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Percentiles for Jostel's TSH index (TSHI or JTI) along with reference ranges for thyroid's secretory capacity (SPINA-GT) and univariable reference ranges for thyrotropin (TSH) and free thyroxine (FT4), shown in the two-dimensional phase plane defined by serum concentrations of TSH and FT4.
People with hyperthyroid will typically "take up" higher than normal levels of radioiodine. Normal ranges for RAI uptake are from 10 to 30%. In addition to testing the TSH levels, many doctors test for T 3, Free T 3, T 4, and/or Free T 4 for more detailed results. Free T 4 is unbound to any protein in the blood.
The Free Thyroxine Index (FTI or T7) is obtained by multiplying the total T 4 with T 3 uptake. [2] FTI is considered to be a more reliable indicator of thyroid status in the presence of abnormalities in plasma protein binding. [2] This test is rarely used now that reliable free thyroxine and free triiodothyronine assays are routinely available.
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]
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 ]
Thyroxine or tetraiodothyronine (T4) is produced by the thyroid gland. The term is sometimes used to refer to hyperthyroidism, but hyperthyroidism is a more general term. [2] When the level of thyroxine (T4) in the blood exceeds normal range, it can lead to symptoms such as irritability and unexplained weight loss. [3] Types include:
[10] [3] IL-1β has been shown to decrease liver D1, [10] as well as thyroid hormone receptor (THR) levels. IL-6 and TNFa downregulate D1 and suppress TSH, are negatively correlated with fT3, and are positively correlated with rT3. [3] NF-κB also inhibits D1, and decreases the expression of Thyroid receptors α and β. [3]
Thyroxine, also known as T 4, is a hormone produced by the thyroid gland. It is the primary form of thyroid hormone found in the blood and acts as a prohormone of the more active thyroid hormone, triiodothyronine (T 3 ). [ 1 ]