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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). [73] 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. [74]
Total thyroxine (Total T 4) is generally elevated in hyperthyroidism and decreased in hypothyroidism. [2] It is usually slightly elevated in pregnancy secondary to increased levels of thyroid binding globulin (TBG). [2] Total T4 is measured to see the bound and unbound levels of T4. The total T4 is less useful in cases where there could be ...
Free T4 and total T3 can be measured when hyperthyroidism is of high suspicion as it will improve the accuracy of the diagnosis. Free T4, total T3 or both are elevated and serum TSH is below normal in hyperthyroidism. If the hyperthyroidism is mild, only serum T3 may be elevated and serum TSH can be low or may not be detected in the blood. [14]
Hypothyroidism is diagnosed by looking at the free thyroxine (T4) levels in people with elevated TSH levels, and comparing the ratio between them. People with high TSH and low T4 get a diagnosis ...
In pregnancy, free thyroxine levels may be lower than anticipated due to increased binding to thyroid binding globulin and decreased binding to albumin. They should either be corrected for the stage of pregnancy, [44] or total thyroxine levels should be used instead for diagnosis. [8]
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 ...