The determination of serum or plasma levels of thyroid stimulating hormone (TSH or thyrotropin) is recognized as an important measurement in the assessment of thyroid function. Thyroid stimulating hormone is secreted by the anterior lobe of the pituitary gland, and induces the production and release of thyroxine (T4) and triiodothyronine (T3) from the thyroid gland. It is a glycoprotein with a molecular weight of approximately 28,000 daltons, consisting of two chemically different subunits, alpha and beta. Although the concentration of TSH in the blood is extremely low, it is essential in the maintenance of normal thyroid function. The release of TSH is regulated by a TSH-releasing hormone (TRH) produced by the hypothalamus. The levels of TSH and TRH are inversely related to the level of thyroid hormone. When there is a high level of thyroid hormone in the blood, less TRH is released by the hypothalamus, so less TSH is secreted by the pituitary. The opposite action will occur when there are decreased levels of thyroid hormones in the blood. This process, known as a negative feedback mechanism, is responsible for maintaining the proper blood levels of these hormones.
