Abstract
New assay methods for the measurement of human thyroid-stimulating hormone (TSH) and improved assays for the measurement of free thyroid hormones have led to changes in the use of available tests for diagnosis and management of thyroid disease. In this article, I review the normal physiologic and pathophysiologic features of the thyroid system and their relationship to the interpretation of thyroid tests. An analysis of the cost-effectiveness of various tests is beyond the scope of this presentation. The use of thyroid tests, however, is based on the assumption that they will be ordered to facilitate decisions concerning diagnosis or management, not as part of a multiphasic screening of large numbers of asymptomatic individuals, except in specific populations in which such screening is either mandatory or effective.
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