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Biochemistry Clinical Biochemistry

Thyroid and Adrenal Function Tests

Topic overview

Start with the big picture

The lesson organizes testing into thyroid and adrenal evaluations. For thyroid disorders, it explains the role of TSH and free T4/T3, how binding-protein changes can affect total T4, and when antibodies, calcitonin, or radioiodine uptake provide additional diagnostic information. It also addresses non-thyroidal illness patterns. Adrenal testing covers cortisol and ACTH assessment for suspected adrenal insufficiency, screening and localization approaches for Cushing syndrome, and investigations for primary hyperaldosteronism and pheochromocytoma. Tests for androgen excess and congenital adrenal hyperplasia are also included. Results are interpreted in clinical context, with attention to what each test can help establish.

Learning objectives

What you'll learn

  • Interpret TSH alongside free T4 and T3 in thyroid dysfunction.
  • Describe when thyroid antibodies, calcitonin, and radioiodine uptake are useful.
  • Distinguish adrenal insufficiency testing from Cushing syndrome screening and localization.
  • Identify tests used to investigate hyperaldosteronism, pheochromocytoma, and androgen excess.
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