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New BC Guidelines Revision: Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder

December 21, 2018

BC Guidelines is pleased to announce the recently revised guideline: Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder.

Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder (2018) is a revision of the 2010 version of the guideline. The guideline scope has expanded to include pediatric and pregnant patients.

Select Key Recommendations include (see full recommendation list):

Routine thyroid function testing is not recommended in asymptomatic patients.

• A TSH value within the laboratory reference interval excludes the majority of cases of primary thyroid dysfunction.

• If initial TSH testing is normal, repeat testing is unnecessary unless there is a change in clinical condition.

• Measurement of fT3 is rarely indicated in suspected thyroid disease.

• Screening for undiagnosed hyperthyroidism or hypothyroidism should not be performed in hospitalized patients or during acute illness.

Other key changes to note include:

1. A laboratory algorithm has been added to the guideline and outlines changes to ordering. If central hypothyroidism is being investigated "suspicion of pituitary insufficiency" should be included as a clinical indication and a request for fT4 (with or without TSH) should be indicated in the space provided on the standard out-patient laboratory requisition.

2. Thyroid function test reports in BC will include trimester specific reference intervals on all women of child bearing age.

Other Updates:

To stay up to date with BC Guidelines, visit the “What’s New” section of our homepage at www.bcguidelines.ca