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A thyroid-stimulating hormone (TSH) blood test is used to check for
thyroid gland problems. TSH is produced when the hypothalamus
releases a substance called thyrotropin-releasing hormone (TRH). TRH
then triggers the pituitary gland to release TSH. See pictures of the
thyroid gland and the pituitary gland.

TSH causes the thyroid gland to make two hormones: triiodothyronine

(T3) and thyroxine (T4). T3 and T4 help control your body's

Triiodothyronine (T3) and thyroxine (T4) are needed for normal growth
of the brain, especially during the first 3 years of life. A baby whose
thyroid gland does not make enough thyroid hormone (congenital
hypothyroidism) may, in severe cases, be mentally retarded. Older
children also need thyroid hormones to grow and develop normally.



Tell your doctor if you have had any tests in which you were given
radioactive materials or had X-rays that used iodine dye within the last
4 to 6 weeks. Your test results may not be correct if you have had
iodine contrast material before having a thyroid-stimulating hormone
(TSH) test.


No special preparations are needed for this test. However, certain

medications, including seizure medication, cardiac drugs, steroids,
birth control pills, and even aspirin can affect the results, so it's
important to tell the doctor about any medication your child is taking.

On the day of the test, it may help to have your child wear a short-
sleeve shirt to allow easier access for the technician who will draw the

The Procedure

A health professional will usually draw the blood from a vein. For an
infant, the blood may be obtained by puncturing the heel with a small
needle (lancet). If the blood is being drawn from a vein, the skin
surface is cleaned with antiseptic, and an elastic band (tourniquet) is
placed around the upper arm to apply pressure and cause the veins to
swell with blood. A needle is inserted into a vein (usually in the arm
inside of the elbow or on the back of the hand) and blood is withdrawn
and collected in a vial or syringe.

After the procedure, the elastic band is removed. Once the blood has
been collected, the needle is removed and the area is covered with
cotton or a bandage to stop the bleeding. Collecting blood for this test
will only take a few minutes.

For Infants


A thyroid-stimulating hormone (TSH) blood test is used to check for

thyroid gland problems.

The normal ranges for the results of this test may vary from laboratory
to laboratory. Results are usually available within 2 to 3 days.

Thyroid-stimulating hormone (TSH)

Adult 0.4-4.5 mIU/L or 0.4-4.5 mU/L

s: (SI units)

Babi 3-18 mIU/L or 3-18 mU/L (SI

es: units)
High values

High TSH levels may be caused by:

• An underactive thyroid (hypothyroidism). Hashimoto's thyroiditis

is the most common cause of primary hypothyroidism.
• A pituitary gland tumor that is making too much TSH. This is
• Not taking enough thyroid hormone medicine for treatment of an
underactive thyroid gland.

Low values

Low TSH levels may be caused by:

• An overactive thyroid gland (hyperthyroidism). Causes of

hyperthyroidism include Graves' disease, a type of goiter (toxic
multinodular goiter), or a noncancerous (benign) tumor called a
toxic nodule.
• Damage to the pituitary gland that prevents it from making TSH
(a condition called secondary hypothyroidism).
• Taking too much thyroid medicine for treatment of an
underactive thyroid gland.
• Pregnancy during the first trimester.

What Affects the Test

Reasons you may not be able to have the test or why the results may
not be helpful include:

• Taking medicine, such as corticosteroids, levodopa, heparin,

dopamine, lithium (such as Carbolith or Duralith), methimazole
(Tapazole), and propylthiouracil.
• Having had a recent X-ray with iodine dye or test using
radioactive materials.
• Having severe stress or a long-term (chronic) illness.

What To Think About

• The thyroid-stimulating hormone (TSH) test is the best screening

test for conditions that can affect the thyroid gland.
• The results of a TSH test should be considered along with the
results of thyroid hormone tests, especially thyroxine (T4)
results. For more information about T3 and T4 testing, see the
medical test Thyroid Hormone Tests.
• The upper value of the normal TSH range for adults is 4.5 mIU/L
or 4.5 mU/L (SI units).