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Epidemiol Health System J. 2025;12(4): 201-206.
doi: 10.34172/ehsj.26366
  Abstract View: 6
  PDF Download: 6

Original Article

Reference Range of Thyroid Function Tests (Total Triiodothyronine, Total Thyroxine, and Thyroid-Stimulating Hormone) Among Iranian Adults

Hossein Fallahzadeh 1 ORCID logo, Mahdieh Momayyezi 1* ORCID logo, Mahmud Baghbanian 2 ORCID logo, Masoud Mirzaei 3 ORCID logo, Seyedmohammad Mohammadi 4 ORCID logo

1 Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Yazd Cardiovascular Research Centre, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
*Corresponding Author: Mahdieh Momayyezi, Email: mahdieh_momayyezi@yahoo.com

Abstract

Background and aims: Thyroid hormones are the primary tests for diagnosing thyroid disorders in individuals. This study aimed to evaluate the reference ranges of serum thyroid-stimulating hormone (TSH), total thyroxine (T4), and total triiodothyronine (T3) among adults in Yazd province.

Methods: This cross-sectional study was conducted on individuals participating in the Yazd Health Study. Overall, 1,943 participants were included according to the National Academy of Clinical Biochemistry criteria. The direct method was employed to establish accurate and relevant reference ranges. Moreover, the 2.5th and 97.5th percentiles were calculated, with 95% confidence intervals for the lower and upper limits. The obtained data were analyzed using MedCalc 12.1 and SPSS 25.

Results: The mean±standard deviation age of the participants was 42.8±11.6 years. In addition, the reference intervals derived for TSH, T4, and T3 were 0.32–4.22 mU/L, 9.54–11.93 pmol/L, and 92.48–194.41 nmol/L, respectively. Furthermore, the 2.5th and 97.5th percentiles for TSH were 1.32 mU/L and 4.60 mU/L, respectively. Significant differences were observed in TSH between genders (P=0.001), while differences in T3 (P=0.146) and T4 (P=0.087) values between genders were not statistically significant.

Conclusion: This study established age-specific and gender-specific reference ranges for T3, T4, and TSH in a large cohort of Iranian adults. Such information can help healthcare professionals categorize patients more accurately by thyroid function levels.


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Submitted: 15 Feb 2025
Revision: 13 Dec 2025
Accepted: 14 Dec 2025
ePublished: 30 Dec 2025
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