Thyroid-Stimulating Hormone (TSH)
Also known as: TSH
TSH is the pituitary signal that drives thyroid hormone output. It is the front-line thyroid screening biomarker, but it is incomplete without free T3, free T4, and reverse T3 in symptomatic patients.
What Thyroid-Stimulating Hormone measures
Thyroid-stimulating hormone (TSH) is the pituitary signal that drives thyroid hormone production. It is the most sensitive single marker of thyroid status because pituitary TSH responds logarithmically to small changes in circulating thyroid hormone.
Clinical significance
TSH detects primary hypothyroidism and hyperthyroidism with high sensitivity. It is necessary but not sufficient — TSH alone misses central thyroid disease, conversion problems, and subclinical patterns that respond to symptom-aware review.
How oMeds reviews it
Always paired with Free T4 in optimization, and with Free T3 + Reverse T3 + TPO antibodies when symptoms or family history warrant. Provider-reviewed wellness flags TSH drift inside the reference range (>2.5 mIU/L) when paired with symptoms.
Standard clinical reference intervals
Lab-reported reference ranges from established standards bodies. These are diagnostic thresholds — they do not represent optimization targets.
Source: AACE/ATA adult reference (typical lab range 0.4-4.5 mIU/L)
oMeds optimization targets
Editorial bands that inform provider-reviewed conversations. These are wellness targets, not diagnostic thresholds.
Symptom resolution and adjacent thyroid hormone targets most consistently align in the 0.8-2.5 mIU/L band in provider-reviewed wellness.
oMeds optimization ranges are editorial targets that inform conversations with a licensed provider. They are NOT diagnostic thresholds and do not replace lab reference ranges.
Thyroid-Stimulating Hormone — frequently asked
Is normal TSH enough?
Often, but not always. Symptom-driven review adds Free T4, Free T3, Reverse T3, and antibodies when TSH is normal but symptoms persist.
What raises TSH?
Primary hypothyroidism (most common), Hashimoto's autoimmunity, iodine deficiency, post-partum thyroiditis, and certain medications (lithium, amiodarone).
Source literature
- AACE/ATA Hypothyroidism Guidelines · Endocrine Practice
How this entity relates
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Conditions this biomarker informs
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