Test Detail
Overview
Interpreting Results
FAQ's
Tests Included

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Written by
Dr. Shreya Gupta
BDS, MDS - Oral and Maxillofacial Pathology
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Dr. Lalit Mohan Gupta
MBBS, MD - Microbiology
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Thyroid profile Total

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Thyroid profile Total Test Includes 3 testsView All
Thyroid profile Total
You need to provide
Blood
This test is for
Male, Female
Test Preparation
  1. No special preparation required

Overview


What is Thyroid profile Total?

The Thyroid Profile Total is a group of tests that are done together to detect or diagnose thyroid diseases. It measures the levels of the following three hormones in the blood: Thyroid Stimulating Hormone (TSH), Thyroxine (T4) - Total and TriIodothyronine (T3) - Total.

Why is Thyroid profile Total done?

The Thyroid Profile Total test is done:

  • To diagnose any suspected thyroid disease (Hypothyroidism or Hyperthyroidism)

  • To monitor treatment in patients with thyroid diseases

  • To investigate the cause of infertility



What does Thyroid profile Total Measure?

The Thyroid Profile Total test measures the levels of the following three hormones in the blood:
Thyroid Stimulating Hormone (TSH)
Thyroxine (T4) - Total
TriIodothyronine (T3) - Total

The thyroid gland (a small, butterfly-shaped gland located in front of the neck) secretes the following hormones:

  • Triiodothyronine (T3)

  • Thyroxine (T4)

Thyroid Stimulating Hormone (TSH), also called Thyrotropin is a hormone secreted into the blood by the Pituitary gland (a gland present in the brain)). It tells your thyroid gland to make and release the thyroid hormones (T3 & T4) into your blood. The thyroid gland uses the iodine gained from food to make the thyroid hormones.

The thyroid hormones are essential for growth and metabolism. If the thyroid gland produces very high amounts of T3 and T4 hormones, you may experience symptoms like weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity to heat, etc. and this is known as Hyperthyroidism.

The decreased production of thyroid hormones (T3 and T4) results in Hypothyroidism which may lead to weight gain, fatigue, slow heart rate, increased sensitivity to cold, depression, dry and thin hair, etc.

There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. When the levels of thyroid hormone decrease, the pituitary gland is stimulated to release TSH.  High TSH in turn increases the release of T3 and T4 thyroid hormones from the thyroid gland and vice-versa.

T3 and T4 circulate in the blood in two forms:

1) Bound form - It is bound to proteins present in blood and this prevents it from entering the body tissues. The three main proteins in the blood that the thyroid hormones are bound to are albumin, transthyretin and Thyroxine-binding globulin (TBG), also called Thyroid hormone Binding Globulin (THBG).

2) Free form - It enters the body tissues where it is  needed

The total T3 or total T4 includes both bound and free forms circulating in the blood. Hence, thyroid hormones can be measured as Free T3, Total T3, Free T4, and Total T4.

The total T3 and total T4 levels can be affected by the amount of protein available in the blood to bind to them.


Interpreting Thyroid profile Total results


Interpretations



T3 (Triiodothyronine), Total                 Reference Range(s)





<1 Month

Not established


1-23 Months

117-239 ng/dL



2-12 Years

105-207 ng/dL



13-20 Years

86-192 ng/dL



>20 Years

76-181 ng/dL




T4 (Thyroxine), Total

                                                 4.5-12.0 mcg/dL


Thyroid Stimulating Hormone (TSH)               Reference Range(s)

Premature Infants (28-36 Weeks)

 1st Week of Life

0.20-27.90 mIU/L

Term Infants (>37 Weeks)

 Serum or Cord Blood

1.00-39.00 mIU/L

 1-2 Days

3.20-34.60 mIU/L

 3-4 Days

0.70-15.40 mIU/L

 5 Days-4 Weeks

1.70-9.10 mIU/L

 1-11 Months

0.80-8.20 mIU/L

 1-19 Years

0.50-4.30 mIU/L

 ≥20 Years

0.40-4.50 mIU/L

Pregnancy

 First Trimester

0.26-2.66 mIU/L

 Second Trimester

0.55-2.73 mIU/L

 Third Trimester

0.43-2.91 mIU/L

    Table 1. Interpretation of the Thyroid Profile Test results

    TSH

    T4

    T3

    INTERPRETATION

    Elevated

    Normal

    Normal

    Mild (subclinical) hypothyroidism

    Elevated

    Low

    Low or normal

    Hypothyroidism

    Low

    Normal

    Normal

    Mild (subclinical) hyperthyroidism

    Low

    Elevated or normal

    High or normal

    Hyperthyroidism

    Low

    Low or normal

    Low or normal

    Nonthyroidal illness; hypothyroidism due to the disease involving the pituitary gland

    Normal

    Elevated

    Elevated

    Thyroid hormone resistance (Impaired sensitivity to thyroid hormone)

  • Low T4 and T3 along with high TSH level indicates hypothyroidism. The most common cause of hypothyroidism is Hashimoto thyroiditis 
  • High T4 and T3 along with low TSH indicate hyperthyroidism. The most common cause of hyperthyroidism is Grave’s disease
  • Normal thyroxine (T4) and T3 along with high TSH usually indicates mild or subclinical hypothyroidism 
  • Normal T3 and T4 along with low TSH indicates mild or subclinical hyperthyroidism 

Note: TSH levels show circadian variation (fluctuates during the 24-hour cycle), reaching peak levels between 2 - 4 am and are at a low between 6-10 pm.

Reference Range(s) may vary from lab to lab.

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Thyroid profile Total


Frequently Asked Questions about Thyroid profile Total

Q. What is Hyperthyroidism?
Hyperthyroidism is a condition in which the thyroid gland is overactive which leads to an increased production of thyroid hormones. Causes of hyperthyroidism include Graves’ disease, multinodular goiter, thyroid nodules, toxic adenoma, inflammation of the thyroid gland, overconsumption of iodine, and excess of synthetic thyroid hormone. Diagnosis of this condition can help relieve the symptoms and prevent long-term complications.
Q. What are the symptoms of Hyperthyroidism?
Symptoms of Hyperthyroidism include: Rapid heartbeat (tachycardia) — commonly more than 100 beats/minute — irregular heartbeat (arrhythmia) or pounding of your heart (palpitations), sudden weight loss, nervousness, anxiety, irritability, tremor (usually a fine trembling in your hands and fingers), changes in menstrual patterns, increased sensitivity towards heat, changes in bowel patterns (especially more frequent bowel movements), an enlarged thyroid gland (goiter) which may appear as a swelling at the base of your neck, increased appetite, sweating, fatigue, muscle weakness, sleep disturbances, skin thinning, fine and brittle hair.
Q. What is Hypothyroidism?
Hypothyroidism, also known as underactive thyroid or low thyroid is a condition in which the thyroid gland does not produce enough thyroid hormones. It can be caused due to low levels of iodine intake in the diet or Hashimoto's thyroiditis (an autoimmune disease). Other less common causes that lead to hypothyroidism include previous treatment with radioactive iodine, injury to the pituitary gland, as a side-effect of certain medicines, previous thyroid surgery or improper functioning of thyroid gland since birth.
Q. What are the symptoms of Hypothyroidism?
Symptoms of Hypothyroidism include: Tiredness (fatigue), constipation, feeling cold, dry skin, weight gain, muscle weakness, decreased sweating, depression, slower heart rate, increased blood cholesterol levels, pain and stiffness in your joints, impaired memory, problems of infertility or menstrual changes, muscle stiffness, aches, and tenderness, hoarseness, puffy face, dry and thin hair.
Q. How is this test performed?
This test is performed on a blood sample. A syringe with a fine needle is used to withdraw blood from a blood vessel in your arm. The healthcare provider will tie an elastic band around your arm to make the blood vessels swell with blood. This makes it easier to withdraw blood. You may be asked to tightly clench your fist. Once the veins are clearly visible, the area is cleaned with an antiseptic solution and then the needle is inserted into the blood vessel to collect the sample. You will feel a tiny pinprick during the procedure. Blood sample once collected will then be sent to the laboratory.
Q. Is there any risk associated with this test?
There is no risk associated with the test. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick.
Q. How can hyperthyroidism affect a pregnant woman and her baby?
An untreated hyperthyroidism during pregnancy can lead to miscarriage, premature birth, low birth weight of the baby, preeclampsia (a very high rise in blood pressure in late pregnancy), thyroid storm (a sudden, severe worsening of symptoms of hyperthyroidism) and congestive heart failure.
Q. How can hypothyroidism affect a pregnant woman and her baby?
An untreated hypothyroidism during pregnancy can cause preeclampsia (a very high rise in blood pressure in late pregnancy), anemia, miscarriage, low birth weight of the baby, stillbirth (death or loss of a baby before or during delivery) and rarely, congestive heart failure. These problems are noticed mostly as a result of severe hypothyroidism. The mother’s thyroid hormones play an important role in the development of the baby’s brain and nervous system. Untreated hypothyroidism, especially during the first trimester can cause low IQ and can hinder the baby’s normal development.
Q. What are the causes of high TSH in a newborn?
Congenital hypothyroidism is an important cause of elevated thyroid-stimulating hormone (TSH) in newborns. Other causes of an elevated TSH level include transient hypothyroidism due to neonatal illness, premature birth, excess or deficiency of iodine. In case the mother has some underlying thyroid disease or is under medication which affects thyroid hormone levels, TSH levels could increase.
Q. Is there any preparation required before the test?
Inform the doctor about the medications you may be taking. No other specific preparations are usually required before this test.
Q. What additional tests can be performed in case the results of Thyroid profile Total test are not in the normal range?
If the thyroid profile total test results are not in the normal range, your doctor may ask for the following tests: Thyroid Hormone Binding Globulin (THBG), Thyroid profile Free, Anti Thyroperoxidase Antibody test.
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Tests Included (3 tests)


  • Thyroxine - Total
  • Thyroid Stimulating Hormone
  • TriIodothyronine Total

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