in clinically doubtful situations , the combined metoclopramide-trh test may be used to distinguish patients with a diminished or absent tsh response as a consequence of depression ( central dopaminergic suppression ) from patients with `` '' preclinical hyperthyroidism '' '' where the tsh response is suppressed by feedback control of tsh by thyroid hormones ( thyroid autonomy ) .
C0020550
hyperthyroidis
C0040132
( thyro