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Der Klinikarzt 2016; 45(02): 66-73
DOI: 10.1055/s-0042-101371
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© Georg Thieme Verlag Stuttgart · New York

Der Referenzbereich des Schilddrüsenwerts TSH – Was ist normal?

The reference range for TSH thyroid levels – What is normal?
Jörg Bojunga
1   Schwerpunkt Endokrinologie, Diabetologie, Ernährungsmedizin, Medizinische Klinik I, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt
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Publication Date:
21 March 2016 (online)

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Die Messung der TSH-Serumkonzentration ist die wichtigste Laboruntersuchung in der Diagnostik von Funktionsstörungen der Schilddrüse. Eine korrekte Interpretation des TSH-Wertes ist nicht allein durch Angabe eines Referenzbereiches, sondern nur unter zusätzlicher Kenntnis klinischer Parameter wie Alter, Geschlecht, Beschwerden, ethnischer Zugehörigkeit, Komorbiditäten und Medikation möglich. Vor allem bei älteren Menschen ist eine korrekte Diagnose von Schilddrüsenfunktionsstörungen und Einleitung einer adäquaten Therapie von besonderer Bedeutung, da Schilddrüsen-assoziierte Symptome den Symptomen des normalen Alterns sowie der Peri- und Postmenopause ähneln und sich mit diesen überlappen können. Ältere Menschen haben zudem ein erhöhtes kardiovaskuläres und Osteoporoserisiko, das durch Schilddrüsenfunktionsstörungen verstärkt werden kann. Eine Übertherapie subklinischer Hypothyreosen und Untertherapie subklinischer Hyperthyreosen kann insbesondere bei älteren Menschen erhebliche gesundheitliche Nachteile für die Betroffenen zur Folge haben.

Measurement of the serum concentration of TSH is one of the most important laboratory tests in the diagnostic work-up for functional disorders of the thyroid gland. A correct interpretation of the TSH level is not possible merely by specification of a reference range but also requires additional information about other clinical parameters such as age, gender, complaints, ethnicity, comorbidities and drugs taken. Especially for the elderly the correct diagnosis of thyroid gland dysfunctions and the initiation of an adequate therapy are of prime importance since thyroid-associated symptoms are similar to and can overlap with those of normal aging as well as those of the peri- and postmenopausal periods. Elderly people have, in addition, increased risks for cardiovascular problems and osteoporosis that can be further intensified by thyroid gland dysfunctions. Excessive therapy for subclinical hypothyroidism and insufficient therapy for subclinical hyperthyroidism can lead to considerable health impairments among elderly patients in particular.

Key words

Subclinical thyroid disease - postmenopausal women - thyroxine - therapy
 

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