The role of high-performance liquid chromatography − tandem mass spectrometry in optimizing diagnosis and treatment of thyroid diseases

Thyroid hormones play an integral role in growth, homeostasis, and maintenance of physiological functions and are necessary for normal development. Therefore, an accurate assessment of thyroid function is important for both diagnosis and treatment of thyroid disorders. Thyroid function is assessed by measuring thyroid-stimulating hormone (TSH) and thyroid hormones: thyroxine (T4), triiodothyronine (T3), total and free fractions. The concentration of thyroid hormones in patients without pathology of the thyroid gland remains constant and correlates with the level of hormones in tissues and their biological effects. However, most circulating hormones are bound to plasma proteins and only a small part is in free form, the most commonly used methods of immunoassay in this connection have limitations. The method of high performance liquid chromatography − tandem mass spectrometry (HPLC-MS/MS) successfully copes with this problem, which allows improving the specificity and accuracy of measurement of thyroid hormones. High performance liquid chromatography − tandem mass spectrometry allows to achieve specificity, accuracy for reliable determination of the level of thyroid hormones, increasing diagnostic capabilities. This method is especially important in the presence of thyroid gland pathology and factors affecting the binding of hormones to the protein.