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The magnitude of the TSH response to TRH is modulated by the thyrotroph response to active thyroid hormone and is thus almost always proportional to the concentration of free thyroid hormone in serum.
With the development of more sensitive TSH assays, the TRH test is generally not needed in the evaluation of a thyrotoxic patient with an undetectable TSH.407 Differential diagnosis of conditions leading to inappropriate secretion of TSH may be aided by the TRH test result.
The TSH response to TRH, is subnormal or absent in one-third of apparently euthyroid patients with autoimmune thyroid disease, and even members of their family, may not respond to TRH.
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