T4 (Thyroxine), Total Most Popular

The T4 (Thyroxine), Total test contains 1 test with 2 biomarkers.

Brief Description: The T4 Total test measures the total levels of thyroxine (T4), a thyroid hormone, in the blood. It assesses the combined levels of both free (unbound) and bound forms of T4.

Also Known As: Total T4 Test, Total Thyroxine Test, T4 Test, T4, T4 Total Test, Bound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Total test ordered?

A T4 Total test may be ordered in several situations to evaluate T4 levels:

  1. Thyroid Function Evaluation: If a patient exhibits symptoms of thyroid dysfunction, such as fatigue, weight changes, or changes in mood, a T4 Total test may be ordered as part of a comprehensive thyroid function evaluation.

  2. Monitoring Thyroid Hormone Therapy: For individuals undergoing thyroid hormone replacement therapy, a T4 Total test helps assess the overall effectiveness of the treatment and ensures that T4 levels are within the target range.

  3. Investigation of Thyroid Disorders: A T4 Total test is valuable in diagnosing specific thyroid disorders, such as hyperthyroidism or hypothyroidism, and provides insights into the functioning of the thyroid gland.

What does a T4 Total blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much Bound T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring Total T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Note: Free T4 Index (T7) will only be calculated and reported if test code code 861 (T3 Uptake) is ordered as well.

Lab tests often ordered with a T4 Total test:

When a Total T4 test is ordered, it may be part of a broader assessment of thyroid function. Here are some tests commonly ordered alongside a Total T4 test:

  1. Thyroid-Stimulating Hormone (TSH):

    • Purpose: TSH is a hormone produced by the pituitary gland that regulates the production of thyroid hormones.
    • Why Is It Ordered: TSH is the primary screening test for thyroid dysfunction. It helps determine whether the thyroid is overactive (hyperthyroidism) or underactive (hypothyroidism).
  2. Free T4 (FT4):

    • Purpose: To measure the unbound portion of T4, which is biologically active and available to the body's tissues.
    • Why Is It Ordered: FT4 levels provide a more direct measurement of the active thyroid hormone available for the body's use.
  3. Free T3 and Total T3:

    • Purpose: To measure levels of triiodothyronine, another thyroid hormone.
    • Why Is It Ordered: T3 is the more potent thyroid hormone, and its levels can help in the assessment of hyperthyroidism or in rare cases of T3 toxicosis where T4 levels might be normal.
  4. Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb):

    • Purpose: To test for the presence of antibodies that target thyroid proteins, indicative of autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves' disease.
    • Why Is It Ordered: These antibodies can help diagnose autoimmune thyroid conditions, which can affect thyroid function and hormone levels.
  5. Liver Function Tests:

    • Purpose: To assess liver health, as liver disease can affect thyroid hormone metabolism.
    • Why Is It Ordered: Liver dysfunction can alter the levels of thyroid hormones and binding proteins.
  6. Sex Hormone Binding Globulin (SHBG):

    • Purpose: To measure levels of SHBG, which can be influenced by thyroid hormone levels.
    • Why Is It Ordered: Elevated levels of SHBG can be seen in hyperthyroidism and can sometimes be used as an indirect marker of thyroid hormone activity.
  7. Reverse T3 (rT3):

    • Purpose: To measure the level of rT3, an inactive form of the hormone.
    • Why Is It Ordered: Sometimes ordered in complex cases of thyroid dysfunction or in critically ill patients to assess thyroid hormone metabolism.
  8. Complete Blood Count (CBC):

    • Purpose: To provide a general overview of health and detect conditions like anemia.
    • Why Is It Ordered: Anemia and other hematological conditions can sometimes be related to thyroid dysfunction.
  9. Iron and Ferritin:

    • Purpose: To measure iron stores and levels, as iron deficiency can affect thyroid function.
    • Why Is It Ordered: Iron is essential for the production of thyroid hormones, and deficiencies can alter thyroid function tests.

These tests, when combined with a Total T4 test, can help provide a comprehensive view of thyroid function and assist in diagnosing, monitoring, and managing thyroid disorders. The selection of these tests will depend on the individual's symptoms, medical history, and the results of initial thyroid function tests

Conditions where a T4 Total test is recommended:

A T4 Total test is commonly ordered for:

  1. Hyperthyroidism: Hyperthyroidism refers to an overactive thyroid gland, leading to excessive production of thyroid hormones. A T4 Total test helps confirm the diagnosis and monitor the treatment response in individuals with hyperthyroidism.

