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The Free Triiodothyronine (T3) Index

CLARK T. SAWIN, M.D.; DEEPAK CHOPRA, M.D.; JOSEPHINE ALBANO, M.D.; and FEREIDOUN AZIZI, M.D., F.A.C.P.
[+] Article and Author Information

Grant support: by the Medical Research Service of the Veterans Administration and National Institutes of Health General Research Support Grant No. 5 SO1 RR 05587-07.

▸Requests for reprints should be addressed to Clark T. Sawin, M.D.; Boston Veterans Administration Hospital, 150 South Huntington Avenue; Boston, MA 02130.


Boston, Massachusetts


© 1978 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1978;88(4):474-477. doi:10.7326/0003-4819-88-4-474
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In a large number of normal men (n = 111) and women (n = 110) the free triiodothyronine (T3), index, calculated from serum total T3 and T3-uptake, was highly correlated with free T3, measured by equilibrium dialysis. The correlation was almost as high as that of the free thyroxine (T4) index with free T4. The correlations of the total T3, free T3, and free T3 index with, respectively, the total T4, free T4, and free T4 index were much lower, though still statistically significant. The free T3 index is clinically useful because serum total T3 may sometimes be misleading. Hyperthyroid patients with apparent T4-toxicosis and normal total T3 may have an elevated free T3 index and thus physiologically elevated levels of both thyroid hormones. Calculation of the free T3 index might also make possible the diagnosis of T3-toxicosis in a patient with a normal free T4 index and normal total T3. Total T3 may be elevated without an elevated total T4 in women taking oral contraceptives; thus the free T3 index may prevent a misdiagnosis of T3-toxicosis. The free T3 index seems no better than total T3 in the diagnosis of primary hypothyroidism, but it can confirm the diagnosis of T3-hypothyroidism.

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