Differential Diagnosis Low TSH Normal T3 T4 | Medical Algorithm

Are you evaluating a patient with a low serum TSH yet normal free T4 and T3 levels?

Yes

Age of the patient

years

Gender of the patient

Male

Female

Does/Has/Is the patient?

• have subclinical hyperthyroidism (due to thyroiditis, etc)?

Yes

• have pituitary insufficiency with thyroid hormone replacement?

Yes

• an elevated serum HCG (early pregnancy, trophoblastic tumor, etc)?

Yes

• had a recent episode of thyrotoxicosis?

Yes

• recently had a severe, life-threatening illness (with or without dopamine infusion)?

Yes

• had a recent episode of acute psychosis or severe depression?

Yes

• receiving glucocorticoid therapy?

Yes

• receiving statin therapy?

Yes

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Specialty

Objective

ICD-10

Differential Diagnosis - Low TSH - Normal Serum Free T4 and T3 Levels

Purpose: To explain the presence of a low serum TSH with normal free T4 and T3 hormone concentrations.