  2. Hypothyroidism: Hypothyroidism, on the other hand, denotes an underactive thyroid gland, resulting in insufficient production of thyroid hormones. A T4 Total test aids in the diagnosis and management of hypothyroidism, especially when symptoms persist despite normal TSH levels.

  3. Thyroid Hormone Replacement Therapy: For individuals receiving thyroid hormone replacement therapy, a T4 Total test is essential to ensure that T4 levels are within the desired therapeutic range and to optimize the treatment effectiveness.

How does my healthcare provider use a T4 Total test?

Healthcare providers use the results of a T4 Total test to:

  1. Evaluate Thyroid Function: Abnormal T4 Total levels can indicate thyroid dysfunction, helping confirm the diagnosis of hyperthyroidism or hypothyroidism.

  2. Monitor Thyroid Hormone Therapy: In individuals undergoing thyroid hormone replacement therapy, the T4 Total test helps determine if the treatment is achieving the desired therapeutic effect and allows adjustments to be made if necessary.

  3. Assess Overall Thyroid Health: The T4 Total test, when considered in conjunction with other thyroid function tests, provides a comprehensive evaluation of thyroid health and aids in making informed decisions regarding patient care and interventions related to thyroid disorders.

What does my T4 Total result mean?

In general, high total T4 levels suggest an overactive thyroid gland, while low total T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased total T4 levels. A pituitary gland issue could be indicated by low total T4 levels along with a low TSH level, or by high total T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their total T4, total T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and total T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

Most Common Questions About the T4 Total test:

Understanding the Test

What is the T4 Total test?

The T4 Total test measures the total amount of thyroxine, or T4, in your blood. This includes both T4 that is bound to proteins and can't enter body tissues (bound T4) and T4 that is free and can enter tissues (free T4).

Why is the T4 Total test done?

The T4 Total test is typically used to evaluate thyroid function and help diagnose thyroid diseases, including hypothyroidism and hyperthyroidism.

Interpreting the Results

What does a high T4 Total result mean in the T4 Total test?

A high T4 Total result could indicate conditions such as hyperthyroidism, thyroiditis, or thyroid hormone resistance. It could also be due to factors like high protein levels that bind to T4.

What does a low T4 Total result mean in the T4 Total test?

A low T4 Total result could suggest hypothyroidism, malnutrition, or illness. It could also be due to low protein levels, which would result in fewer binding sites for T4.

The Test in Different Situations

Can the T4 Total test help if I'm experiencing symptoms of a thyroid disorder?

Yes, the T4 Total test can help identify if your symptoms are due to a thyroid disorder. The test can assist in diagnosing conditions like hypothyroidism and hyperthyroidism, whose symptoms can often be confused with other conditions.

Can the T4 Total test be useful during pregnancy?

Yes, the T4 Total test can be particularly useful during pregnancy as physiological changes during this period can lead to higher levels of thyroxine-binding globulin, increasing total T4 levels. Free T4 and TSH tests are usually preferred, but total T4 can provide additional information.

About the Test

Can certain medications affect the results of the T4 Total test?

Yes, certain medications such as birth control pills, aspirin, steroids, and thyroid hormone replacement can affect the results of the T4 Total test. Always tell your healthcare provider about any medications you're taking.

What factors can influence the results of the T4 Total test?

Factors such as pregnancy, liver disease, severe illness, and changes in the level of proteins that bind to thyroxine can influence the results of the T4 Total test.

Understanding the Implications

What role does T4 play in the body, as assessed by the T4 Total test?

T4, or thyroxine, is one of the two main hormones produced by the thyroid gland. It's involved in regulating metabolism, growth and development, and body temperature. The T4 Total test measures the combined level of bound and unbound T4 in the blood.

Can the T4 Total test give insight into my metabolic health?

Yes, as the T4 hormone is crucial for metabolism, the T4 Total test can provide insights into your metabolic health. Abnormal T4 levels may lead to symptoms related to changes in body temperature, energy levels, and weight.

Risks and Precautions

Are there risks associated with having high Total T4 levels in the T4 Total test?

High Total T4 levels could indicate conditions like hyperthyroidism, which can lead to complications such as heart problems, osteoporosis, and in severe cases, a potentially life-threatening condition called thyroid storm if left untreated.

