| Roti et al., Parma, Italy, analyzed thyroid function tests requested in 1995 in a 1600 bed hospital serving a city of 166,000 residents. The results show that in 20% of 12,116 hospitalized patients thyroid function tests were requested where only in 14 patients (= 0.6%) abnormalities in thyroid function were detected. They also show that in their hospital the frequency of the low T3 syndrome was very low i.e. around 2%, probably due to the lower severity of illness. On the basis of their analysis they conclude that T3 and FT3 measurements are not justified in routine thyroid function panels and that serum TSH alone is the most appropriate initial thyroid function test. (Comment: I totally agree with the conclusions of this study. To my opinion T3 should not be routinely determined but only in rare cases like T3 hyperthyroidism. The fact is that T3 may be low in starvation and in illness in general, it may be elevated in T3 toxicosis but also in marginal hypothyroidism. To interpret a T3 value, one should be aware of all these different aspects. Routine testing of serum T3 will more often lead to a misdiagnosis than a correct diagnosis.) |
