Mass Spectrometry

This talk will focus on how mass spectrometry improves both diagnosis and treatment of patients with hypothyroidism (20million in the USA). We will discuss current problems with immunoassays for thyroid testing which frequently lead to thewrong diagnosis and poor patient management. In contrast the diagnosis of hypothyroidism is more reliable utilizing UF LCMS/MS (ultra-filtration tandem mass spectrometry) for the measurement of FT4, FT3, TT3 and TT4. The suboptimal current role ofthe FDA in licensing inaccurate and unreliable immunoassay methods and the approaches of the AACC and IFCC to harmonizeimmunoassay platforms with reference LCMS/MS methods will be critiqued. Finally evidence of poor performance of thyroidstimulating hormone (TSH) tests in predicting thyroid disease will be discussed.