Endocrine Disorders: Evaluation and Management
Summary
- Total T4 levels may correlate poorly with disease states because of extensive protein binding
- Estrogen use, pregnancy, acute hepatitis, and certain genetic abnormalities may result in a T4 level that is misleadingly elevated
- Conversely, nephrotic syndrome, hepatic failure, hereditary TBG deficiency, high-dose androgen use, and glucocorticoid use may underestimate the concentration of active thyroid hormone
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