Journal List > Kosin Med J > v.29(2) > 1057020

Kim, Lew, Choi, Lee, Kim, Kim, Kim, Jung, Jung, and Hahm: The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging



We conducted a study to investigate the normal range for TSH and within-individual variations of TSH according to temperat䴸re and aging.

Patients and Methods:

We enrolled patients who underwent periodic medical examinations five times over a six year period (2007.8~2013.6). Anthropometric data and thyroid ultrasonography were evaluated, and serum TSH, T3, and T4 were assayed.


Subjects were 19-64 years old, 120 were female, and 208 were male. Reference ranges for TSH were 0.53-4.94 mlU/L in the first test, 0.49-5.61 mlU/L in the second test, 0.46-6.06 mlU/L in the third test, 0.48-5.99 mlU/L in the fourth test, and 0.52-6.3 mlU/L in the fifth test. When the TSH level was analyzed according to temperature and sex, mean TSH was higher in months in which the average monthly temperatures were below 100C in Jinju, Gyeongnam and female. The aging and low temperatures are associated with increased serum TSH concentrations in the within-individual.


This study showed that aging is associated with increased serum TSH concentrations in the within- individual and serum TSH concentrations are different in the within-individual according to the temperature.


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Fig. 1
Schematic presentation of enrolled subjects for analysis.
Estimated marginal means natural logarithm(TSH)SE that was checked five times for six years
Fig, 3
Within-individual TSH levels separated by average monthly temperature(10iC) for 146 subjects.
Table 1.
Baseline characteristics of subjects in first check-up
Characteristic Total (n=328)
Age (Years), mean±SD 42.1±8.09
Age stratum (Years), n(%)  
  ≤29 20 (6.1)
  30-39 111(33.8)
  40-49 139(42.4)
  50-59 48(14.6)
  60≥ 10(3.0)
Female, n(%) 120(36.6)
BMI, mean±SD 23.34土 2.91
Presence of thyroid nodules n(%) 21(6.4)
Presence of Fatty liver, n(%)  
    Normal echogenecity 277(84.4)
    Mild 18(5.5)
    Moderate-severe 33(10.1)
Alcoliol intake, n(%)  
    Nearly not 117(37.5)
    < 20 g/day 102(31.1)
    ≥ 20 g/day 109(33.2)

SD: Standard Deviation, BMI: Body mass index

Table 2.
Mean TSH and thyroid hormones values for each subject check-up.
Sequence of tests TFT(n=328)
  T3(ng/dL) T4(ug/dL) T4(ng/dL)
First 107.2±15.6 7.55±1.24 1.29±0.16
Second 109.3±15.2 7.44±1.14 1.32±0.18
Third 109.5±16.9 7.54±1.18 1.32±0.17
Fourth 110.3±15.8 7.34±1.24 1,30±0.18
Fifth 108.2±15.9 7.67±1.29 1.29±0.15

Values are mean ± SD SD: Standard Deviation

249 analyzed

295 analyzed due to missing values.

Table 3.
Reference range of TSH values according to the serial check-ups.
Sequence of tests TSH reference range(mIU/L)
Lower limit Mean Upper limit
First 0.53 1.62 4.94
Second 0.49 1.65 5.61
Third 0.46 1.67 6.00
Fourth 0.48 1.70 5.99
Fifth 0.52 1.78 6.13

The ranges were calculated as mean ± 2SD of log-transformed serum TSH concentrations for each sequence of check-up

Table 4.
Mean TSH value according to gender, age stratum, thyroid nodules, alcohol intake, fatty liver, temperature, and BMI.
Factors TSH(mIU/L)
First Second Third Fourth Fifth
Age, year 42.1±8.09 43.3±8.11 44.6±8.14 45.8±8.12 47.1±8.18
Female(120) 1.98±1.15 2.06±1.11 2.08±1.18 2.15±1.33 2.29±1.30
Male(208) 1.83±1.02 1.87±1.04 1.93±1.20 1.95±1.20 2.00±1.76
Age stratum          
30 내이하(131) 1.86±0.95 1.87±1.03 1.88±1.04 1.92±1.03 2.01±0.98
40 내(139) 1.89±1.16 1.99±1.05 2.05±1.30 2.05±1.23 2.09±1.27
50 내이성(58) 1.94±1.11 1.96±1.21 2.08±1.26 2.20±1.22 2.38±1.59
Nodule(-) 1.90± 1.07(307) 1.97±1.04(298) 2.01±1.20(300) 2.05±1.22(301) 2.14±1.23(298)
Nodule(+) 1.67± 1.06(21) l.66±0.73(29) 1.71±1.15(28) 1.67±1.24(27) 1.83± 1.22(30)
Not intake(H7) 1.B6±1.10 1.97±1.08 1.96±1.13 2.05±1.31 2.16±1.25
<20g/day(102) 1.90±1.07 1.90±1.05 1.97±1.16 2.08±1.27 2.09±1.18
≥20g/day(109) 1.90±1.04 1.94±1.08 2.03±1.30 1.94±1.07 2.08±1.27
Fatty Liver          
(-) 1.90±1.07(277) 1.97±1.09(259) 2.02±1.24(259) 2.06±1.20(24S) 2.15±1.26(234)
(+) 1.82±1.07(51) 1.82±0.97(68) 1.85±1.01{69) 1.91±1.28(80) 2.01±1.13(94)
월평균 기온          
A 1.81±1.02(239) 1.84±1.04(231) 1.95±1.18(237) 2.05±1.27(230) 2.06±1.21(228)
B 2.10±1.16(89) 2.17±1.11(97) 2.09±1.23(91) 1.96±1.08(98) 2.22±1.28(100)
<23kg/m2 1.88±1.06(172) 1.93±1.16(155) 2.05±1.18(151) 1.97±1.06(141) 2.13±1.13(146)
23-24 1.80±94(54) 1.71±0.75(76) 1.83±1.06(79) 2.06±1.22(85) 2.07±132(71)
≥25kg/m2 1.96±1.14(100) 2.12±1.17(95) 2.01±1.31(97) 2.10±1.22(102) 2.10±1.23(110)

Values are mean ± SD SD: Standard Deviation, T: Temperature, A:months that average monthly temperature is above 10°C in Jinju, Gyeongnam, B:months that average monthly temperature is below 10°C in Jinju, Gyeongnam, BMI: Body Mass Index P value(mean±SD

is 0.032, P value(mean±SD

)is 0.034, P value(mean±SD

)is 0.008. P value by T-test or ANOVA(Analysis of variance)

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