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A health practitioner may order a TSH test when someone has symptoms of hyperthyroidism or hypothyroidism and/or when a person has an enlarged thyroid gland (goiter). The eyes may be affected: puffiness around the eyes, dryness, irritation, and, in some cases, bulging of the eyes.
A serum TSH measurement is required for confirming that an elevated thyroid hormone level is due to hyperthyroidism and not a thyroid hormone binding protein abnormality (such as FDH). A serum TSH measurement is the primary test for detecting amiodarone-induced thyroid dysfunction (see Guideline 5). As shown in Table 1, binding protein abnormalities or assay technical problems are the most common causes for a discordant FT4/TSH relationship.