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This review summarizes the main principles for the appropriate use of laboratory testing in the diagnosis and management of thyroid disorders, as well as controversies that have arisen in association with some of these biochemical tests. To place a test in perspective, the sensitivity and accuracy of the test should be taken into account. Ordering the correct laboratory tests facilitates the early diagnosis of a thyroid disorder and institutes timely and appropriate treatment. This review will focus on a comprehensive update regarding thyroid-stimulating hormone (TSH),