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Inappropriately normal thyroid-stimulating hormone level

MedGen UID:
1691608
•Concept ID:
C5232538
•
Finding
Synonym: Inappropriately normal TSH
 
HPO: HP:0033075

Definition

A normal or elevated serum thyroid-stimulating hormone (TSH) level in the face of an elevation in circulating FT4 and/or FT3. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVInappropriately normal thyroid-stimulating hormone level

Conditions with this feature

X-linked central congenital hypothyroidism with late-onset testicular enlargement
MedGen UID:
763877
•Concept ID:
C3550963
•
Disease or Syndrome
Central hypothyroidism and testicular enlargement (CHTE) is characterized by central hypothyroidism, delayed pubertal testosterone rise, adult macroorchidism, variable prolactin deficiency, and occasional transient partial GH deficiency. Some carrier females also exhibit central hypothyroidism and mild prolactin deficiency. Inter- and intrafamilial variability has been observed (summary by Joustra et al., 2016).
See: Condition Record
Hypothyroidism, congenital, nongoitrous, 8
MedGen UID:
1684717
•Concept ID:
C5231395
•
Disease or Syndrome
Congenital nongoitrous hypothyroidism-8 (CHNG8) is characterized by relatively mild central hypothyroidism, which may be accompanied by hearing loss in some patients (Heinen et al., 2016).
See: Condition Record
Hypothyroidism, congenital, nongoitrous, 9
MedGen UID:
1684807
•Concept ID:
C5231396
•
Disease or Syndrome
Nongoitrous congenital hypothyroidism-9 (CHNG9) is characterized by a small thyroid gland with low free T4 (FT4) levels and inappropriately normal levels of thyroid-stimulating hormone (TSH) (Heinen et al., 2018).
See: Condition Record
Hypothyroidism, congenital, nongoitrous, 8
Hypothyroidism, congenital, nongoitrous, 9
X-linked central congenital hypothyroidism with late-onset testicular enlargement

Professional guidelines

PubMed

Excess use of thyroid hormone treatment among patients with fibromyalgia: a cross-sectional study in primary health care.
Aleksi V, Elise K, Koskela TH
BMC Res Notes 2022 Feb 24;15(1):83. doi: 10.1186/s13104-022-05971-y. PMID: 35209937Free PMC Article
Management of Fetal and Neonatal Graves' Disease.
Léger J
Horm Res Paediatr 2017;87(1):1-6. Epub 2016 Dec 16 doi: 10.1159/000453065. PMID: 27978517
Diagnosis and Management of Subclinical Hypothyroidism in Elderly Adults: A Review of the Literature.
Hennessey JV, Espaillat R
J Am Geriatr Soc 2015 Aug;63(8):1663-73. Epub 2015 Jul 22 doi: 10.1111/jgs.13532. PMID: 26200184

Recent clinical studies

Etiology

Covid-19, the thyroid and the pituitary - The real state of play.
Geslot A, Chanson P, Caron P
Ann Endocrinol (Paris) 2022 Apr;83(2):103-108. Epub 2022 Jan 20 doi: 10.1016/j.ando.2021.12.004. PMID: 35065920Free PMC Article
Autoimmune thyroid disease and thyroid function test fluctuations in patients with resistance to thyroid hormone.
Okazaki-Hada M, Nishihara E, Hisakado M, Kudo T, Ito M, Fukata S, Nishikawa M, Akamizu T, Miyauchi A
Eur J Endocrinol 2021 Dec 2;186(1):73-82. doi: 10.1530/EJE-21-0584. PMID: 34727089
Management of Fetal and Neonatal Graves' Disease.
Léger J
Horm Res Paediatr 2017;87(1):1-6. Epub 2016 Dec 16 doi: 10.1159/000453065. PMID: 27978517
Hypopituitarism.
Ascoli P, Cavagnini F
Pituitary 2006;9(4):335-42. doi: 10.1007/s11102-006-0416-5. PMID: 17077946
Thyroid Hormone Resistance in children.
Ercan O
Pediatr Endocrinol Rev 2003 Dec;1 Suppl 2:191-8; discussion 198. PMID: 16444158

Diagnosis

Receptors of thyroid hormones.
Aranda A, Alonso-Merino E, Zambrano A
Pediatr Endocrinol Rev 2013 Sep;11(1):2-13. PMID: 24079074
Central hypothyroidism.
Lania A, Persani L, Beck-Peccoz P
Pituitary 2008;11(2):181-6. doi: 10.1007/s11102-008-0122-6. PMID: 18415684
Thyroid hormone resistance.
Olateju TO, Vanderpump MP
Ann Clin Biochem 2006 Nov;43(Pt 6):431-40. doi: 10.1258/000456306778904678. PMID: 17132274
Hypopituitarism.
Ascoli P, Cavagnini F
Pituitary 2006;9(4):335-42. doi: 10.1007/s11102-006-0416-5. PMID: 17077946
Thyrotropin-secreting pituitary microadenoma.
Lee EJ, Kim KR, Lee KM, Yoon DH, Kim YS, Kim DI, Jung WH, Chung YS, Lim SK, Lee HC
Yonsei Med J 1992 Dec;33(4):368-73. doi: 10.3349/ymj.1992.33.4.368. PMID: 1309018

