Abstract
With the recent development of radioimmunoassay techniques for the measurement of serum triiodothyronine (T3) concentration, new concepts have arisen regarding the biologic role of T3 in health and disease and its interrelationships with thyroxine (T4). An awareness of the influence of clinical conditions that affect binding of thyroid hormone to plasma proteins is required in the interpretation of moderately increased or decreased serum T3 values. Hormone preparations containing T3 may produce transient increases in T3 concentration into the hyperthyroid range. Measurements of serum T3 concentration appear to be particularly indicated in clinical situations in which hyperthyroidism is suspected but serum T3 resin uptake and serum T4 values are normal, to exclude the T3-toxicosis syndrome. Also, when serum T4 values are in the hypothyroid range, measurement of serum T3 as well as serum thyrotropin (TSH) concentrations can lead to recognition of abnormalities in thyroid gland biosynthesis. Before a diagnosis of hypothyroidism is made on the basis of a low serum T3 value, one must exclude a variety of clinical nonthyroidal conditions that can result in changes in plasma T3 protein binding or impaired peripheral conversion of T4 to metabolically active T3 without producing a hypometabolic state.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abuid J., Klein A. H., Foley T. P., Jr, Larsen P. R. Total and free triiodothyronine and thyroxine in early infancy. J Clin Endocrinol Metab. 1974 Aug;39(2):263–268. doi: 10.1210/jcem-39-2-263. [DOI] [PubMed] [Google Scholar]
- Abuid J., Stinson D. A., Larsen P. R. Serum triiodothyronine and thyroxine in the neonate and the acute increases in these hormones following delivery. J Clin Invest. 1973 May;52(5):1195–1199. doi: 10.1172/JCI107286. [DOI] [PMC free article] [PubMed] [Google Scholar]
- AvRuskin T. W., Tang S. C., Shenkman L., Mitsuma T., Hollander C. S. Serum triiodothyronine concentrations in infancy, childhood, adolescence and pediatric thyroid disorders. J Clin Endocrinol Metab. 1973 Aug;37(2):235–237. doi: 10.1210/jcem-37-2-235. [DOI] [PubMed] [Google Scholar]
- BLACKBURN C. M., McCONAHEY W. M., KEATING F. R., Jr, ALBERT A. Calorigenic effects of single intravenous doses of L-triiodothyronine and L-thyroxine in myxedematous persons. J Clin Invest. 1954 Jun;33(6):819–824. doi: 10.1172/JCI102953. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bermudez F., Surks M. I., Oppenheimer J. H. High incidence of decreased serum triiodothyronine concentration in patients with nonthyroidal disease. J Clin Endocrinol Metab. 1975 Jul;41(1):27–40. doi: 10.1210/jcem-41-1-27. [DOI] [PubMed] [Google Scholar]
- Braverman L. E., Ingbar S. H., Sterling K. Conversion of thyroxine (T4) to triiodothyronine (T3) in athyreotic human subjects. J Clin Invest. 1970 May;49(5):855–864. doi: 10.1172/JCI106304. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burr W. A., Black E. G., Griffiths R. S., Hoffenberg R. Serum triiodothyronine and reverse triiodothyronine concentrations after surgical operation. Lancet. 1975 Dec 27;2(7948):1277–1279. doi: 10.1016/s0140-6736(75)90612-1. [DOI] [PubMed] [Google Scholar]
- Chopra I. J. A radioimmunoassay for measurement of thyroxine in unextracted serum. J Clin Endocrinol Metab. 1972 Jun;34(6):938–947. doi: 10.1210/jcem-34-6-938. [DOI] [PubMed] [Google Scholar]
- Chopra I. J., Ho R. S., Lam R. An improved radioimmunoassay of triiodothyronine in serum: its application to clinical and physiological studies. J Lab Clin Med. 1972 Nov;80(5):729–739. [PubMed] [Google Scholar]
- Chopra I. J., Solomon D. H., Chopra U., Young R. T., Chua Teco G. N. Alterations in circulating thyroid hormones and thyrotropin in hepatic cirrhosis: evidence for euthyroidism despite subnormal serum triiodothyronine. J Clin Endocrinol Metab. 1974 Sep;39(3):501–511. doi: 10.1210/jcem-39-3-501. [DOI] [PubMed] [Google Scholar]
- Chopra I. J., Solomon D. H., Chua Teco G. N. Thyroxine: just a prohormone or a hormone too? J Clin Endocrinol Metab. 1973 Jun;36(6):1050–1057. doi: 10.1210/jcem-36-6-1050. [DOI] [PubMed] [Google Scholar]
- Erenberg A., Phelps D. L., Lam R., Fisher D. A. Total and free thyroid hormone concentrations in the neonatal period. Pediatrics. 1974 Feb;53(2):211–216. [PubMed] [Google Scholar]
- Gharib H., Mayberry W. E., Ryan R. J. Radioimmunoassay for triiodothyronine: A preliminary report. J Clin Endocrinol Metab. 1970 Dec;31(6):709–712. doi: 10.1210/jcem-31-6-709. [DOI] [PubMed] [Google Scholar]
