T3 T4
Secretion 30 microgram/day 80 microgram/day
Source 20-25% by gland Solely by gland
75-80% by conversion
Half-life 1 day 7 days
Potency 3-4 times more potent than T4 Potent
Binding 0.4% is unbound 0.04% is unbound
Thyroid Disorder:
Symptoms of Hypothyroidism:
Lethargy
Constipation
Dry and Coarse Skin and Hair
Facial puffiness
Cold intolerance
Decreased Sweating
Impaired memory
Confusion
Dementia
Low speech and motor activity
Anemia
Causes of Hypothyroidism:
Primary Secondary
Iodine deficiency Hypopituitarism
Excess Iodide Intake Adenoma
Thyroid Ablation (surgery) Ablative Therapy
Hashimoto’s Thyroiditis Pituitary destruction
Subacute Thyroiditis
Genetic Abnormalities Why hypothalamus?
Goiterogenic Food (Cabbagge) Because it’s the main regulatory system for thyroid
Drugs (Lithium, Amiodarone, Anti-Thyroid Agent) hormone.
Tertiary:
CC 3- Lab FKM ‘17
Symptoms of Hyperthyroidism:
Super fast metabolism
Nervousness
Fatigue
Weight loss
Heat intolerance
Increase sweating
Tachychardia
Atrial fibrillation
Warm and moist skin
Exophthalmos – bulging of eyeballs around the orbit
Causes of hyperthyroidism:
1. Overproduction of Thyroid Hormone
Grave’s Disease
TSH Secreting Pituitary Adenoma
Multinodular Goiter
Thyroid Tests:
Measures the concentration of products secreted by the thyroid gland:
Free T4
Ref. Range: 0.8-2.7 nanogram/dL
Measure: Unbound fraction of T4
Method: Direct Equilibrium Dialysis
Used to different drug induced TSH elevation and hypothyroidism .
Primary hypothyroidism: Decrease FT4 / Increase TSH
Non-Pituitary Hyperthyroidism: Increase FT4 / Decrease TSH
Total Serum T4
Ref. Range: 5.5-12.5 ug/dL or 71-161 nmol/L (adult)
11.8-22.6 ug/dL or 152-292 nmol/L (neonate)
Method: Radioimmunoassay, Chemilluminometric Assay, Immunometric Assay
Increase Decrease
Hyperthyroidism Hypothyroidism
Increase concentration of Thyroid binding Protein Decrease concentration of Thyroid Binding Protein
Non-Thyroidal Illness (DM, Liver Disease)
CC 3- Lab FKM ‘17
Serum T3 Resin Uptake:
Ref. Range: 25-35%
Indirectly estimates the number of binding sites on thyroid binding protein occupied by T3.
The T3 resin uptake is high when decrease number of binding sites.
The T3 resin uptake is low when increase number of binding sites.
Increase Decrease
Primary Hypothyroidims Primary Hyperthyroidism
Hashimoto’s Thyroiditis Secondary and Tertiary Hypothyroidism
Thyrotoxicosis due to Pituitary Tumor Treated Grave’s Disease (Normal function of Thyroid gland but
decrease TSH)
TSH Antibodies Euthyroid Sick Disease
Thyroid Hormone Resistance Over replacement of Thyroid Hormone in hypothyroidism