Thyroid Tests

TSH

Also written as: Thyroid stimulating hormone

The pituitary signal that tells the thyroid to work harder.

What it measures

Thyroid stimulating hormone, produced by the pituitary gland. It is not a thyroid hormone itself - it is the instruction the brain sends to the thyroid, which is why it moves in the opposite direction to thyroid activity.

Why a doctor orders it

It is the usual first-line thyroid test, and it is monitored when someone takes thyroid hormone replacement.

What is generally associated with a higher result

A higher TSH means the pituitary is signalling harder, which is broadly associated with an underactive thyroid. It can also rise temporarily while recovering from illness.

What is generally associated with a lower result

A lower TSH is broadly associated with an overactive thyroid, and with taking more thyroid hormone replacement than the body needs.

Everyday things that move this number

Not every shift in a value reflects disease. These are ordinary factors known to affect this particular measurement:

  • Time of day - TSH is typically higher overnight and early morning
  • Recent acute illness
  • Biotin supplements, which interfere with many thyroid assays
  • Pregnancy, which shifts the expected range

Questions to take to your appointment

  • Should free T4 be checked alongside this?
  • Do I take biotin, and could it have affected this result?

Build a printable questionnaire with your own results →

Where to read more

MedlinePlus, from the US National Library of Medicine, publishes patient-facing pages on individual lab tests and is a reliable next stop: medlineplus.gov/lab-tests .

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