Her general practitioner found no physical

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pandora essence Her general practitioner found no physical signs in the chest, although there was a small, multinodular goitre. A measurement of thyroid stimulating hormone (TSH) was requested, and the result was 0.06 mU/L (reference interval 0.4 4.0 mU/L).What is the next investigation?The presence of a goitre prompted examination for clinical signs of thyrotoxicosis, but sinus tachycardia, atrial fibrillation, fine tremor, eye signs (lid lag or retraction), and warm palms were absent. A drug history should also be taken: in this setting of a low TSH level, is the patient taking amiodarone or levothyroxine? pandora charms Less common drug induced causes of a low TSH level are high dose prednisolone, recent treatment with carbimazole, and dopamine infusion.Thyroid function testsLaboratories vary in their testing strategy when a request for thyroid function tests is made.1 Because a serum TSH level within the reference interval excludes primary thyroid disease, and secondary (pituitary or hypothalamic) causes of thyroid dysfunction are uncommon, many laboratories measure only TSH if thyroid function tests are requested. pandora essence

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