Role of thyrotropin measurements in the diagnosis and management of thyroid disease.

This article reviews the role of thyrotropin assays in clinical medicine and illustrates the advantages and limitations of assays that can measure subnormal concentrations. Analytic considerations that can significantly alter the performance of these assays are outlined. The concept of assay generations is defined, and the potential roles of third and fourth generation assays are postulated. In addition, a diagnostic strategy is presented for using TSH and other procedures in the diagnosis and management of thyroid disease.