Serum Thyroglobulin Levels in Healthy Subjects and in Patients with Thyroid Disease

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Abstract
Between 60 and 70% of normal subjects have circulating thyroglobulin demonstrable by a radioimmunoassay with a sensitivity of 10 ng/ml. Thyroglobulin was more frequently detectable in the sera of pregnant women and in newborn infants. Thyroglobulin did not cross the placenta in experiments on the rat. As expected, considerable amounts of thyroglobulin are released at operation or by therapeutic doses of radioiodine but there was no appreciable increase in the serum concentration following tracer doses, suggesting that during routine uptake tests leakage through radiation damage is negligible. In nontoxic nodular goiters elevated serum thyroglobulin concentrations were observed which correlated with goiter size. Thyroglobulin levels were higher in the patients giving a family history of thyroid disease although this group also had larger goiters. Thyroglobulin assay curves for goiter extract, the patient's serum and standard thyroglobulin were parallel. It is known that increased amounts of thyroglobulin are released by TSH stimulation of the thyroid in normal animals and the higher levels seen in patients with active Graves' disease probably arise through LATS stimulation causing an exaggeration of the normal physiological release mechanisms. There was a moderate correlation between PBI and thyroglobulin concentration (r =0.57; p<0.02). Higher levels were seen in untreated hyperthyroid patients and in those maintained on carbimazole as compared with patients in permanent remission. The results obtained in chronic thyroiditis were difficult to interpret owing to the opposing effects of several factors. Levels in De Quervain's thyroiditis and papillary carcinoma of the thyroid did not exceed the normal range.

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