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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 ...
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. [73] 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]
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]
When circulating in the body, T3 and T4 are bound to transport proteins. Only a small fraction of the circulating thyroid hormones are unbound or free, and thus biologically active. T3 and T4 levels can thus be measured as free T3 and T4, or total T3 and T4, which takes into consideration the free hormones in addition to the protein-bound hormones.
The therapeutic target range TSH level for patients on treatment ranges between 0.3 and 3.0 μIU/mL. [18] For hypothyroid patients on thyroxine, measurement of TSH alone is generally considered sufficient. An increase in TSH above the normal range indicates under-replacement or poor compliance with therapy.
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 ...
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 elevation is usually a marked increase over the normal range and is generally greater than 20 mg/dl. [18] Free T4 levels will usually be lowered, but sometimes might be normal. [58] Doctors may check thyroglobulin antibodies (TgAb) whenever a thyroglobulin test is performed to see if the antibody is interfering.