Therapy

Central Hypothyroidism is Frequent During Mitotane Therapy in Adrenocortical Cancer Patients: Prevalence and Timeline.
Poirier J, Godemel S, Mourot A, Grunenwald S, Olney HJ, Le XK, Lacroix A, Caron P, Bourdeau I
J Clin Endocrinol Metab 2023 Aug 18;108(9):2336-2342. doi: 10.1210/clinem/dgad115. PMID: 36856782
Management of Fetal and Neonatal Graves' Disease.
Léger J
Horm Res Paediatr 2017;87(1):1-6. Epub 2016 Dec 16 doi: 10.1159/000453065. PMID: 27978517
Hypopituitarism.
Ascoli P, Cavagnini F
Pituitary 2006;9(4):335-42. doi: 10.1007/s11102-006-0416-5. PMID: 17077946
Thyroid Hormone Resistance in children.
Ercan O
Pediatr Endocrinol Rev 2003 Dec;1 Suppl 2:191-8; discussion 198. PMID: 16444158
Thyroid hormone resistance syndromes.
McDermott MT, Ridgway EC
Am J Med 1993 Apr;94(4):424-32. doi: 10.1016/0002-9343(93)90155-i. PMID: 8475937

Prognosis

Case 308: Van Wyk-Grumbach Syndrome.
Kandasamy D, Malik R, Sharma R, Jana M
Radiology 2022 Dec;305(3):746-750. doi: 10.1148/radiol.211119. PMID: 36409615
Case 308.
Kandasamy D, Malik R, Sharma R, Jana M
Radiology 2022 Aug;304(2):485-487. doi: 10.1148/radiol.211118. PMID: 35877547
Covid-19, the thyroid and the pituitary - The real state of play.
Geslot A, Chanson P, Caron P
Ann Endocrinol (Paris) 2022 Apr;83(2):103-108. Epub 2022 Jan 20 doi: 10.1016/j.ando.2021.12.004. PMID: 35065920Free PMC Article
Management of Fetal and Neonatal Graves' Disease.
Léger J
Horm Res Paediatr 2017;87(1):1-6. Epub 2016 Dec 16 doi: 10.1159/000453065. PMID: 27978517
Persistently raised thyroid stimulating hormone in adequately treated congenital hypothyroidism on long-term follow-up.
Kara C, Ocal G, Berberoğlu M, Siklar Z, Adiyaman P
J Pediatr Endocrinol Metab 2008 Mar;21(3):251-6. doi: 10.1515/jpem.2008.21.3.251. PMID: 18540252

Clinical prediction guides

Central Hypothyroidism is Frequent During Mitotane Therapy in Adrenocortical Cancer Patients: Prevalence and Timeline.
Poirier J, Godemel S, Mourot A, Grunenwald S, Olney HJ, Le XK, Lacroix A, Caron P, Bourdeau I
J Clin Endocrinol Metab 2023 Aug 18;108(9):2336-2342. doi: 10.1210/clinem/dgad115. PMID: 36856782
Leptin Does Not Influence TSH Levels in Obese Short Children.
Adamczewska K, Adamczewski Z, Lewiński A, Stawerska R
Front Endocrinol (Lausanne) 2022;13:838881. Epub 2022 Mar 24 doi: 10.3389/fendo.2022.838881. PMID: 35399935Free PMC Article
Covid-19, the thyroid and the pituitary - The real state of play.
Geslot A, Chanson P, Caron P
Ann Endocrinol (Paris) 2022 Apr;83(2):103-108. Epub 2022 Jan 20 doi: 10.1016/j.ando.2021.12.004. PMID: 35065920Free PMC Article
Thyrotropin-secreting pituitary microadenoma.
Lee EJ, Kim KR, Lee KM, Yoon DH, Kim YS, Kim DI, Jung WH, Chung YS, Lim SK, Lee HC
Yonsei Med J 1992 Dec;33(4):368-73. doi: 10.3349/ymj.1992.33.4.368. PMID: 1309018
Subclinical hypothyroidism in the elderly: to treat or not to treat?
Drinka PJ, Nolten WE
Am J Med Sci 1988 Feb;295(2):125-8. doi: 10.1097/00000441-198802000-00007. PMID: 3278607

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