Thyroid Lab Interpretation Guide
  • Home
  • About The Author
  • Primary Thyroid Lab Tests
    • TSH
    • Total T4
    • Free T4
    • Free T3
    • Reverse T3
    • TPO
    • Thyroglobulin Antibody
  • Secondary Thyroid Lab Tests
    • Thyroglobulin
    • TSI
    • TSH Receptor Antibody (TRaB)
    • SHBG
    • D3
    • Ferritin
    • Magnesium
    • Cortisol
    • Thyroid Cancer Monitoring
  • Worthless Thyroid Lab Tests
    • T3 Uptake
    • TBG
  • Poorman's Chart of Thyroid Metabolism
  • Contact
  • Resources & Links
  • Consult DR.T on your Lab Tests

Total T4

​Total T4 (Thyroxine): One of the two main thyroid hormones.
Produced by: Thyroid Gland
Purpose: T4 is not really a hormone but a prohormone for T3. T4’s main purpose in life is to be available for conversion into T3.
Lab Reference Range: 4.5-12.0 mcg/dL
When to order:
-  To monitor thyroid hormone medication usage.
Pearls:
High total T4 may mean that you are on too much thyroid medication, or if you are not on thyroid medication it may represent Grave’s Disease.
The thyroid gland produces T4 and T3 in a ratio of 14:1 to 20:1 (so, a lot more T4).
T4 is the reservoir for T3 production.
Synthroid, Levothyroid, Levothyroxine are all T4 products.
If you are not on thyroid medication and you have a low total T4 with Low or normal TSH, you may have secondary hypothyroidism. This is when the pituitary is not functioning properly and not producing TSH in response to a low T4.
Causes of secondary hypothyroidism:
  • Sheehan’s Syndrome
  • Radiation to Pituitary
  • Trauma or damage to Pituitary
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  • Home
  • About The Author
  • Primary Thyroid Lab Tests
    • TSH
    • Total T4
    • Free T4
    • Free T3
    • Reverse T3
    • TPO
    • Thyroglobulin Antibody
  • Secondary Thyroid Lab Tests
    • Thyroglobulin
    • TSI
    • TSH Receptor Antibody (TRaB)
    • SHBG
    • D3
    • Ferritin
    • Magnesium
    • Cortisol
    • Thyroid Cancer Monitoring
  • Worthless Thyroid Lab Tests
    • T3 Uptake
    • TBG
  • Poorman's Chart of Thyroid Metabolism
  • Contact
  • Resources & Links
  • Consult DR.T on your Lab Tests