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Fasting versus postprandial state: Impact on thyroid function testing
Dheeman Futela, K Maheswari, Tejasvini Khanna
Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
Correspondence Address:
K Maheswari,
Department of Biochemistry, Maulana Azad Medical College, New Delhi
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/trp.trp_11_21
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Context: Thyroid dysfunctions are common health problems worldwide. Thyroid function tests (TFTs) are the mainstay of diagnosis. A common question by labs and clinicians is whether food intake makes a clinically significant difference for TFTs.
Aims: We aimed to assess the effect of fasting and postprandial state on thyroid-stimulating hormone (TSH), free T3, and free T4.
Settings and Design: A cross-sectional study was conducted. Sixty patients were prospectively selected.
Subjects and Methods: Patients were divided into two groups: Group A (known case of thyroid disorder and on medication) and Group B (no prior history of thyroid dysfunction). Two blood samples were collected from each patient, before and after breakfast, with a gap of 2 h. Serum samples were analyzed for TSH, free T3, and free T4.
Results: Mean (± standard deviation) TSH values (mIU/L) in fasting state were 2.38 ± 1.88 and in postprandial state were 2.08 ± 1.65. A statistically significant postprandial decline was observed in TSH values (mean difference: -0.30 mIU/L) and free T3 (mean difference: –0.21 pmol/L), in both groups.
Conclusions: TFT results were altered in a statistically significant manner after food intake. Multiple studies have reported a similar postprandial decline in serum TSH. This may impact the diagnosis and management of thyroid patients, especially where minor changes in TSH levels are clinically relevant.
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