Steven J Soldin
Steven Soldin, National Institutes of Health, USA
Title: The role of mass spectrometry in improving the diagnosis and treatment of patients with thyroid diseases
Biography
Biography: Steven J Soldin
Abstract
Statement of the Problem: Patients diagnosed with hypothyroidism (20 million in USA) are usually treated with T4 monotherapy (90% are female). Despite treatment with T4 monotherapy and immunoassay measurement of TSH, FT4, FT3, T4, and T3 all being normal, approximately 50% of these patients claim they still have symptoms of hypothyroidism.
Methodology & Mass Spectrometry Studies: The same samples when analyzed by mass spectrometric methods frequently reveal that T3 and FT3 are low and occasionally that FT4 and T4 are low as well. Adjustment of dosages of T3 and T4 almost always corrects the clinical problem.
Conclusion & Significance: Current immunoassays for thyroid hormones are unreliable at low concentrations and correct diagnosis and treatment of hypothyroidism requires measurement by LC-MS/MS with appropriate dosage adjustments.