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TSH is the current gold standard for diagnosis of hypothyroidism but are the current TSH levels optimal and how do they relate to Hashimoto’s disease? An excellent paper out of China entitled, “Using Hashimoto thyroiditis as gold standard to determine the upper limit value of thyroid stimulating hormone in a Chinese cohort” has shed some light on this important question which looked at the upper limit of TSH levels in relation to Hashimoto’s disease and hypothyroidism.
The authors begin by stating that subclinical hypothyroidism is characterized by “normal” T4, T3, Free T4, and Free T3 with an elevated TSH. And these patients have an increased risk of cholesterol abnormalities, heart disease, mental illness, and pregnancy complications even though their symptoms are relatively mild.