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What is a T4 test?
1. T4 is a hormone that plays a role in several body functions, including
growth and metabolism.
2. There are two kinds of T4 tests: a total T4 test and a free T4 test.
3. A number of drugs can interfere with your T4 levels, so tell your doctor
what medications you’re taking before a T4 test.

Your thyroid produces a hormone called thyroxine, which is known as T4. This
hormone plays a role in several of your body’s functions, including growth and

Some of your T4 is called free T4. This means that it hasn’t bonded to protein in
your blood. Most of the T4 in your body does bond with protein.

There are two kinds of T4 tests: a total T4 test and a free T4 test. A total T4 test
measures the T4 that has bonded to protein and the free T4. A free T4 test
measures only the free T4 in your blood.

Why do doctors perform a T4 test?
Your doctor may order a T4 test if a thyroid-stimulating hormone (TSH) test
has come back with abnormal results. A T4 test will help your doctor determine
what is wrong with your thyroid.

Some thyroid disorders include:

 hyperthyroidism (overactive thyroid)
 hypothyroidism (underactive thyroid)
 hypopituitarism (underactive pituitary gland)
 thyrotoxic periodic paralysis (occasional muscle weakness caused by high
levels of thyroid hormone)

If your T4 levels are abnormal but you’re pregnant. irritation. and bulging  skin dryness or puffiness  hair loss  hand tremors  increased heart rate You may also experience more general symptoms such as:  weight changes  difficulty sleeping or insomnia  anxiety  fatigue and weakness  intolerance to cold  sensitivity to light  menstrual irregularity  Sometimes. stimulates your thyroid to release both T3 and T4. such as thyroiditis or toxic multinodular goiter. Performing one or both of these other tests may help your doctor gain a better understanding of your thyroid problem. Elevated T4 levels may indicate hyperthyroidism. your doctor may order further testing. . your doctor may also order a test for T3 and/or TSH. They may also need to consider the results of tests for T3 and TSH levels. puffiness.  In some cases. For example. such as dryness. or thyroid-stimulating hormone. What do abnormal T4 test results mean? An abnormal result on the T4 test may not give your doctor enough information to fully understand or diagnose your condition. Pregnancy can affect your T4 levels. the levels of T3 in your blood may help your doctor understand your situation. Your doctor may suspect that one of these thyroid conditions is present if you have symptoms such as:  eye issues. your doctor may perform one or more of these tests to help assess whether a known thyroid issue is improving. They may also indicate other thyroid problems. The TSH.

the problem isn’t with your thyroid. and tertiary. or an iodine deficiency  medications that affect protein levels  hypothyroidism  illness What is primary hypothyroidism?  Your thyroid gland controls the metabolism of your body. your pituitary gland isn’t stimulating your thyroid to produce enough hormones. malnutrition. it isn’t able to produce enough thyroid hormones for your body to function properly. Abnormally low levels of T4 may indicate:  dietary issues. secondary. However.  In primary hypothyroidism. T3 and T4. Because X-ray dye includes iodine. This means that your thyroid itself is the source of the problem. These hormones control your metabolism.  In secondary hypothyroidism. a recent X-ray involving dye may also raise your T4 test results. your thyroid doesn’t produce enough of these hormones. a group of rare pregnancy-related tumors  germ cell tumors Too much iodine can raise your T4 levels. your thyroid is being stimulated properly. In other words. This is also known as an underactive thyroid. The same is true with tertiary hypothyroidism. What causes primary hypothyroidism? .  There are three types of hypothyroidism: primary. such as fasting. your pituitary gland releases a hormone known as thyroid- stimulating hormone (TSH). Your thyroid then releases two hormones.  In hypothyroidism. To stimulate your thyroid. Other abnormal results may indicate:  high levels of protein in the blood  too much iodine  too much thyroid replacement medication  trophoblastic disease.

At first. and depend on the severity of the disease. Both can result in hypothyroidism. your doctor would have surgically removed your thyroid. Other possible causes of hypothyroidism include:  insufficient dietary iodine  a congenital disease  certain drugs  viral thyroiditis In some cases. This is an autoimmune disease that causes your immune system to mistakenly attack your thyroid. According to the National Institutes of Health. You might also develop primary hypothyroidism for a number of other reasons. to treat the cancer. a woman might develop hypothyroidism after giving birth. This treatment destroys the thyroid. or part of it. The most common cause of primary hypothyroidism is Hashimoto’s disease. What are the symptoms of primary hypothyroidism? The symptoms of hypothyroidism vary widely from person to person. A less common treatment for hyperthyroidism involves the surgical removal of part or all of the thyroid. Symptoms typically develop slowly. A common treatment for hyperthyroidism is radioactive iodine. If you had hyperthyroidism (or overactive thyroid). If you had thyroid cancer. your treatment may have left you with hypothyroidism. you may notice general symptoms including:  fatigue  lethargy . the disease is most common in women and people over 60 years old.

