IGeL thyroid test: TSH measurement

The health insurance does not pay for these medical services, which is why they are called "Individual Health Services" (IGeL). Is the investment worth it? We do the check. This time: a blood test for thyroid function

What is being done there?

The blood level of the messenger substance TSH, which controls the production and release of thyroid hormones, is measured. If it deviates from the norm, there may be an over- or underactive thyroid.

Thyroid hormones influence many processes in the body. Too little or too much therefore triggers different symptoms. With hypofunction, patients often feel tired, with overactive they sweat easily or are constantly nervous.

The health insurance company pays for the TSH test if the doctor deems it medically necessary. For example, if there are signs of a malfunction. A blood analysis without a medical reason will be billed to the patient.

Per

  • The test is easy and not overly expensive. The effort for the patient: a simple blood sample.
  • It can reveal malfunctions that patients do not experience symptoms.
  • The German Society for Endocrinology recommends the self-pay service to pregnant women. Thyroid dysfunction, which occurs in about 1 in 100 expectant mothers, increases the risk of miscarriage and developmental disorder in the child.

Contra

  • The TSH value can fluctuate depending on the measurement method and time of day. It is also influenced by some drugs and diseases, age and body weight. A second measurement often gives a value in the normal range again.
  • A US analysis of the data has shown: Not a single study was able to assess whether people without symptoms benefit from the TSH measurement. Almost all studies showed, however, that if you do not suffer from underactive symptoms, you will not benefit from therapy anyway - neither in terms of quality of life and mental fitness nor in terms of blood pressure.
  • Treatment often begins prematurely. "It often starts with a one-off increase in value," says Professor Joachim Spranger, Director of the Clinic for Endocrinology and Metabolic Medicine at the Charité Berlin, "without repeating the measurement or measuring thyroid hormones directly." Possible consequence: People who are being treated for allegedly underactive suddenly show overactive.

costs

According to the medical fee schedule, the test including the blood sample costs between 17 and 21 euros - a little more if the doctor includes the consultation.

Conclusion

A TSH measurement is primarily useful if there is a suspicion of over- or under-function or the doctor wants to clarify whether the thyroid gland is involved in a disease. In these cases, however, the health insurance companies bear the costs anyway.

Experts - for example Joachim Spranger - advise against a test without a medical reason. He does not recommend individual health performance even if there is a familial increased risk of thyroid diseases.

But not all medical professionals agree. For example, Professor Petra-Maria Schumm-Draeger, medical director of the Center for Internal Medicine / Fünf Höfe in Munich, says: "If there is a family predisposition to nodes, Hashimoto or Basedow, I find the test useful."