Thyroid disorders are common in pediatrics. Tests of thyroid function are widely available and frequently ordered in the pediatric healthcare setting. This is sometimes driven by common signs or symptoms of thyroid disease. All too often, it is driven by patients and their parents requesting thyroid tests for nonspecific symptoms, such as fatigue, obesity or family history of thyroid disease. The decision to order thyroid tests, as well as which test(s) of thyroid function to order, deserves careful thought rather than a reflexive “thyroid panel” for every patient. Thyroid stimulating hormone (TSH) is the single most appropriate test of thyroid function when screening a pediatric or adolescent for thyroid disorders. Adding more tests only increases the likelihood that a minor (and often insignificant) abnormality will be found. These incidental abnormalities can create anxiety for the parent and child, and usually results in additional testing, referral to a pediatric endocrinologist, and further expense. This review will aim to guide the pediatric primary care provider on the choice of appropriate screening test(s) for acquired thyroid dysfunction in children and adolescents, as well as the proper interpretation of the test(s). Emphasis will be placed on the “slightly” abnormal thyroid screening test. Specific thyroid tests to be reviewed include TSH, (free) T4, (free) T3, and thyroid antibodies. Finally, this review will aim to guide decisions on follow-up, additional testing, and reasons for referral to a pediatric endocrinologist. Congenital hypothyroidism, including abnormalities on state newborn screening, will not be discussed.

甲状腺疾病常见于儿科。甲状腺功能检查广泛可用，在儿科医疗机构中经常订购。有时这是由甲状腺疾病的常见体征或症状引起的。通常，它是由患者及其父母要求对甲状腺进行非特异性症状（例如疲劳，肥胖或甲状腺疾病的家族史）进行甲状腺检查。订购甲状腺检查以及订购哪种甲状腺功能检查的决定，值得每位患者仔细考虑，而不是反思性的“甲状腺检查”。筛查小儿或青少年甲状腺疾病时，甲状腺刺激激素（TSH）是对甲状腺功能的最合适测试。添加更多测试只会增加发现轻微（通常不重要）异常的可能性。这些偶然的异常情况可能会给父母和孩子造成焦虑，通常会导致额外的检查，转诊给儿科内分泌科医生以及其他费用。这项审查的目的是指导儿童初级保健提供者选择针对儿童和青少年获得性甲状腺功能障碍的适当筛查测试，以及对测试的正确解释。重点将放在“轻微”异常甲状腺筛查测试上。要检查的特定甲状腺检查包括TSH，（游离）T4，（游离）T3和甲状腺抗体。最后，本次审查旨在指导有关随访，其他检查以及转诊至儿科内分泌科医生的原因的决定。先天性甲状腺功能减退症，包括状态新生儿筛查异常，将不予讨论。