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Thyroid Panel with TSH : 7444
Test CodeTP3C or 7444
CPT Codes
84443, 84436, 84479
Includes
Panel includes: T3 Uptake, T4 (Thyroxine) Total, Free T4 Index (T7), TSH
Transport Container
Specimen:
2 mL serum
Minimum Volume: 1.2 mL
2 mL serum
Minimum Volume: 1.2 mL
Transport Temperature
Room temperature.
Specimen Stability
Room temperature: 7 days; Refrigerated: 7 days; Frozen: 28 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Plasma
Methodology
Immunoassay
Setup Schedule
Sunday - Saturday
Report Available
1 day
Reference Range
T3 Update
22-35 %
T4 (Thyroxine), Total
Male (mcg/dL) Female (mcg/dL)
<1 Month 4.5-17.2 4.5-17.2
1-23 Months 5.9-13.9 5.9-13.9
2-12 Years 5.7-11.6 5.7-11.6
13-20 Years 5.1-10.3 5.3-11.7
>20 Years 4.9-10.5 5.1-11.9
Free T4 Index (T7) 1.4-3.8
TSH
Premature Infants (28-36 Weeks)
1st Week of Life 0.20-27.90 mIU/L
Term Infants (>37 Weeks)
Serum or Cord Blood 1.00-39.00 mIU/L
1-2 Days 3.20-34.60 mIU/L
3-4 Days 0.70-15.40 mIU/L
5 Days-4 Weeks 1.70-9.10 mIU/L
1-11 Months 0.80-8.20 mIU/L
1-19 Years 0.50-4.30 mIU/L
≥20 Years 0.40-4.50 mIU/L
Pregnancy
First Trimester 0.26-2.66 mIU/L
Second Trimester 0.55-2.73 mIU/L
Third Trimester 0.43-2.91 mIU/L
TSH levels decline rapidly during the first week of life in most children, but may remain transiently elevated in a few individuals despite normal free T4 levels.For proper interpretation of an abnormal TSH from a newborn thyroid screen, the Total T4 should be considered.
22-35 %
T4 (Thyroxine), Total
Male (mcg/dL) Female (mcg/dL)
<1 Month 4.5-17.2 4.5-17.2
1-23 Months 5.9-13.9 5.9-13.9
2-12 Years 5.7-11.6 5.7-11.6
13-20 Years 5.1-10.3 5.3-11.7
>20 Years 4.9-10.5 5.1-11.9
Free T4 Index (T7) 1.4-3.8
TSH
Premature Infants (28-36 Weeks)
1st Week of Life 0.20-27.90 mIU/L
Term Infants (>37 Weeks)
Serum or Cord Blood 1.00-39.00 mIU/L
1-2 Days 3.20-34.60 mIU/L
3-4 Days 0.70-15.40 mIU/L
5 Days-4 Weeks 1.70-9.10 mIU/L
1-11 Months 0.80-8.20 mIU/L
1-19 Years 0.50-4.30 mIU/L
≥20 Years 0.40-4.50 mIU/L
Pregnancy
First Trimester 0.26-2.66 mIU/L
Second Trimester 0.55-2.73 mIU/L
Third Trimester 0.43-2.91 mIU/L
TSH levels decline rapidly during the first week of life in most children, but may remain transiently elevated in a few individuals despite normal free T4 levels.For proper interpretation of an abnormal TSH from a newborn thyroid screen, the Total T4 should be considered.
Clinical Significance
Thyroid Panel with TSH - This panel provides an assessment of thyroid function
and includes tests for thyroid stimulating hormone (TSH), total thyroxine (T4),
triiodothyronine (T3) uptake (T3 resin uptake), and free T4 index. This panel may
be useful for evaluating thyroid function when pituitary disease is not suspected.
The results of the panel may help in the diagnosis of hyperthyroidism and
hypothyroidism [1].
T3 and T4 are hormones derived from the thyroid and released into the blood to
regulate metabolism. Both T3 and T4 are produced in response to TSH from the
pituitary gland. T4 circulates mostly bound to plasma proteins, with a small amount
unbound and available for biological activity. To estimate free T4 concentration, a
total T4 test and T3 uptake test are used to calculate the free T4 index [1].
A normal TSH result excludes most cases of primary overt thyroid disease.
Therefore, a cascaded testing approach (test code 15102) may be preferable for
evaluating and monitoring thyroid function. This panel does not identify T3
thyrotoxicosis, which requires measurement of free T3 [2,3].
Note: Interference due to heterophile antibodies has been known to occur [1].
The results of this panel should be interpreted in the context of pertinent clinical
and family history and physical examination findings.
References
1. Demers LM, et al. The thyroid: pathophysiology and thyroid function testing. In:
Burtis CA, et al. eds. Tietz Textbook of Clinical Chemistry and Molecular
Diagnostics. 4th ed. Elsevier; 2006:2053-2095.
2. Ross DS, et al. Thyroid. 2016;26(10):1343-1421.
3. Vasileiou M, et al; Guideline Committee. BMJ. 2020;368:m41.
and includes tests for thyroid stimulating hormone (TSH), total thyroxine (T4),
triiodothyronine (T3) uptake (T3 resin uptake), and free T4 index. This panel may
be useful for evaluating thyroid function when pituitary disease is not suspected.
The results of the panel may help in the diagnosis of hyperthyroidism and
hypothyroidism [1].
T3 and T4 are hormones derived from the thyroid and released into the blood to
regulate metabolism. Both T3 and T4 are produced in response to TSH from the
pituitary gland. T4 circulates mostly bound to plasma proteins, with a small amount
unbound and available for biological activity. To estimate free T4 concentration, a
total T4 test and T3 uptake test are used to calculate the free T4 index [1].
A normal TSH result excludes most cases of primary overt thyroid disease.
Therefore, a cascaded testing approach (test code 15102) may be preferable for
evaluating and monitoring thyroid function. This panel does not identify T3
thyrotoxicosis, which requires measurement of free T3 [2,3].
Note: Interference due to heterophile antibodies has been known to occur [1].
The results of this panel should be interpreted in the context of pertinent clinical
and family history and physical examination findings.
References
1. Demers LM, et al. The thyroid: pathophysiology and thyroid function testing. In:
Burtis CA, et al. eds. Tietz Textbook of Clinical Chemistry and Molecular
Diagnostics. 4th ed. Elsevier; 2006:2053-2095.
2. Ross DS, et al. Thyroid. 2016;26(10):1343-1421.
3. Vasileiou M, et al; Guideline Committee. BMJ. 2020;368:m41.
Performing Laboratory
med fusion
