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Total triiodothyronine (Total T 3) is rarely measured, having been largely superseded by free T3 tests. Total T3 is generally elevated in hyperthyroidism and decreased in hypothyroidism. [2] Reference ranges depend on the method of analysis. Results should always be interpreted using the range from the laboratory that performed the test.
T 3 is the more metabolically active hormone produced from T 4.T 4 is deiodinated by three deiodinase enzymes to produce the more-active triiodothyronine: . Type I present in liver, kidney, thyroid, and (to a lesser extent) pituitary; it accounts for 80% of the deiodination of T 4.
When circulating in the body, T3 and T4 are bound to transport proteins. Only a small fraction of the circulating thyroid hormones are unbound or free, and thus biologically active. T3 and T4 levels can thus be measured as free T3 and T4, or total T3 and T4, which takes into consideration the free hormones in addition to the protein-bound hormones.
People with hyperthyroid will typically "take up" higher than normal levels of radioiodine. Normal ranges for RAI uptake are from 10 to 30%. In addition to testing the TSH levels, many doctors test for T 3, Free T 3, T 4, and/or Free T 4 for more detailed results. Free T 4 is unbound to any protein in the blood.
Affected patients may have normal, low, or slightly elevated TSH depending on the spectrum and phase of illness. Total T4 and T3 levels may be altered by binding protein abnormalities, and medications. Reverse T3 levels are generally increased, while FT3 is decreased. FT4 levels may have a transient increase, before becoming subnormal during ...
This in turn causes the thyroid to produce T3 and T4, which play a role in the aforementioned processes. ... by looking at the free thyroxine (T4) levels in people with elevated TSH levels, and ...
However, as the two thyroid hormones travel bound to other molecules, and it is the "free" component that is biologically active, free T 3 and free T 4 levels can be measured. [84] T 3 is preferred, because in hypothyroidism T 3 levels may be normal. [84] The ratio of bound to unbound thyroid hormones is known as the thyroid hormone binding ...
A related parameter is the free thyroxine index, which is total T 4 multiplied by thyroid hormone uptake, which, in turn, is a measure of the unbound TBG. [75] Additionally, thyroid disorders can be detected prenatally using advanced imaging techniques and testing fetal hormone levels. [76]