Immunoradiometric assay of thyrotropin as a "first-line" thyroid-function test in the routine laboratory.

We compared the utility of a sensitive immunoradiometric assay for serum thyrotropin as a "first-line" thyroid-function test with a strategy based on first measuring total thyroxin in serum. The immunoradiometric assay appears to distinguish primary hypothyroidism and hyperthyroidism from euthyroidism in "new" patients. The role of this test in monitoring antithyroid treatment or thyroxin-replacement therapy is not yet established, there being particular difficulty in interpreting low thyrotropin concentrations in such patients. Nevertheless, because a normal thyrotropin concentration in most, if not all, situations signifies the euthyroid state, thyrotropin determination by immunoradiometric assay merits consideration as an initial test by laboratories performing thyroid-function tests.