Prevalence and Clinical Characteristics of Macro-TSH in Patients with Subclinical Hypothyroidism
Authors' conclusion
Macro-TSH complexes comprise several immunoglobulin isotypes. In cases with low antibody-TSH binding affinity and positive antithyroid autoantibodies, TSH levels may fluctuate during the clinical course, thereby complicating diagnosis and management.
Study context
- Population
- Patients with SCH (TSH > 4.23 mIU/L with normal fT4), untreated or on levothyroxine (LT4) monotherapy, August–November 2023
- Participants
- 1,599 consecutive patients
- Outcome
- Prevalence and clinical features of macro-TSH
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Macro-TSH prevalence (high molecular-weight TSH peaks >150 kDa)
Patients with macro-TSH
4
0.25%
Observational data: associations, not effects.
Further findings
Clinical features of macro-TSH patients
Patients
- Substantial variation in TSH recovery after polyethylene glycol (PEG) precipitation on reevaluation
- 2
- Previously received LT4 therapy, with modest TSH reduction
- 4
- Positive for TgAb and/or TPOAb
- 3
Original publication
Prevalence and Clinical Characteristics of Macro-TSH in Patients with Subclinical Hypothyroidism. Thyroid. Published 3 June 2026. doi:10.
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