Thyroid Stimulating Hormone (TSH)

Also known as: TSH, Thyrotropin, Thyroid Function Test

EndocrinologyBlood

The TSH test measures the level of thyroid-stimulating hormone in your blood. TSH is produced by the pituitary gland and tells the thyroid gland to make and release thyroid hormones (T3 and T4). It is the most sensitive and commonly used test for evaluating thyroid function.

Purpose

Screening for thyroid disorders (hypothyroidism and hyperthyroidism). Evaluating symptoms such as unexplained weight changes, fatigue, hair loss, cold or heat intolerance, depression, or anxiety. Monitoring thyroid hormone replacement therapy (levothyroxine dosing). Newborn screening for congenital hypothyroidism. Evaluating fertility issues — thyroid disorders can affect ovulation and pregnancy.

Preparation

No fasting is required. If you take thyroid medication (levothyroxine), your doctor may advise you to delay your dose until after the blood draw, as it can temporarily affect results. Biotin (vitamin B7) supplements can interfere with some TSH assays — stop biotin 2–3 days before testing.

Procedure

A standard blood draw from a vein in your arm. Blood is sent to the laboratory for immunoassay analysis. Takes about 5 minutes.

Normal Range

Adults: 0.4–4.0 mIU/L (some labs use 0.5–5.0 mIU/L). Pregnancy: Lower ranges apply — first trimester 0.1–2.5 mIU/L, second trimester 0.2–3.0 mIU/L, third trimester 0.3–3.0 mIU/L. Note: 'Normal' ranges are debated; some endocrinologists consider levels above 2.5 worth monitoring.

Abnormal Results

High TSH usually indicates hypothyroidism (underactive thyroid) — the pituitary is producing more TSH to try to stimulate a sluggish thyroid. Common causes: Hashimoto's thyroiditis, thyroid surgery, radiation, iodine deficiency. Low TSH usually indicates hyperthyroidism (overactive thyroid) — the pituitary reduces TSH because thyroid hormone levels are already high. Common causes: Graves' disease, thyroid nodules, thyroiditis, excess thyroid medication.

Risks

Minimal — standard venipuncture risks.

Turnaround Time

Results typically available in 1–2 days.

Estimated Cost

$25–$75 without insurance. Covered by most insurance plans when medically indicated.

Frequently Asked Questions

What is a Thyroid Stimulating Hormone (TSH) test?

The TSH test measures the level of thyroid-stimulating hormone in your blood. TSH is produced by the pituitary gland and tells the thyroid gland to make and release thyroid hormones (T3 and T4). It is the most sensitive and commonly used test for evaluating thyroid function.

What is the normal range for a Thyroid Stimulating Hormone (TSH)?

Adults: 0.4–4.0 mIU/L (some labs use 0.5–5.0 mIU/L). Pregnancy: Lower ranges apply — first trimester 0.1–2.5 mIU/L, second trimester 0.2–3.0 mIU/L, third trimester 0.3–3.0 mIU/L. Note: 'Normal' ranges are debated; some endocrinologists consider levels above 2.5 worth monitoring.

How do I prepare for a Thyroid Stimulating Hormone (TSH)?

No fasting is required. If you take thyroid medication (levothyroxine), your doctor may advise you to delay your dose until after the blood draw, as it can temporarily affect results. Biotin (vitamin B7) supplements can interfere with some TSH assays — stop biotin 2–3 days before testing.

What do abnormal Thyroid Stimulating Hormone (TSH) results mean?

High TSH usually indicates hypothyroidism (underactive thyroid) — the pituitary is producing more TSH to try to stimulate a sluggish thyroid. Common causes: Hashimoto's thyroiditis, thyroid surgery, radiation, iodine deficiency. Low TSH usually indicates hyperthyroidism (overactive thyroid) — the pituitary reduces TSH because thyroid hormone levels are already high. Common causes: Graves' disease, thyroid nodules, thyroiditis, excess thyroid medication.

Related Lab Tests

Medical Disclaimer

This lab test information is for educational purposes only and should not replace professional medical advice. Lab results should always be interpreted by a qualified healthcare provider who knows your complete medical history. Normal ranges may vary between laboratories.