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Thyroid Function Tests

Thyroid function tests are a series of measurements of different aspects of thyroid hormone presence in the blood stream.

A common panel of thyroid function tests consists of:


T4 (Thyroxine)

This is a measure of all of the active form of thyroid hormone in the blood. 95% of the total is bound to plasma proteins, particularly thyroid binding globulin (TBG). 

It is elevated in hyperthyroidism and depressed in hypothyroidism. It is usually slightly elevated during pregnancy because of increased levels of TBG.


T3 (Triiodothyronine, T3-RIA) by radioimmunoassay

T3 is metabolically a more active form of thyroid hormone than T4, but its' effects are of shorter duration.

It is elevated in hyperthyroidism and depressed in hypothyroidism. 


T3 Uptake

This is a measure of the unbound throxine binding globulins in the blood (unsaturated with thyroid hormone). The less thyroid hormone that is present, the more unsaturated TBG is present.

This is an indirect measure of thyroid hormone levels. It has nothing to do with T3, despite the name.


Free T3 (FT3, Free Triiodothyronine T3)

Free T3 is one of the determinations used to measure thyroid function. T3 is mostly bound to plasma proteins, and the remainder (FT3) is unbound.

It is elevated in hyperthyroidism and depressed in hypothyroidism.


Free T4 (FT4, Free Thyroxin)

Most thyroid hormone is bound to plasma proteins. Some (about 5%) is not bound ("free") and available to serve a metabolic role. Free T4 is the most accurate assessment of thyroid hormone levels, because it avoids changes in plasma protein binding capabilities. 

It is elevated in hyperthyroidism and depressed in hypothyroidism.


FTI (Free Thyroxine Index, FTI, T7)

The FTI is obtained by multiplying the (Total T4) times (T3 Uptake) to obtain an index.

The FTI is considered a more reliable indicator of thyroid status in the presence of abnormalities in plasma protein binding.

It is elevated in hyperthyroidism and depressed in hypothyroidism.


TSH (Thyroid Stimulating Hormone)

Because of the normal feed-back loop, TSH rises whenever the thyroid gland fails to produce sufficient thyroid hormone. 

For the same reason, whenever there is too much thyroid hormone present in the serum, the brain responds by lowering the TSH.

It is elevated in hyperthyroidism and depressed in hypothyroidism.

Normal Values*


Total T4

Men 5-12.5 µg/dl 64.4-161 nmol/L
Women 5-12 µg/dl 64.4-154 nmol/L
Pregnancy 10-17 µg/dl 128.7-219 nmol/L

Free T4

Men 0.8-2.4 ng/dl 10-30 pmol/L

Women

1-2 ng/dl 13-26 pmol/L

Total T3

Men 120-195 ng/dl 1.2-2.6 nmol/L
Women 70-190 ng/dl 1.0-2.6 nmol/L
Pregnancy 100-220 ng/dl 1.1-2.8 nmol/L

Free T3

Men 230-660 pg/dl 3.54-5.44 pmol/L

Free Thyroxine Index

Men 1.3-4.2

Women

1.75-4.95

TSH

Men 0.5-6 mIU/L

Women

4-5 mIU/L

T3 Uptake

Men 25-35%
Women 25-35%
Pregnancy 15-25%

*These are general values taken from a variety of sources. The actual normal values may vary from lab to lab and from one type of testing protocol to another.