Ordering Recommendation

Assess thyroid function. Identify risk in patients with palpable thyroid nodules. Includes reflex to free thyroxine for thyroid stimulating hormone results outside 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.
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: 5 days; 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



No compliance statements are in use for this test.

Note

If the Thyroid Stimulating Hormone is outside the reference interval, then Thyroxine, Free (Free T4) testing will be added. Additional charges apply.

Hotline History
N/A
CPT Codes

84443; if reflexed, add 84439

Components
Component Test Code* Component Chart Name LOINC
2006109 Thyroid 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
Thyroid Stimulating Hormone with reflex to Free Thyroxine