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  • Hypothyroidism Diagnosis Flowchart

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    Kim Yang Chong
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    This flowchart outlines the process for diagnosing hypothyroidism. It begins with measuring a patient's thyroid stimulating hormone (TSH) levels if they show signs or symptoms of hypothyroidism. If the TSH is above 5.5, free T4 levels are then measured to determine if it is below normal, indicating primary hypothyroidism. If TSH is normal but free T4 is below normal, it is subclinical hypothyroidism. A TSH below 0.35 may indicate a hyperthyroid state.

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    This flowchart outlines the process for diagnosing hypothyroidism. It begins with measuring a patient's thyroid stimulating hormone (TSH) levels if they show signs or symptoms of hypothyroidism. If the TSH is above 5.5, free T4 levels are then measured to determine if it is below normal, indicating primary hypothyroidism. If TSH is normal but free T4 is below normal, it is subclinical hypothyroidism. A TSH below 0.35 may indicate a hyperthyroid state.

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    © All Rights Reserved
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    26 views1 page

    Hypothyroidism Diagnosis Flowchart

    Uploaded by

    Kim Yang Chong
    This flowchart outlines the process for diagnosing hypothyroidism. It begins with measuring a patient's thyroid stimulating hormone (TSH) levels if they show signs or symptoms of hypothyroidism. If the TSH is above 5.5, free T4 levels are then measured to determine if it is below normal, indicating primary hypothyroidism. If TSH is normal but free T4 is below normal, it is subclinical hypothyroidism. A TSH below 0.35 may indicate a hyperthyroid state.

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    © All Rights Reserved
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    Hypothyroidism Diagnosis Flowchart

    Signs or symptoms
    of hypothyroidism

    Measure serum TSH

    TSH > 5.5 mlU per L TSH in normal range TSH < 0.35 mIU per L*

    Measure serum free T₄ Patient is euthyroid Consider


    hyper-thyroid state

    Free T₄ is below Free T₄ is within Free T₄ is above


    normal range normal range normal range

    Primary Subclinical Not primary


    hypothyroidism hypothyroidism hypothyroidism

    *—TSH reference ranges may vary depending on the laboratory.

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