Other biochemical tests, including levels of α-TSH, SHBG, and thyroid antibodies, as well as radiologic assessment of the sellar region through MRI are used for further diagnosis and differential diagnosis.[7,11,19,20] In some cases, RTH needs to be distinguished from thyroid autoimmune diseases and pituitary TSH-secreting adenoma (TSHoma). This evidence concerns the gene SHBG and autoimmune thyroid disease.