Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1972 Mar;25(3):259–262. doi: 10.1136/jcp.25.3.259

The T4-free thyroxine index as a test of thyroid function of first choice

P J N Howorth 1,1, Richard L Ward 1
PMCID: PMC477274  PMID: 4623000

Abstract

The T4-free thyroxine index was used as the thyroid function test of first choice in a district general hospital for one year. Ninety-two patients were assessed both initially and at follow up by a single physician. The index agreed with clinical assessment in 69 out of 74 patients in whom diagnosis was unequivocal. There was initial doubt about thyroid status in 14 patients; after re-assessment the index agreed with status in seven cases, in three cases there is still some uncertainty, whilst the index was at variance with clinical status in four patients. Some possible causes of discrepancy between clinical thyroid status and the index are a low index in euthyroid patients due to a fall in serum thyroxine-binding prealbumin (`sick euthyroid'), a raised index in euthyroid patients due to latent thyroid heart disease, and a normal index in thyrotoxicosis due to preferential secretion of triiodothyronine.

Full text

PDF
259

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. CLARK F., HORN D. B. ASSESSMENT OF THYROID FUNCTION BY THE COMBINED USE OF THE SERUM PROTEIN-BOUND IODINE AND RESIN UPTAKE OF 131-I-TRIIODOTHYRONINE. J Clin Endocrinol Metab. 1965 Jan;25:39–45. doi: 10.1210/jcem-25-1-39. [DOI] [PubMed] [Google Scholar]
  3. Goolden A. W., Gartside J. M., Sanderson C. Thyroid status in pregnancy and in women taking oral contraceptives. Lancet. 1967 Jan 7;1(7480):12–15. doi: 10.1016/s0140-6736(67)92420-8. [DOI] [PubMed] [Google Scholar]
  4. HOBBS J. R., BAYLISS R. I., MACLAGAN N. F. The routine use of 132-I in the diagnosis of thyroid disease. Lancet. 1963 Jan 5;1(7271):8–13. doi: 10.1016/s0140-6736(63)91143-7. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. MYANT N. B., OSORIO C. Paper electrophoresis of thyroxine in tris-maleate buffer. J Physiol. 1960 Jul;152:601–612. doi: 10.1113/jphysiol.1960.sp006511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Maclagan N. F., Howorth P. J. Thyroid function studies using resin uptake of radioactive thyronines from serum and total thyroxine assay; the free thyroxine index. Clin Sci. 1969 Aug;37(1):45–60. [PubMed] [Google Scholar]
  8. OSORIO C., JACKSON D. J., GARTSIDE J. M., GOOLDEN A. W. The assessment of free thyroxine in plasma. Clin Sci. 1962 Dec;23:525–530. [PubMed] [Google Scholar]
  9. TATA J. R., WIDNELL C. C., GRATZER W. B. A systematic study of factors affecting the binding of thyroxine and related substances to serum proteins. Clin Chim Acta. 1961 Sep;6:597–612. doi: 10.1016/0009-8981(61)90102-4. [DOI] [PubMed] [Google Scholar]
  10. Taylor S., Kapur M., Adie R. Combined thyroxine and triiodothyronine for thyroid replacement therapy. Br Med J. 1970 May 2;2(5704):270–271. doi: 10.1136/bmj.2.5704.270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. ZLATKIS A., ZAK B., BOYLE A. J. A new method for the direct determination of serum cholesterol. J Lab Clin Med. 1953 Mar;41(3):486–492. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES