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Hemolysis Effect on TSH

TSH blood test samples can be inaccurate due to hemolysis, a process in which the membranes of red blood cells break, allowing hemoglobin to infiltrate the surrounding plasma.

  1. Significance

    • The pituitary gland produces thyroid stimulating hormone (TSH), which promotes the thyroid's secretion of metabolic hormones thyroxine and triiodothyronine, both of which are measured in the blood.

    Function

    • TSH tests evaluate serum levels of thyroid functioning hormones thyroxine (t4) and triiodothyronine (t3) levels. The hemolysis effect on TSH testing due to red blood cell breakage contaminates the serum, decreasing accuracy and skewing results.

    Potential

    • Abnormal thyroid causes hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid). Both conditions are treatable with medication or hormone therapy; however, they cause symptoms and complications if untreated due to hemolysis-related misdiagnosis.

    Types

    • The two types of hemolysis that can affect TSH are in-vitro hemolysis and in-vivo hemolysis. In-vitro occurs externally due to tampered samples, whereas in-vivo is an internal condition with pathological causes.

    Considerations

    • In-vitro hemolysis, more common than in-vivo, is caused by specimen trauma resulting from the incorrect transport of blood samples, incorrect needle size, contaminated samples, mixing, shaking, or exposure to extreme temperatures.

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