If your hypothyroidism is extremely severe. An elevated TSH level can indicate to your doctor that you have a thyroid problem. these symptoms gradually become more severe. your pituitary gland will produce more TSH in an attempt to get your thyroid to produce more T3 and T4. Your doctor will typically start you on a low dose and . your doctor might decide to do tests to check whether you have this condition. sensitivity to cold  depression  muscle weakness Because the thyroid hormones control the metabolism of all your cells. known as a myxedema coma. If your thyroid is malfunctioning. you might fall into a coma. How is primary hypothyroidism treated? Treatment for hypothyroidism involves taking medication to replace the missing thyroid hormones. Other possible symptoms include:  pain in your joints or muscles  constipation  brittle hair or nails  voice hoarseness  puffiness in your face As the disease progresses. How is primary hypothyroidism diagnosed? If you show physical symptoms of hypothyroidism. you might also gain weight. This is a life-threatening condition. Your doctor will generally use a blood test to check your T4 and TSH levels.

are too low. Make sure to tell your doctor about all medications that you take. The goal is for your levels of thyroid hormones to return to within the normal range. Foods to Avoid Many common foods and supplements contain compounds that interfere with thyroid functions. Hypothyroidism Diet Plan Hypothyroidism occurs when levels of the two thyroid hormones. You’ll continue to take your thyroid medication throughout your life. This means that if you stop taking it. In general. You may also need to cut back on eating anything made from soy and some high-fiber foods. Some medications and foods can interfere with your medications.  Iodine-rich foods: Some forms of hypothyroidism are caused by a lack of sufficient iodine. can also interfere with your treatment. avoiding some foods and eating more of others can help improve your body’s absorption of the hormones. Your medication replaces the thyroid hormones that your thyroid is unable to produce. Some vitamins and supplements. your symptoms will return. Although changing your diet alone isn’t enough to restore normal thyroid hormone levels. using iodized salt or iodine-enriched foods can be beneficial. You should talk with your doctor about any supplements you’re taking. including over-the-counter drugs. it’s best to avoid the following foods and supplements:  Soy: Studies suggest that phytoestrogens in soybeans and soy-rich foods may inhibit the activity of an enzyme that makes the thyroid hormones. increase it gradually. In such cases. especially those for iron and calcium. But eating too much iodine can have the opposite effect and . One study found that women who consumed soy supplements were three times more likely to develop hypothyroidism. triiodothyronine (T3) and thyroxine (T4). It does not correct your thyroid disease.

and other foods rich in antioxidants can improve overall health and benefit the thyroid gland. People with hypothyroidism can choose to be vegetarian.  High-fiber foods: Although a high-fiber diet is usually recommended. Diet Plans and Herbal Supplements  Hypothyroidism doesn’t prevent or limit you from following a certain health lifestyle. Eating foods high in B vitamins. and Brussels sprouts can inhibit thyroid drug absorption. spinach. .  You may also decide to use alternative medicines. like ashwagandha (Withania somnifera). bell peppers. coleus (Coleus forskohlii). or avoid allergy-causing ingredients. Caffeine. Eating selenium-rich foods. like whole grains. may also help. gotu kola (Centella asiatica). Ask your doctor for tips on how to regulate or reduce your consumption. Check with your doctor before taking supplements. But evidence to support these claims are limited. such as sunflower seeds or Brazil nuts. tobacco. Foods to Eat Nutrient-rich foods that improve your health may also benefit your thyroid gland. suppress thyroid gland activity. kale. Always speak with your doctor before making any big changes to your eating habits or before taking any supplements. too much fiber may interfere with the absorption of thyroid medicines.  Certain vegetables: Cruciferous vegetables that are rich in fiber like broccoli. cabbage. tomatoes. and guggul (Commiphora mukul) have been suggested to benefit some symptoms of hypothyroidism.  Tyrosine: This amino acid is used by the thyroid gland to produce T3 and T4. and alcohol can also influence the effectiveness of thyroid medicine. including:  Antioxidant-rich fruits and vegetables:Blueberries. eat protein-rich foods. Reducing the amounts of such produce in your diet may help.  Selenium: Tiny amounts of selenium are needed for enzymes that make thyroid hormones to work properly. can be beneficial. Some plant extracts.  Iron and calcium supplements: Taking iron or calcium supplements can also change the effectiveness of many thyroid medications.

 T4 and TSH Results  The T4 test and the TSH test are the two most common thyroid function tests.0 milli- international units of hormone per liter of blood (mIU/L). and brittle hair and fingernails.  If you show signs of hypothyroidism and have a TSH reading above 2. The TSH has a normal test range between 0. A high level of T4 indicates an overactive thyroid (hyperthyroidism).4 and 4. fatigue. such as levothyroxine. Your doctor will likely want to perform thyroid function tests at least every other year going forward.  The TSH test measures the level of thyroid-stimulating hormone in your blood. . Symptoms include weight gain. depression. you’re at risk for progressing to hypothyroidism. They’re usually ordered together. tremors. and diarrhea.  The T4 test is known as the thyroxine test. Your doctor may also decide to begin treating you with medications. unplanned weight loss. to ease your symptoms. Symptoms include anxiety.0 mIU/L.