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Total thyroxine is rarely measured, having been largely superseded by free thyroxine tests. 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]
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 ]
Both excess and deficiency of thyroxine can cause disorders. Hyperthyroidism (an example is Graves' disease) is the clinical syndrome caused by an excess of circulating free thyroxine, free triiodothyronine, or both. It is a common disorder that affects approximately 2% of women and 0.2% of men.
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 ...
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]
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 ...
More specifically, optimal levels are generally close to a central tendency of the values found in the population. However, usual and optimal levels may differ substantially, most notably among vitamins and blood lipids, so these tables give limits on both standard and optimal (or target) ranges.
In overt primary hyperthyroidism, TSH levels are low and T 4 and T 3 levels are high. Subclinical hyperthyroidism is a milder form of hyperthyroidism characterized by low or undetectable serum TSH level, but with a normal serum free thyroxine level. [32]