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Total triiodothyronine (Total T 3) is rarely measured, having been largely superseded by free T3 tests.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.
Triiodothyronine can be measured as free triiodothyronine, which is an indicator of triiodothyronine activity in the body. It can also be measured as total triiodothyronine, which also depends on the triiodothyronine that is bound to thyroxine-binding globulin. [18]
They can also be measured as total T 3 and total T 4, which depend on the amount that is bound to thyroxine-binding globulin (TBG). [74] 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]
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.
D1, D2, and D3 regulate the levels of T4, T3, and rT3. Three primary deiodinases are responsible for thyroid hormone conversion and breakdown. Type 1 (D1) deiodinates T4 to the biologically active T3, as well as the hormonally inactive and possibly inhibitory rT3. [3] [5] Type 2 (D2) converts T4 into T3, and breaks down rT3. D3 produces rT3 ...
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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 ...
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.