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Thyroid function tests (TFTs) is a collective term for blood tests used to check the function of the thyroid. [1] TFTs may be requested if a patient is thought to suffer from hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroid-suppression or hormone replacement therapy.
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 ...
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.
Free T3 and T4 measurements are important because certain drugs and illnesses can affect the concentrations of transport proteins, resulting in differing total and free thyroid hormone levels. There are differing guidelines for T3 and T4 measurements. Free T4 levels should be measured in the evaluation of hypothyroidism, and low free T4 ...
Further information: Thyroid function tests. Triiodothyronine (T 3) and thyroxine (T 4) can be measured as free T 3 and free T 4, which are indicators of their activities in the body. [74] 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]
As the free amount reflects the amount available to body tissues, the most treatment-relevant measures for thyroid disorders are Free T 3 and Free T 4. [68] Typically, Free T 4 is the preferred test for hypothyroidism, [ 69 ] as Free T 3 immunoassay tests are less reliable at detecting low levels of thyroid hormone, [ 70 ] and they are more ...
Low-T3 syndrome and high-T3 syndrome: Consequences of step-up hypodeiodination, e.g. in critical illness as an example for type 1 allostasis, [20] or hyperdeiodination, as in type 2 allostasis, including posttraumatic stress disorder. [12] Resistance to thyroid hormone: Feedback loop interrupted on the level of pituitary thyroid hormone receptors.
Subclinical hypothyroidism is a biochemical diagnosis characterized by an elevated serum TSH level, but with a normal serum free thyroxine level. [48] [49] [50] The incidence of subclinical hypothyroidism is estimated to be 3-15% and a higher incidence is seen in elderly people, females and those with lower iodine levels. [48]