Thyroid Stimulating Hormone with reflex to Free Thyroxine
2006108
Ordering Recommendation
Use to assess thyroid function. Includes reflex to free thyroxine for thyroid stimulating hormone results outside of the reference range.
Mnemonic
TSHREFLEX
Methodology
Quantitative Electrochemiluminescent Immunoassay
Performed
Sun-Sat
Reported
Within 24 hours  
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
  
Collect
Serum separator tube or plasma separator tube. Also acceptable: Lavender (EDTA) or green (sodium or lithium heparin).  
Specimen Preparation
Allow specimen to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)  
Storage/Transport Temperature
Refrigerated.  
Unacceptable Conditions
Grossly hemolyzed specimens.  
Remarks
  
Stability
After separation of cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month  
Reference Interval
Effective May 16, 2011
 
 Males Females
0-​3 days 5.17-​14.60 mU/L 5.17-​14.60 mU/L
4-​30 days 0.43-​16.10 mU/L 0.43-​16.10 mU/L
1-​24 months 0.62-​8.05 mU/L 0.62-​8.05 mU/L
2-​6 years 0.54-​4.53 mU/L 0.54-​4.53 mU/L
7-​11 years 0.66-​4.14 mU/L 0.66-​4.14 mU/L
12-​19 years 0.53-​3.59 mU/L 0.53-​3.59 mU/L
20 years and older 0.30-​4.00 mU/L 0.30-​4.00 mU/L
1st trimester (10-​13 weeks gestation)  0.03-​3.40 mU/L
2nd trimester (14-​20 weeks gestation)  0.19-​4.06 mU/L
Interpretive Data
 
Note
If the Thyroid Stimulating Hormone is outside the reference interval, then Thyroxine, Free (Free T4) testing will be added. Additional charges apply.
CPT Code(s)
84443; if reflexed 84439
Components
Component Test Code*Component Chart NameLOINC
2006109Thyroid Stim. Hormone w/Rflx to Free T4 
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Free T4
  • free thyroxine
  • Thyrotropin
  • TSH