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