Can the T4 Total test provide insight into my risk of developing certain diseases?

While the T4 Total test itself is not a diagnostic tool for specific diseases, abnormal results can indicate a problem with your thyroid function. This could signal an increased risk of conditions such as cardiovascular disease, osteoporosis, or autoimmune diseases.

Dealing with Abnormal Results

What should I do if my T4 Total test shows a high level?

If your T4 Total test shows a high level, you should consult your healthcare provider. They can help determine the cause of the high T4 level and recommend appropriate treatment.

Are there ways to lower a high T4 Total level identified in the T4 Total test?

Treatment for high T4 Total levels depends on the underlying cause. For hyperthyroidism, treatment may include anti-thyroid medications, radioactive iodine therapy, or in some cases, surgery.

Interpreting the Test Results

How are the results of the T4 Total test interpreted?

The results of the T4 Total test are interpreted based on reference ranges provided by the lab. Results outside these ranges may indicate a problem with thyroid function. However, your healthcare provider will also consider other factors like your overall health, symptoms, and results from other tests when interpreting your results.

Understanding the Test with Other Conditions

How does the T4 Total test contribute to understanding my thyroid function if I have Graves' disease?

In Graves' disease, an autoimmune condition that leads to hyperthyroidism, the T4 Total test can help measure the level of excess hormone. Higher Total T4 levels can suggest more severe disease.

Can the T4 Total test be used in conjunction with other tests to diagnose Hashimoto'sdisease?

Yes, while the T4 Total test can indicate the level of thyroid function, diagnosing Hashimoto's disease often involves other tests, such as the TSH test and thyroid autoantibodies, to check for the presence of antibodies against the thyroid gland.

Further Evaluation and Treatment

What further tests might be ordered if my T4 Total test is abnormal?

If your T4 Total test is abnormal, your healthcare provider may order additional tests such as TSH, T3, and thyroid antibodies tests to further evaluate your thyroid function and identify the cause of the abnormal result.

If my T4 Total test indicates hyperthyroidism, what treatments might be considered?

Treatments for hyperthyroidism aim to reduce thyroid hormone production. This could include anti-thyroid medications, radioactive iodine treatment, or in some cases, surgery to remove part of the thyroid.

If my T4 Total test indicates hypothyroidism, what treatments might be considered?

Treatment for hypothyroidism usually involves taking a synthetic thyroid hormone (levothyroxine) to restore normal thyroid hormone levels.

Pre-Test Considerations

Should I tell my healthcare provider about any symptoms before getting the T4 Total test?

Yes, it's essential to discuss any symptoms you're experiencing with your healthcare provider before getting a T4 Total test. Symptoms can help your healthcare provider interpret your test results and decide if any further testing is needed.

What should I discuss with my healthcare provider before getting a T4 Total test?

You should discuss your medical history, any symptoms, and all the medications, supplements, or treatments you're currently taking. Certain medications or conditions can affect your T4 Total level.

Management and Follow-Up

Will I need to have the T4 Total test done regularly if I have a known thyroid disorder?

Yes, if you have a thyroid disorder, your healthcare provider will likely recommend regular T4 Total testing to monitor your condition and adjust treatment as necessary.

How does the T4 Total test help manage my treatment for a thyroid disorder?

The T4 Total test helps manage treatment for a thyroid disorder by monitoring the level of total T4 in the blood. This can indicate how well your treatment is working and whether any adjustments are needed.

Can the T4 Total test be used to monitor my condition if I have thyroid cancer?

While the T4 Total test can help assess thyroid function, it is not commonly used alone to monitor thyroid cancer. Other tests, like thyroglobulin, are more often used to monitor people with thyroid cancer. However, the T4 Total test can still provide useful information about your overall thyroid function.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: T4 Thyroxine Total

Free T4 Index (T7)

FTI stands for the Free Thyroxine Index and is also sometimes referred to as T7. It is a calculated value determined from the T3 uptake test and total T4 test and provides an estimate of the level of free T4 in the blood.

T4 (Thyroxine), Total

This test measures the amount of thyroxine, or T4, in the blood. T4 is one of two major hormones produced by the thyroid gland. The total T4 test is used to help diagnose hyperthyroidism and hypothyroidism. It is a useful test but can be affected by the amount of protein available in the blood to bind to the hormone.
*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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