In most cases, ordering a different test is more useful than repeating the same test (e.g., if a patient has specific clinical findings and a TSH result does not appear to correlate with the patient’s clinical status, it may be more appropriate to follow with an fT4 measurement). There are other thyroid antibody tests with specific indications which are not covered in this guideline and are discussed in the associated BC Guideline Hormone Testing – Indications and Appropriate Use. Once a patient is known to be TPO antibody positive, repeat analysis is not indicated. TPO antibody positivity increases the risk of developing hypothyroidism in patients with subclinical hypothyroidism, autoimmune diseases (e.g., type 1 diabetes), chromosomal disorders (e.g., Turner syndrome and Down syndrome) or patients who are on certain drug therapies (e.g., lithium, amiodarone) or are pregnant or postpartum (see Thyroid Disease in Pregnancy section below) 13, 14. In patients with a goitre or mildly elevated TSH, anti-TPO measurement is used to evaluate whether the cause is autoimmune thyroiditis 13. In specific circumstances it may be helpful in further clinical decision making. See Figure 1 for a Clinical Algorithm of Thyroid Function Tests for Diagnosis and Monitoring in Symptomatic Non-Pregnant Patients and Table 2 for Potential Causes of Abnormal Hormone Levels.Īnti-TPO measurement is not routinely indicated in patients with hypothyroidism as it does not generally change clinical management.
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