Principles Of, and Pitfalls In, Thyroid Function Tests
JOURNAL OF NUCLEAR MEDICINE 6:853-901, 1965 Principles of, and Pitfalls in, Thyroid Function Tests James C. Sisson, M.D.' Ann Arbor, Michigan INTRODUCTION Thyroid function tests are now readily available to, and widely used by, practitioners of the medical arts. However, proper interpretation of the results of such tests requires an understanding of the physiological processes being evaluated, and how this evaluation is accomplished. It is the purpose of this communication to describe the principles of, and some pitfalls in, the uses of certain well established clinical tests with an em phasis on the vagaries encountered. Not all thyroid function procedures will be reviewed, but only those which are in common usage, and which, by apparent inconsistencies, may puzzle the practitioner. Thyroid diseases will not be discussed in any detail. The various clinical entities of thyroid dysfunction will be discussed only as they affect the function tests, and hyper- and hypothyroidism will be included only as points of reference for the laboratory procedures. Hyperthyroidism may be defined as the state of response of the body tissues to too much thyroid hormone, and, conversely, hypothyroidism occurs when the body tissues function in the presence of too little thyroid hormone. No laboratory procedure now available specifically indicates the existence of hyper- or hypo thyroidism. Of the clinical tests in current usage, the basal metabolic rate (BMR) best reflects the action of thyroid hormones on the body cells. However, many factors other than thyroid hormones are involved in the rate of body metabolism, and the BMR is perforce a nonspecific and frequently an imprecise diagnostic aid in thyroid dysfunction.
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