TSH increased

Etiology

  • Primary hypothyroidism
  • "Subclinical" hypothyroidism: high TSH, clinically euthyroid, normal T4
  • Autoimmune disease (assay interference)
  • Recovery from nonthyroidal illness
  • Acute psychiatric illness
  • Drugs: dopamine antagonists (eg, metoclopramide), phenothiazines, atypical antipsychotics
  • Levothyroxine malabsorption due to iron, sucralfate, aluminum hydroxide antacids, calcium supplements, soy milk
  • Rare cases of hyperthyroidism due to inappropriate pituitary TSH secretion, eg, neoplasm

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