{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:21:38Z","timestamp":1760188898157,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1989,12]]},"abstract":"<jats:p>The clinical importance of an undetectable thyroid stimulating hormone (TSH) concentration (less than 0.2 mU\/l) was studied in a consecutive series of 2573 requests for routine thyroid function tests. Two hundred and seventeen (8.4%) patients had an undetectable TSH concentration, and of these 39 (18%) had otherwise normal thyroid hormone concentrations and no history of thyroid disease. In a follow up study 71 patients (34 outpatients and 37 inpatients) with undetectable TSH concentration associated with otherwise normal thyroid hormone concentrations were randomly selected during routine reporting of thyroid function test results. None of these patients had a history of thyroid disease. Sex hormone binding globulin concentrations were increased in five out of 50 of these patients and antithyroid antibodies were detectable in four out of 49, suggesting that in most cases the isolated undetectable TSH concentration was not associated with thyroid dysfunction, particularly hyperthyroidism. Isolated undetectable TSH concentration was observed in both inpatients and outpatients and was not associated with any particular clinical condition. Repeat specimens were received in 54 of the 71 patients and TSH concentration remained persistently undetectable in 35 of these.<\/jats:p>","DOI":"10.1136\/jcp.42.12.1237","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"1237-1240","source":"Crossref","is-referenced-by-count":2,"title":["Laboratory based study of undetectable thyroid stimulating hormone."],"prefix":"10.1136","volume":"42","author":[{"given":"M A","family":"Pollock","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1989,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1177\/000456328502200502","article-title":"Circulating thyrotrophin as an index of thyroid function","volume":"22","author":"Woodhead, J.S.; Weeks, I.","year":"1985","unstructured":"Woodhead JS, Weeks I. Circulating thyrotrophin as an index of thyroid function. Ann Clin Biochem 1985;22:455-9.","journal-title":"Ann Clin Biochem"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1136\/bmj.289.6455.1334","article-title":"A sensitive immunoradiometric assay for serum thyroid stimulating hormone: a replacement for the thyrotrophin releasing hormone test","volume":"289","author":"Seth, J.; Kellett, H.A.; Caldwell, G.","year":"1984","unstructured":"Seth J, Kellett HA, Caldwell G, et al. A sensitive immunoradiometric assay for serum thyroid stimulating hormone: a replacement for the thyrotrophin releasing hormone test. Br MedJ 1984;289:1334-6.","journal-title":"Br MedJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1093\/clinchem\/30.8.1396","article-title":"An automated immunoradiometric assay for human thyrotrophin","volume":"30","author":"John, R.; Jones, M.K.","year":"1984","unstructured":"John R, Jones MK. An automated immunoradiometric assay for human thyrotrophin. Clin Chem 1984;30:1396-8.","journal-title":"Clin Chem"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1093\/clinchem\/30.9.1558","article-title":"Use of a rapid sensitive immunoradiometric assay for thyrotrophin to distinguish normal from euthyroid subjects","volume":"30","author":"Cobb, W.E.; Lamberton, R.P.; Jackson, I.D.D.","year":"1984","unstructured":"Cobb WE, Lamberton RP, Jackson IDD. Use of a rapid sensitive immunoradiometric assay for thyrotrophin to distinguish normal from euthyroid subjects. Clin Chem 1984;30:1558-60.","journal-title":"Clin Chem"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1093\/clinchem\/30.7.1213","article-title":"A new monoclonal antibody two site solid phase immunoradiometric assay for human thyrotrophin evaluated","volume":"30","author":"Pekary, A.E.; Hershman, J.M.","year":"1984","unstructured":"Pekary AE, Hershman JM. A new monoclonal antibody two site solid phase immunoradiometric assay for human thyrotrophin evaluated. Clin Chem 1984;30: 1213-5.","journal-title":"Clin Chem"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1136\/bmj.291.6498.773","article-title":"Diagnostic value of thyrotrophin releasing hormone tests in elderly patients with atrial fibrillation","volume":"291","author":"Davies, A.B.; Williams, I.; John, R.","year":"1985","unstructured":"Davies AB, Williams I, John R, et al. Diagnostic value of thyrotrophin releasing hormone tests in elderly patients with atrial fibrillation. Br MedJ 1985;291:773-6.","journal-title":"Br MedJ"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/S0140-6736(86)92641-3","article-title":"Thyroid stimulating hormone measurements by immunoradiometric assay in severely ill patients","volume":"ii:","author":"Dubuis, J.M.; Burger, A.G.","year":"1986","unstructured":"Dubuis JM, Burger AG. Thyroid stimulating hormone measurements by immunoradiometric assay in severely ill patients. Lancet 1986;ii:1036-7.","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1093\/clinchem\/33.8.1391","article-title":"Specificity of sensitive assays of thyrotrophin (TSH) used to screen for thyroid disease in hospitalised patients","volume":"33","author":"Spencer, C.; Eigen, A.; Shen, D.","year":"1987","unstructured":"Spencer C, Eigen A, Shen D, et al. Specificity of sensitive assays of thyrotrophin (TSH) used to screen for thyroid disease in hospitalised patients. Clin Chem 1987;33:1391-6.","journal-title":"Clin Chem"},{"key":"ref_9","first-page":"138","article-title":"Thyrotoxicosis: relations between clinical state and biochemical changes during carbimazole treatment","volume":"i:","author":"Mortimer, C.H.; Anderson, D.C.; Liendo-Ch, P.","year":"1977","unstructured":"Mortimer CH, Anderson DC, Liendo-Ch P, et al. 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London: ACB, 1985.","journal-title":"Scientific Committee"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1056\/NEJM198502283120904","article-title":"Suppression of thyrotrophin in the low thyroxine state of severe non-thyroidal illness","volume":"312","author":"Wehmann, R.E.; Grogerman, R.I.; Burns, W.H.; el al","year":"1985","unstructured":"Wehmann RE, Grogerman RI, Burns WH, el al. Suppression of thyrotrophin in the low thyroxine state of severe non-thyroidal illness. N EnglJ Med 1985;312:546-52.","journal-title":"N EnglJ Med"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1093\/clinchem\/33.7.1213","article-title":"Anomalous thyrotrophin values","volume":"33","author":"Ratnaike, S.; Goodwin, M.; Dean, D.","year":"1987","unstructured":"Ratnaike S, Goodwin M, Dean D. Anomalous thyrotrophin values. 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