Reader Remarks on:

Natural History of Thyroid-Stimulating Hormone in Children

TSH in children

TSH in children

François Isabelle, Saint-Hubert, Quebec, 3 Jun 2009 11:55 PM EST

Competing interests: None declared

Circadian TSH level fluctuates more in children. We don't hear much about a longer period fluctuation, seasonal or hormonal in adults, let alone children.

A yearly TSH test may only be a snapshot, not representative of the patient's average value, and not showing occasional peaks in times of physiological stress in a borderline patient. The famed sensitivity of the test doesn't take that into account.

Unfortunately, it is too often assumed that only primary thyroid dysfunction have to be screened, with the TSH-only method.

Are we still thinking in terms of cost-effectiveness with a once-a-year TSH-only test?

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