title: The significance of an isolated elevated TSH level in a depressed patient: a clinical commentary.
abstract: OBJECTIVE
  To discuss the approach to the isolated finding of an elevated thyrotropin (TSH) level on routine biochemical screening of a depressed patient.
  
  
  METHODS
  A focused literature review as well as discussion of published clinical guidelines and the formulation of a rational clinical approach.
  
  
  RESULTS
  Screening for thyroid dysfunction is part of the routine assessment of the depressed patient. It is not uncommon for such patients to have an isolated elevation of TSH levels with nor laboratory or clinical features of thyroid disease. There is often misunderstanding about how to deal with this isolated laboratory finding which can lead to unnecessary investigation and treatment.
  
  
  CONCLUSIONS
  A rational approach to evaluation and management of an isolated elevated TSH level is suggested.
authors.affiliation: Staten Island University Hospital, New York Hofstra LIJ North Shore School of Medicine, Hempstead, New York.
authors.forename: Russell T
authors.initials: RT
authors.lastname: Joffe
authors.affiliation: Staten Island University Hospital, New York New York Medical College, Valhalla.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Sullivan
mesh_terms: D000367:Age Factors; D000368:Aged; D003865:Major Depressive Disorder / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood*
chemical_list: D013972:Thyrotropin
keywords: L-thyroxine; hypothyroidism; subclinical hypothyroidism; thyroid; thyrotropin