A health practitioner may order a TSH test when someone has symptoms of hyperthyroidism or hypothyroidism and/or when a person has an enlarged thyroid gland (goiter). Signs and symptoms of hyperthyroidism may include: Increased heart rate Anxiety Weight loss Difficulty sleeping Tremors in the hands Weakness Diarrhea (sometimes) Light sensitivity, visual disturbances The eyes may be affected: puffiness around the eyes, dryness, irritation, and, in some cases, bulging of the eyes. Signs and symptoms of hypothyroidism may include: Weight gain Dry skin Constipation Cold intolerance Puffy skin Hair loss Fatigue Menstrual irregularity in women TSH may be ordered at regular intervals when an individual is being treated for a known thyroid disorder. When a person's dose of thyroid medication is adjusted.The thyroid-stimulating hormone (TSH) test is often the test of choice for evaluating thyroid function and/or symptoms of a thyroid disorder, including hyperthyroidism or hypothyroidism. TSH is produced by the pituitary gland (A tiny organ located below the brain and behind the sinus cavities), It is part of the body's feedback system to maintain stable amounts of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood and to help control the rate at which the body uses energy. A TSH test is frequently ordered along with or preceding a free T4 test. Other thyroid tests that may be ordered include a free T3 test and thyroid antibodies (if autoimmune-related thyroid disease is suspected). Sometimes TSH, free T4 and free T3 are ordered together as a thyroid panel. TSH testing is used to: Diagnose a thyroid disorder in a person with symptoms Screen newborns for an underactive thyroid Monitor thyroid replacement therapy in people with hypothyroidism Monitor anti-thyroid treatment in people with hyperthyroidism Help diagnose and monitor infertility problems in women Help evaluate the function of the pituitary gland (occasionally)