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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.
In humans, the ratio of T 4 to T 3 released into the blood is approximately 14:1. [6] T 4 is converted to the active T 3 (three to four times more potent than T 4) within cells by deiodinases (5′-deiodinase). These are further processed by decarboxylation and deiodination to produce iodothyronamine (T 1 a) and thyronamine (T 0 a).
Reverse triiodothyronine, also known as rT 3, is an isomer of triiodothyronine (T 3).. Reverse T 3 is the third-most common iodothyronine the thyroid gland releases into the bloodstream, at 0.9%; tetraiodothyronine (levothyroxine, T 4) constitutes 90% and T 3 is 9%.
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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]