglobulin (TG). The immunoassays for TH testing utilize various methodologies dependent upon specific reagent manufacturers. This presents a challenge for laboratories to provide TH measurements that are dependable and consistent. This challenge has led to initiatives for the standardizations and harmonization of TH testing. TH immunoassays are complex methods that are highly susceptible to interferences such as heterophile antibodies, binding proteins, and anti-reagent antibodies. In addition, there is a lack of appropriately established reference intervals (RI) for TH laboratory values. Factors such as pregnancy, age, sex, and geographical location complicate the standardization of TH RIs. Harmonization and standardization for TH testing is challenging, however, it is clear that patients with thyroid disease would benefit from these initiatives.


Key words: Thyroid hormones; Thyroid testing; Harmonization; Standardization


Int. J. Bio. Lab. Sci 2023(12)2:85-85 【PDF】

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