DEVELOPMENTS IN THYROID-STIMULATING HORMONE TESTING - THE PURSUIT OF IMPROVED SENSITIVITY

In this, the second installment in a continuing education series on th yroid disease, we describe the many technologic developments that have led to the use of thyroid-stimulating hormone (TSH) measurements as a screening test for thyroid dysfunction. First-generation, competitive TSH radioimmunoassays were capable only of diagnosing primary hypothy roidism. Applying monoclonal antibodies, second-generation TSH immunom etric assays (IMAs) were sensitive enough to diagnose hyperthyroidism and primary hypothyroidism. In the future, diagnostic companies will c ontinue to apply technologic improvements toward the delivery of fully automated, rapidly processed TSH IMAs with third-generation performan ce or better.