Real or Not Real? An Elevated TSH

    October 2024 in “ Journal of the Endocrine Society ”
    Marla Elaine Sevilla-Alsina, Aleida Salvat, Mohammad Shohidul Islam, Jane Y. Yang, Michael J. McPhaul, Roy E. Weiss
    TLDR Recognizing macro-TSH is crucial to avoid unnecessary treatments.
    The article discusses macro-thyroid-stimulating hormone (macro-TSH), a rare condition that causes elevated TSH levels despite normal free T4 and T3 concentrations, often leading to misdiagnosis and unnecessary treatment. The study presents a case of a 19-year-old male with elevated TSH levels due to macro-TSH, confirmed through TSH antibody testing and gel filtration chromatography. The condition has a prevalence of 0.6-1.6%, and the gold standard for confirmation is size fractionation chromatography, though it is not commercially available. The case highlights the importance of recognizing macro-TSH to prevent unnecessary medical interventions.
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