TSH is a common blood test in Bangladesh. Doctors ask the patients to take a TSH test to determing the thyroid hormone discharge of the body. Any diversion from the natural range might be a cause of hyperthyroidism or hypothyroidism. As the test does not require any additional diagnosis machinery, the test is done in most of the diagnostic centers and hospitals.
As the test is conducted by reagents and chemicals, the cost is not such high and very convenient for patients to pluck the result with a single donation of blood sample. Nowadays the doctors recommend T3, T4 and other thyroid tests along with TSH test. All these tests are done with a single sample. Below there is a table with name of the TSH tests and their price. The rate can be different from one place to another.
Due to being a very common test within the patients, Bangladesh Government has set a fixed price for this test. The Government imposed cost or price for this test is 700 taka. Though, many hospitals and diagnostic centers may cut off some amount from their profit which might result in a little less cost.
Thyroid Stimulating Hormone
The other name of thyroid stimulating hormone is thyrotropin or thyrotropic hormone. The short form of thyroid stimulating hormone is TSH. This is one of the pituitary hormones which vitalize the production of thyroxine (T4), triiodothyronine (T3) to stimulate tissue metabolism. The nature of the hormone is under the category of glycoprotein hormone. This particular hormone is produced by thyrotrope cells present in the anterior pituitary gland. This results in the function of endocrine activity. Endocrine hormones are directly related to blood.
Thyroid gland is placed in the frontal part of the neck. It is a gland which is shaped like a butterfly. This hormone regulate the energy flow into the body as per body movements or distributive actions.
The Modern Standard Of Care
The modern standard regarding the thyroid test is to define the deficit or superfluity of the hormone itself. In recent times, third generation reagents are common standard methodology of taking highest care of the patient. If the flow of the hormone is not at the optimal level, the doctor can treat the patient with medicines as the hormone plays a vital role within the body system. The hormone does regulate the energy flow of the body by its own.
So, if the hormone is not quite up to the mark, the body can loose its balance and susceptible to muscle cramp, tiredness, depression, loosing muscle balance, reduced muscle movements, pain, weight loss, nausea, etc. The disease is easily treated by oral medicine and very handy for patients with a very cheap rate. In other case, if the patient has higher rate of TSH flow, the patient can have symptoms like weight gain, muscle weakness, fatigue, constipation, cold, hoarseness, dry skin, etc.
The higher rate of secretion is called hypothyroidism and it can also be reduced by oral medicine. Though, the treatment process is long enough and the patient has to take a certain amount of medicines for a long time until the secretion level comes to normal. Also in some cases, the patient might have to take it for the rest of their life. The medicine is cheap enough and most of the patients are able to take care of the cost.
Diagnostic Reference and Application
The reference range of TSH may vary very slightly. Depended on the mode of analysis, if the result fall within the range, the disfunctions are not supposed to happen. The standard range set by the Association for Clinical Biochemistry of United Kingdom is between 0.4 µIU/mL-4.0 µIU/mL. Moreover, according to the National Academy of Clinical Biochemistry (NACB), the normal range of TSH is between 0.4 µIU/mL-2.5 µIU/mL. The concentration of TSH hormone is relatively higher for young children.
Normal range for newborn children is about 1.3 µIU/mL to 19 µIU/mL while 10 weeks old baby might have a common level of TSH between 0.6 µIU/mL to 10 µIU/mL. The normal range falls as the children get older. The adults have a proper standard limit of the range to be considered normal. Range for 14 months young children is 0.4 µIU/mL to 7.0 µIU/mL. As the children gradually get raised up to teenage or puberty, the normal range falls between 0.3 µIU/mL to 3.0 µIU/mL.
Thyroid follicular cells are the receptor of TSH hormones. If the follicular cells are stimulated, T3 and T4 production increases along with the secretion. There are six steps involved in TSH or thyroid hormone synthesis.
(i) The increase in activities and stimulation of sodium iodide symporter (NIS). NIS work on the basolateral membrane which are placed on follicular cells. This process increase intracellular concentration of iodine. The overall procedure is called iodine trapping.
(ii) Among the follicular lumen, iodination of thyroglobuling occurs. This is considered as a precursor protein.
(iii) Iodized tyrosine is stimulated. This influences the formation of tri-iodothyronine and thyroxine, which are known as T3 and T4 respectively. T3 and T4 are attached to thyroglobulin protein.
(iv) The rest of the endocytocis move back to the follicular cells.
(v) Free tri-iodothyronine (T3) and thyroxine (T4) are formed from proteolysis or thyrodlobulin (iodinated).
(vi) T3 and T4 secretion occur and it gets circulated into the basolateral membrane.
Thyroid Function Tests
Third generation immunometric assay methods are typically automated. Fourth generation TSH immunometric assay has been developed for use in research.
TSH was first tested in 1965. The procedure of testing TSH at that point of time was assessed by radioimmunoassay. As time passed by, several improvements and the adoption of variants of radioimmunoassay were taken. Though in the mid-1980, the assay technique of immunmetric was declined and new technologies were discovered.
The new technologies were much more accurate. Consequently, the second, third and fourth generations of TSH immunometric processes were developed. Each upgrade of newer generations were up to ten times more accurate than the previous ones. Up to the time the third generation process got developed, the whole procedure became automated. Nowadays, the fourth generation immunometric assays are used in research purposes.
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