In December 2022, the HAS published recommendations for good practice on the management of hyperthyroidism and hypothyroidism in adults (screening, etiological diagnosis, treatment and monitoring).
Since 05/07/2024, Social Security has imposed reimbursement conditions that follow these recommendations. The general principles are as follows:
As first intention, only the TSH dosage must be requested and can only be followed in cascade of T4L+/-T3L dosages depending on the TSH result,
TSH control: minimum frequency 6 weeks,
T4L dosage not recommended in the monitoring of hypothyroidism,
the dosage of antithyroperoxidase antibodies is limited to once per patient in the event of positivity.
Within LABOUEST, in accordance with these recommendations, we suggest prescribing in cascade for your hyper or hypothyroidism screenings “TSH +/- T4L +/- T3L” and we will apply the following protocols:
If TSH < 0.1 mIU/L, in the absence of known history and/or treatment reported to the laboratory, addition T4L+/- T3L if T4L normal.
If TSH > 10mIU/L, in the absence of known history and/or treatment reported to the laboratory, addition T4L.
If TSH outside the usual values but between 0.1 and 10 mIU/L, check at least 6 weeks.
If TSH control again outside the usual values, add T4L and indicate to measure anti-thyroid Ab.
i If you still wish to have a thyroid test analyzed outside of the HAS recommendations, please specify the clinical context and the possible treatment justifying the prescription. In the absence of clinical information, the analyzes will then be non-refundable, at the patient’s expense.