Endocrinology General Medicine Strong — NICE CG72 / ATA Guidelines

Thyroid Function Interpreter

Interprets TSH and free T4 pattern to classify thyroid function status.

Used in: Thyroid Disorders

Score interpretation

Euthyroid 0

Normal TSH + Normal fT4: Euthyroid. Normal thyroid function.

→ No further investigation required unless clinical concern persists.

Subclinical Hypothyroidism 1

Mildly raised TSH + Normal fT4: Subclinical hypothyroidism.

→ Repeat in 3–6 months. Treat if TSH >10, symptomatic, or planning pregnancy. Check TPO antibodies.

Overt Hypothyroidism 2–3

Markedly raised TSH + Low or normal fT4: Overt (primary) hypothyroidism.

→ Start levothyroxine (50 mcg/day; 25 mcg in elderly/cardiac). Recheck TFTs in 6–8 weeks. Target TSH 0.4–2.5 mIU/L.

Subclinical Hyperthyroidism 4

Suppressed TSH + Normal fT4: Subclinical hyperthyroidism.

→ Repeat in 3–6 months. If persistent: endocrinology referral. Bone and cardiac risk. Check for causes: multinodular goitre, Graves', excess thyroxine.

Overt Hyperthyroidism 5–6

Suppressed TSH + Elevated fT4: Overt (primary) hyperthyroidism.

→ Endocrinology referral. Consider carbimazole 20–40 mg/day. TFT + CBCs fortnightly initially. Check TSH receptor antibodies (Graves'). Consider radio-iodine or surgery.

Interpretation bands for the TFT Interpreter. Apply clinical judgement and local guidance.

References

NICE CG72. Hypothyroidism. 2019.
Bahn RS et al. ATA/AACE Guidelines for Hyperthyroidism. Endocr Pract. 2011.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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