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Thyroid hormone binding ratio (THBR) is a thyroid function test that measures the "uptake" of T3 or T4 tracer by thyroid-binding globulin (TBG) in a given serum sample. This provides an indirect and reciprocal estimate of the available binding sites on TBG within the sample. The results are then reported as a ratio to normal serum.
Thyroid hormone uptake (T uptake or T 3 uptake) is a measure of the unbound thyroxine binding globulins in the blood, that is, the TBG that is unsaturated with thyroid hormone. [2] Unsaturated TBG increases with decreased levels of thyroid hormones. It is not directly related to triiodothyronine, despite the name T 3 uptake. [2] Reference ranges:
The saturation of binding spots on thyronine-binding globulin (TBG) by endogenous T 3 can be estimated by the triiodothyronine resin uptake test. The test is performed by taking a blood sample, to which an excess of radioactive exogenous T 3 is added, followed by a resin that also binds T 3.
Thyroxine-binding globulin (TBG) is a globulin protein encoded by the SERPINA7 gene in humans. TBG binds thyroid hormones in circulation.It is one of three transport proteins (along with transthyretin and serum albumin) responsible for carrying the thyroid hormones thyroxine (T 4) and triiodothyronine (T 3) in the bloodstream.
The patient swallows a radioisotope of iodine in the form of capsule or fluid, and the absorption (uptake) of this radiotracer by the thyroid is studied after 4–6 hours and after 24 hours with the aid of a scintillation counter. The dose is typically 0.15–0.37 MBq (4–10 μCi) of 131 I iodide, or 3.7–7.4 MBq (100–200 μCi) of 123 I ...
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]
Thyroid function testing frequently reveals decreased thyroid stimulating hormone (TSH) and increased serum levels of triiodothyronine (T3) and thyroxine (T4) during the acute phase of the disease. [2] The intrathyroidal T3 and T4 levels are often reflected by the T3 to T4 ratio, which is typically less than 20 (ng/dL divided by μg/dL). [22]
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.