Transcription of High Total or Free T4 (analogue method) …
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High Total or Free T4 (analogue method) …
Figure. Differential Diagnosis of Hyperthyroxinemia and Nonsuppressed TSH High Total or free T4 ( analogue method) Normal/high TSHRule out levothyroxine therapy, acute non-thyroidal illness, and drug effectsNormal DFT4 Normal/high TSHS uspect resistance to thyroid hormone (RTH)Positive RTH very likelyTSH-secreting pituitary adenoma probableTSH not suppressedNegative Alpha subunit:TSH ratio >1 Alpha subunit:TSH ratio <1 Hyperthyroxinemianot confirmedPossible RTH without THRB mutation (15% of cases)Suspect TSH-secreting pituitary tumorSuspect analytical interferenceNo abnormalities detectedHigh DFT4 Normal/high TSHC ontent reviewed 12/2012 TSH partially suppressedFree T4, Direct Dialysis (DFT4) and TSHQ uest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics.
Title: Differential Diagnosis of Hyperthyroxinemia and Nonsuppressed TSH. Subject: This algorithm provides a strategy for differentiating analytical interference, resistance to thyroid hormone, and TSH-secreting pituitary adenoma in patients with a high total or free T4 and a normal or high TSH.
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