THYROID FUNCTION TEST(TFT)

PAPUN KUMAR ROUT GUIDE- Dr. Chanchal Rana

MBBS 2019 Batch
Roll No-143
 CONTENT:-

 INTRODUCTION

 THYROID HORMONE SYNTHESIS & REGULATION

 TRANSPORTATION PROTEIN

 TESTS OF THYROID FUNCTION

 ALGOTHARM OF TFT
 INTRODUCTION
• Thyroid function test is a collective term for blood tests used to check the function of the thyroid.

• They are required when patient is suspected to be-

o Hyerthyroidsm

o hypothyroidism

o subcliical hyperthyroidism.

• Thyroid hormones :

o Tetraiodothyronine / Thyroxine (T4)

o Triiodothyronine (T3)
THYROID HORMONE STNTHESIS AND REGULATION:

IN BLOOD WHENEVER:
T4/T3 INCREASES –TSH DECRESES

T4/T3 DECRESES -TSH INCRESES

Tetraiodothyronin or
triodothyronin
thyroxin
Tranportation of thyroid hormone:
• Both hormones are bound to plasma proteins
• Thyroxine-binding globulin (TBG)
• Transthyretin (TTR, formerly known as thyroxine-binding prealbumin, or
TBPA )
• Albumin

• When the effects of the various binding proteins are combined, ~99.98% of T4
and 99.7% of T3 are protein-bound
 CLASSIFICATION OF TFT:
• BLOOD TEST
 TSH
FREE T3 And FREE T4
TOTAL T3&T4
TOTAL T3 RESIN UPTAKE

• THYROID ANTIBODY TEST

 Thyroid peroxidase antibody (TPO ab)
 Thyroglobulin antibody. (Tg ab)

• OTHER
Radioactive Iodine Uptake(RAIU)
Thyroid Scanning
TSH (Thyroid Stimulating Hormone)
• Measures the response of the pituitary gland to circulating T4 and T3
• When t3 &t4 is low –TSH is high
• When t3&t4 is high –TSH is low

• Reference range : 0.3 - 5 micro units /L

• Changes in TSH serve as an “early warning system” – often occurring

before the actual level of thyroid hormones in the body becomes too
high or too low.
Free T4 (FT4):
• The FT4 measures the concentration of free thyroxin(unbouned)

biologically active fraction in the serum.

• Reference range : 0.8 - 2.7 nano gram/ dl

• The free thyroxine is not affected by changes in concentrations of

binding proteins ;such in
o Pregnancy,
o Estrogen and Androgen therapy
TFT interpretation:
 TOTAL T4:
• Reference range : 4- 12 microgram/ dl

• Measure both bound and free T4

• Decreased total serum T4 - Hypothyroidism / Decrese

concentration of thyroid binding proteins.

• Increased total serum T4 - Hyperthyroidism / Increase

concentration of thyroid binding proteins.
TOTAL T3:
• T3 tests are useful to diagnosis hyperthyroidism or to determine the
severity of the hyperthyroidism.

• The T3 is increased in almost all cases of hyperthyroidism.

• In hypothyroidism the T3 is often normal even when the T4 is low.

• Reference range: 95-190 ng/dl

Serum T3 resin uptake :
• Thyroid hormone binding ratio

• Indirectly estimates the number of binding sites on thyroid binding protein

occupied by T3.

• Reference range : 25 - 35 %

• Increase in T3 resin uptake is consistent with hyperthyroidism and decrease

in T3 resin uptake is consistent with hypothyroidism
Thyroid autoantibody test:
• Thyroid peroxidase (TPO) and antithyroglobulin (TgAb) antibodies
are measured .

• confirm or rule out autoimmune thyroid disease.

• High titers of these antibodies are present in

o Grave’s disease or Hashimoto’s thyroiditis

• Thyroid receptor stimulating antibody(TSIs) is characteristic of

Grave’s disease (Present in 90%)
Radioactive iodine uptake (RAIU):
• The thyroid gland selectively transports radioisotopes of iodine (123I, 125I,
131I) allowing thyroid imaging and quantitation of radioactive tracer fractional
uptake.
• The normal uptake at 6 hours is 5-15% and at 24 hours 8-30%.

• In thyrotoxicosis due to Graves' disease or toxic nodular goiter,

the 24- hour RAIU is markedly elevated.

• A thyroid scan may be obtained, which shows a picture of the thyroid

gland and reveals what parts of the thyroid have taken up the iodine
References:
THANK YOU