Carole Ann Spencer, PhD

Professor of Research Medicine

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Dr. Spencer’s major areas of research interest are thyroid physiology and pathology, thyroglobulin and thyroid cancer, immunoassay techniques, thyroid hormone metabolism, and the cost-effective use of thyroid tests. Her current research includes clinical significance of Tg and TgAb in patients with thyroid cancers, parameters for optimizing thyroid hormone suppression of TSH for DTC. Studies on hypothalamic/pituitary mechanisms for regulating TSH, and testing for thyroid dysfunction during pregnancy.

Dr. Spencer earned her PhD from Glasgow University in Scotland. She then went on to complete two fellowships, one in Clinical Biochemistry at Glasgow, and the other at the National Academy of Clinical Biochemistry.


  • Endocrine Society: International Award for Publishing Excellence, 2011
  • National Academy of Clinical Biochemistry: Distinguished Scientist Award, 2004
  • American Association of Clinical Chemistry: Albert L. Chaney Award, 2003
  • American Association for Clinical Chemistry: Outstanding Speaker, 1998
  • Clinical Ligand Assay Society: Distinguished Scientist Award, 1998
  • American Association for Clinical Chemistry: Outstanding Speaker, 1997
  • American Association for Clinical Chemistry: Outstanding Speaker, 1992
  • London Academy of Music and Dramatic Art: Gold Medal, 1967


  • Response to Fitzgerald et alre: “Thyroid Stimulating Hormone and Thyroid Hormones (Triiodothyronine and Thyroxine): An American Thyroid Association-Commissioned Review of Current Clinical and Laboratory Status”. Thyroid. 2024 Jan 17. . View in PubMed
  • Thyroid Stimulating Hormone and Thyroid Hormones (Triiodothyronine and Thyroxine): An American Thyroid Association-Commissioned Review of Current Clinical and Laboratory Status Thyroid. 2023 09; 33(9):1013-1028. . View in PubMed
  • Laboratory Thyroid Tests: A Historical Perspective Thyroid. 2023 04; 33(4):407-419. . View in PubMed
  • Clinical Interpretation of Thyroid Tests: Considerations for Reference Intervals Thyroid. 2023 04; 33(4):404-406. . View in PubMed
  • Evaluation of risk-factor-based screening for thyroid peroxidase antibody positivity in pregnancy Clin Endocrinol (Oxf). 2016 Mar; 84(3):417-22. . View in PubMed
  • Marginal Iodine Status and High Rate of Subclinical Hypothyroidism in Washington DC Women Planning Conception Thyroid. 2015 Oct; 25(10):1151-4. . View in PubMed
  • Thyroglobulin (Tg) Testing Revisited: Tg Assays, TgAb Assays, and Correlation of Results With Clinical Outcomes J Clin Endocrinol Metab. 2015 Aug; 100(8):E1074-83. . View in PubMed
  • Serum thyroglobulin (Tg) monitoring of patients with differentiated thyroid cancer using sensitive (second-generation) immunometric assays can be disrupted by false-negative and false-positive serum thyroglobulin autoantibody misclassifications J Clin Endocrinol Metab. 2014 Dec; 99(12):4589-99. . View in PubMed
  • How sensitive (second-generation) thyroglobulin measurement is changing paradigms for monitoring patients with differentiated thyroid cancer, in the absence or presence of thyroglobulin autoantibodies Curr Opin Endocrinol Diabetes Obes. 2014 Oct; 21(5):394-404. . View in PubMed
  • In search of an unstimulated thyroglobulin baseline value in low-risk papillary thyroid carcinoma patients not receiving radioactive iodine ablation Thyroid. 2014 Jul; 24(7):1127-33. . View in PubMed
  • Commentary on: Implications of thyroglobulin antibody positivity in patients with differentiated thyroid cancer: a clinical position statement Thyroid. 2013 Oct; 23(10):1190-2. . View in PubMed
  • Thyroglobulin antibody (TgAb) methods – Strengths, pitfalls and clinical utility for monitoring TgAb-positive patients with differentiated thyroid cancer Best Pract Res Clin Endocrinol Metab. 2013 Oct; 27(5):701-12. . View in PubMed
  • Clinical review: Clinical utility of thyroglobulin antibody (TgAb) measurements for patients with differentiated thyroid cancers (DTC) J Clin Endocrinol Metab. 2011 Dec; 96(12):3615-27. . View in PubMed
  • Current thyroglobulin autoantibody (TgAb) assays often fail to detect interfering TgAb that can result in the reporting of falsely low/undetectable serum Tg IMA values for patients with differentiated thyroid cancer J Clin Endocrinol Metab. 2011 May; 96(5):1283-91. . View in PubMed
  • Effect of environmental perchlorate on thyroid function in pregnant women from Córdoba, Argentina, and Los Angeles, California Endocr Pract. 2011 May-Jun; 17(3):412-7. . View in PubMed
  • Serum TSH determinations in pregnancy: how, when and why? Nat Rev Endocrinol. 2010 Sep; 6(9):526-9.. View in PubMed
  • Serum Basal thyroglobulin measured by a second-generation assay correlates with the recombinant human thyrotropin-stimulated thyroglobulin response in patients treated for differentiated thyroid cancer Thyroid. 2010 Jun; 20(6):587-95. . View in PubMed
  • Effect of thyroid peroxidase antibodies on thyroid-stimulating hormone reference limits in a primarily Latina population Obstet Med. 2009 Dec; 2(4):154-6. . View in PubMed
  • Free T4 immunoassays are flawed during pregnancyAm J Obstet Gynecol. 2009 Mar; 200(3):260. e1-6. . View in PubMed
  • Mildly elevated TSH and cognition in middle-aged and older adults Thyroid. 2009 Feb; 19(2):111-7. . View in PubMed
  • Measuring thyroglobulin and thyroglobulin autoantibody in patients with differentiated thyroid cancer Nat Clin Pract Endocrinol Metab. 2008 Apr; 4(4):223-33. . View in PubMed
  • National Health and Nutrition Examination Survey III thyroid-stimulating hormone (TSH)-thyroperoxidase antibody relationships demonstrate that TSH upper reference limits may be skewed by occult thyroid dysfunction J Clin Endocrinol Metab. 2007 Nov; 92(11):4236-40. . View in PubMed
  • Thyroglobulin reference values in a pediatric infant population Thyroid. 2007 Nov; 17(11):1049-54. . View in PubMed
  • Clinical impact of thyroglobulin (Tg) and Tg autoantibody method differences on the management of patients with differentiated thyroid carcinomas J Clin Endocrinol Metab. 2005 Oct; 90(10):5566-75. . View in PubMed
  • A simple lifestyle score predicts survival in healthy elderly men Prev Med. 2005 Jun; 40(6):712-7. . View in PubMed
  • Are detection and treatment of thyroid insufficiency in pregnancy feasible? Thyroid. 2005 Jan; 15(1):44-53.. View in PubMed
  • Challenges of serum thyroglobulin (Tg) measurement in the presence of Tg autoantibodies J Clin Endocrinol Metab. 2004 Aug; 89(8):3702-4. . View in PubMed
  • Laboratory medicine practice guidelinesLaboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003 Jan; 13(1):3-126. . View in PubMed
  • Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma J Clin Endocrinol Metab. 1998 Apr; 83(4):1121-7. . View in PubMed
  • Absence of thyroid hormone resistance in vitamin D-;resistant new world primates Am J Primatol. 1994; 32(3):215-222. . View in PubMed