Definition

TSI stands for thyroid stimulating immunoglobulin. TSIs are antibodies that tell the thyroid gland to become more active and release excess amounts of thyroid hormone into the blood. A TSI test measures the amount of thyroid stimulating immunoglobulin in your blood.

Alternative Names

TSH receptor stimulating antibody; Thyroid stimulating immunoglobulin; Hypothyroidism - TSI; Hyperthyroidism - TSI; Goiter - TSI; Thyroiditis - TSI

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

No special preparation is usually necessary.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed

Your health care provider may recommend this test if you have signs or symptoms of an overactive thyroid (hyperthyroidism), including symptoms of:

• Graves disease
• Toxic multinodular goiter
• Thyroiditis (swelling and inflammation of the thyroid gland caused by an overactive immune system)

The test is also done during the last 3 months of pregnancy to predict Graves disease in the baby.

The TSI test is most commonly done if you have signs or symptoms of hyperthyroidism but are unable to have a test called thyroid uptake and scan.

This test is not commonly done because it is expensive. Most of the time, another test called TSH receptor antibody test is ordered instead.

Normal Results

Normal values are less than 130% of basal activity.

Normal value ranges may vary slightly among different laboratories. Some laboratories use different measurements or may test different specimens. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

A higher-than-normal level may indicate:

• Graves disease (most common)
• Hashitoxicosis (very rare)
• Neonatal thyrotoxicosis

Risks

There is little risk involved with having your blood taken.Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling lightheaded
• Multiple punctures to locate veins
• Hematoma (blood buildup under the skin)
• Infection (a slight risk any time the skin is broken)

References

Guber HA, Oprea M, Russell YX. Evaluation of endocrine function. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

Hollenberg A, Wiersinga WM. Hyperthyroid disorders. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 12.

Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.

Smith JR, Wassner AJ. Thyrotoxicosis. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 606.

Weetman AP, Kahaly GJ. Graves disease. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 71.