Several tests and strategies for the differential diagnosis of TSHomas have been proposed, and include biochemical parameters (e.g., SHBG, markers of bone metabolism, serum alpha subunit) (11–13), dynamic testing (e.g., TRH stimulation or T3 suppression tests) (14–19) or a short course of long-acting somatostatin analog (LAR–SMS) administration (20), in addition to pituitary MRI scan and THRB sequencing (1). This evidence concerns the gene TRH and TSH-secreting pituitary adenoma.