Registered Nurse (RN) Endocrine Licensure Exam

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What lab finding is expected in a patient with hypothyroidism?

Elevated T3 and T4 levels.
Decreased TSH levels.
Increased TSH levels.
Normal thyroid function tests.

The correct answer is: Increased TSH levels.

In the context of hypothyroidism, the expected lab finding is an increased level of Thyroid Stimulating Hormone (TSH). This occurs due to the body's feedback mechanism in response to low thyroid hormone levels (T3 and T4). When the thyroid gland is underactive and does not produce sufficient amounts of these hormones, the pituitary gland senses this deficiency and increases its production of TSH to stimulate the thyroid. This increase in TSH is a compensatory mechanism, trying to induce the thyroid to produce more hormones. In patients with hypothyroidism, one would typically see low levels of T3 and T4 hormones along with elevated TSH levels, indicating that the hypothalamus-pituitary-thyroid axis is working to compensate for the thyroid's reduced functionality.