Endocrine Disorders: Evaluation and Management

  • Author: Todd T. Brown, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 11/14/16 (What's New)


  • 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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