- Gharib H., Ryan R. J., Mayberry W. E. Triiodothyronine (T3) radioimmunoassay. A critical evaluation. Mayo Clin Proc. 1972 Dec;47(12):934–937. [PubMed] [Google Scholar]
- Harington C. R., Barger G. Chemistry of Thyroxine: Constitution and Synthesis of Thyroxine. Biochem J. 1927;21(1):169–183. doi: 10.1042/bj0210169. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hollander C. S., Mitsuma T., Nihei N., Shenkman L., Burday S. Z., Blum M. Clinical and laboratory observations in cases of triiodothyronine toxicosis confirmed by radioimmunoassay. Lancet. 1972 Mar 18;1(7751):609–611. doi: 10.1016/s0140-6736(72)90408-4. [DOI] [PubMed] [Google Scholar]
- Howorth P. J., Maclagan N. F. Clinical application of serum-total-thyroxine estimation, resin uptake, and free-thyroxine index. Lancet. 1969 Feb 1;1(7588):224–228. doi: 10.1016/s0140-6736(69)91240-9. [DOI] [PubMed] [Google Scholar]
- Ingenbleek Y., Beckers C. Triiodothyronine and thyroid-stimulating hormone in protein-calorie malnutrition in infants. Lancet. 1975 Nov 1;2(7940):845–848. doi: 10.1016/s0140-6736(75)90236-6. [DOI] [PubMed] [Google Scholar]
- LERMAN J. The physiologic activity of l-triiodothyronine. J Clin Endocrinol Metab. 1953 Nov;13(11):1341–1346. doi: 10.1210/jcem-13-11-1341. [DOI] [PubMed] [Google Scholar]
- Larsen P. R. Inhibition of triiodothyronine (T3) binding to thyroxine-binding globulin by sodium salicylate and its application to immunoassay of T3 in human serum. Metabolism. 1971 Oct;20(10):976–980. doi: 10.1016/0026-0495(71)90018-7. [DOI] [PubMed] [Google Scholar]
- Larsen P. R. Triiodothyronine: review of recent studies of its physiology and pathophysiology in man. Metabolism. 1972 Nov;21(11):1073–1092. doi: 10.1016/0026-0495(72)90038-8. [DOI] [PubMed] [Google Scholar]
- Lieblich J., Utiger R. D. Triiodothyronine radioimmunoassay. J Clin Invest. 1972 Jan;51(1):157–166. doi: 10.1172/JCI106786. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MURPHY B. E., PATTEE C. J. DETERMINATION OF THYROXINE UTILIZING THE PROPERTY OF PROTEIN-BINDING. J Clin Endocrinol Metab. 1964 Feb;24:187–196. doi: 10.1210/jcem-24-2-187. [DOI] [PubMed] [Google Scholar]
- Marsden P., Chalkley S., Leatherdale B., Howorth P. J., Acosta M., McKerron C. G. Hormonal pattern of relapse in hyperthyroidism. Lancet. 1975 Apr 26;1(7913):944–947. doi: 10.1016/s0140-6736(75)92006-1. [DOI] [PubMed] [Google Scholar]
- Nicoloff J. T., Low J. C., Dussault J. H., Fisher D. A. Simultaneous measurement of thyroxine and triiodothyronine peripheral turnover kinetics in man. J Clin Invest. 1972 Mar;51(3):473–483. doi: 10.1172/JCI106835. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oppenheimer J. H., Schwartz H. L., Surks M. I. Propylthiouracil inhibits the conversion of L-thyroxine to L-triiodothyronine. An explanation of the antithyroxine effect of propylthiouracil and evidence supporting the concept that triiodothyronine is the active thyroid hormone. J Clin Invest. 1972 Sep;51(9):2493–2497. doi: 10.1172/JCI107063. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ROCHE J., LISSITZKY S., MICHEL R. Sur la présence de triiodothyronine dans la thyroglobuline. C R Hebd Seances Acad Sci. 1952 Mar 10;234(11):1228–1230. [PubMed] [Google Scholar]
- Sterling K., Brenner M. A., Newman E. S. Conversion of thyroxine to triiodothyronine in normal human subjects. Science. 1970 Sep 11;169(3950):1099–1100. doi: 10.1126/science.169.3950.1099. [DOI] [PubMed] [Google Scholar]
- Sterling K., Brenner M. A., Newman E. S., Odell W. D., Bellabarba D. The significance of triiodothyronine (T3) in maintenance of euthyroid status after treatment of hyperthyroidism. J Clin Endocrinol Metab. 1971 Nov;33(5):729–731. doi: 10.1210/jcem-33-5-729. [DOI] [PubMed] [Google Scholar]
- Sterling K., Refetoff S., Selenkow H. A. T3 thyrotoxicosis. Thyrotoxicosis due to elevated serum triiodothyronine levels. JAMA. 1970 Jul 27;213(4):571–575. doi: 10.1001/jama.213.4.571. [DOI] [PubMed] [Google Scholar]
- Surks M. I., Schadlow A. R., Oppenheimer J. H. A new radioimmunoassay for plasma L-triiodothyronine: measurements in thyroid disease and in patients maintained on hormonal replacement. J Clin Invest. 1972 Dec;51(12):3104–3113. doi: 10.1172/JCI107137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wahner H. W. T3 hyperthyroidism. Mayo Clin Proc. 1972 Dec;47(12):938–943. [PubMed] [Google Scholar]