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AMERICAN ASSOCIATION OF CLINICAL ENDROCRINOLOGISTS (AACE)-
REVISED TSH GUIDELINES
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Until November 2002, doctor's had relied on a TSH (thyroid stimulating hormone) level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now AACE encourages doctors to consider treatment  for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.04, AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now.

CLINICAL CHEMISTS ISSUE REVISED THYROID TESTING GUIDELINES
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The National Academy of Clinical Biochemistry, part of the Academy of the American Association for Clinical Chemistry (AACC), has issued new Laboratory Medicine Practice Guidelines for thyroid testing.

These practice guidelines are a fairly noticeable departure, and should have far-reaching effects on thyroid diagnosis and treatment.

Of specific interest are the following findings from the guidelines:
"It is likely that the current upper limit of the population reference range is skewed by the inclusion of persons with occult thyroid dysfunction."

"In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

"A serum TSH result between 0.5 and 2.0 mIU/L is generally considered the therapeutic target for a standard L-T4 replacement dose for primary hypothyroidism."

"Thyroxine requirements increase during pregnancy. Thyroid status should be checked with TSH + FT4 during each trimester of pregnancy. The L-T4 dose should be increased (usually by 50 micrograms/day) to maintain a serum TSH between 0.5 and 2.0 mIU/L and a serum FT4 in the upper third of the normal reference interval."


The complete text of the guidelines are available online at: http://www.nacb.org/lmpg/thyroid_LMPG_PDF.stm

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