The "urgent" thyroid function tests referred to in the recent thread of
course need interpreting with care. This came home to me recently through
serendipity:
A 65 year old lady was diagnosed 12 months previously as a clear
uncomplicated primary hypothyroid when she had presented to her community
physician complaining of "weight loss"(!). Over the next few months she was
stabilised on 100 ug/day of T4 replacement. Adequacy of thereapy was
confirmed by three normal TSH levels in Oct 98 and April 99.
The very next day in April she was admitted as an emergency to the cardiac
unit with "Bradycardia, ?MI" and subsequently was diagnosed to have had an
Inferior MI. CK and Troponin I were high as would be expected. Throughout
her admission she received her normal T4 dose.
Results:
Day before Day 1 Day 2 Day 6
admission
TSH mU/L Ref 0.3-5.5 5.0 60.1 ! 11.3 11.6
FT4 pmol/L Ref 10-25 16.8 14.9 10.9
FT3 pmol/L Ref 3.0-6.5 2.8 2.9 <1.0
Geoff Lester
Chemical Pathology
Frenchay Hospital.
BRISTOL UK.
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