does fasting or postprandial state affect thyroid function testing?

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ID: 147377
2014
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Abstract
Background: Thyroid stimulating hormone (TSH) levels vary with the time of the day and probably in relation to food. In this study, we addressed the question of whether a fasting or non-fasting sample would make a clinically significant difference in the interpretation of thyroid function tests. Materials and Methods: Fifty seven adult ambulatory patients were selected from our laboratory database and were divided into Group A [Normal free thyroxine (T4) and TSH], Group B (subclinical hypothyroid with increased TSH and normal free T4) and Group C (overt hypothyroid with low free T4 and high TSH). Thyroid functions (free T4 and TSH) were done in fasting state and 2 hours postprandially. Results: TSH was suppressed in all subjects after food irrespective of the fasting levels. Free T4 values did not change significantly. This resulted in reclassification of 15 out of 20 (75%) subjects as subclinical hypothyroidism (SCH) based on fasting values whose TSH values were otherwise within range in the postprandial sample. This may have an impact on the diagnosis and management of hypothyroidism especially where even marginal changes in TSH may be clinically relevant as in SCH and in pregnancy. Conclusion: TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.
Reference Key
nair2014indiandoes Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Rakesh Nair;Shriraam Mahadevan;R S Muralidharan;S Madhavan
Journal journal of physical chemistry a
Year 2014
DOI
10.4103/2230-8210.139237
URL
http://www.ijem.in/article.asp?issn=2230-8210;year=2014;volume=18;issue=5;spage=705;epage=707;aulast=Nair
Keywords
fasting Gastroenterology clinical endocrinologydiseases of the digestive system thyroid function test

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