Thyroid Function (TSH, fT4)
Last reviewed 25 August 2026 · Evidence-graded review — see Methodology
TSH does the primary screening, with free T4 added once TSH returns abnormal. Thyroid hormone sets metabolic rate, so disease in either direction reaches into weight, mood, cardiovascular and bone health, and subclinical disease is genuinely common — especially in older women. The question is not whether the test works. It is whether finding subclinical disease in someone who feels well leads anywhere useful.
Testing is well-evidenced and clearly indicated once symptoms, goitre or risk factors are present — postpartum, autoimmune disease, family history, amiodarone or lithium use. Screening asymptomatic non-pregnant adults is a separate question, and the US Preventive Services Task Force’s 2004 recommendation statement found the evidence insufficient to recommend for or against it (Grade I): fair evidence that TSH detects subclinical disease, poor evidence that treating screen-detected cases improves outcomes. A 2015 update reached materially the same conclusion.
US Preventive Services Task Force. Ann Intern Med. 2004. PubMed: PMID 14734336 · Full cost breakdown & who should test →
Singapore guidance
Not covered in the current review
Singapore’s national screening committee has not reviewed this test in the current volume of its report, which covers nine conditions. That is not a verdict either way.
Source: Screening Test Review Committee report 2026, Volume 1 (Academy of Medicine Singapore and Ministry of Health, February 2026). The full national list · How this is used.
What you would actually pay
- Healthier SG
- Not subsidised
- MediSave
- Not among the screenings named for outpatient claims
Source: Healthier SG Screening (HealthHub) and MediSave outpatient care (Ministry of Health). Absence from either list is not a statement that the test is discouraged — only that no subsidy or claim applies. Gross prices compared.
What it costs when it is wrong
- Basis
- No published harm criterion found
- Severity
- Not documented
Not covered in the current volume of the committee’s report, so no harm criterion was found either way.
An empty finding, not a clean bill of health: this means nothing documented was found for this test. It is not a claim that the test is safe.
Screening harm is not only a laboratory question: the committee’s own criteria advise against a test when “the screening test, or follow-up tests arising from a positive screen, are associated with significant medical risks”. Sources on overdiagnosis → · How this is graded.
Singapore pricing. We have a full price breakdown for this test, using checked 2026 figures from named providers — read the price guide →
FAQ
Is the Thyroid Function (TSH, fT4) worth doing in Singapore?
Thyroid Function (TSH, fT4) carries a moderate evidence grade for screening adults without symptoms. It typically costs S$30–45 in Singapore. It is most appropriate for symptomatic patients, women with risk factors, or as part of a fatigue/weight-change workup. It is not routine in asymptomatic average-risk adults; consider once around perimenopause or with symptoms/risk factors.
Weighing this against something else? Compare it with two other tests → · Price it inside a panel →