Free T3 is reduced: what is the reason and what to do?

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Decreased T3 hormone

Triiodothyronine levels may decrease if the production of all hormones produced by the thyroid gland is impaired. This condition occurs with the following diseases:

• Hashimoto's thyroiditis is a disease in which a person's immune system begins to kill some of the cells in the thyroid gland. They cannot be restored and most often stop working and producing hormones forever.
• Hyperthyroidism - this disease occurs after taking certain drugs aimed at treating diffuse and nodular toxic goiter. The most dangerous drugs in this regard are considered to be thyreostatics such as Tyrozol, Propicil, Mercazolil.
• Hormone levels may decrease after surgery to remove all or just part of the thyroid gland.
• Treatment with radioactive iodine also helps reduce triiodothyronine levels. This therapy is aimed at removing diffuse toxic goiter.
• Hormone levels may drop when taking products containing large amounts of iodine. These include "Amiodarone", "Cordarone" and others.

But a decrease in the level of the T3 hormone in the blood does not always indicate the presence of a disease. This condition is typical for women expecting a child from 6 to 9 months of pregnancy.

You should know that the hormones T3 and T4, as well as TSH, decrease in a certain sequence. The T4 hormone level always decreases first, and only after this does triiodothyronine decrease. This happens due to the peculiarity of the body, which is protected as a result of a decrease in the hormone T3, since it is almost 10 times more active than T4.

Thanks to this, the patient does not feel the effects of hyperthyroidism so acutely. Thus, you can independently find out whether a laboratory error was made. If, according to the results of the analysis, the level of triiodothyronine is low (and it does not matter whether it is the St. T3 hormone or the total one), and T4 and TSH are within normal limits, then the data obtained should definitely be rechecked in another laboratory and the blood should be donated again.

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Why is a T3 hormone test necessary?

To determine the condition of the thyroid gland, the endocrinologist must give the patient a referral for blood tests for three hormones - TSH, T4, T3. Testing for triiodothyronine is considered very important, as it allows to minimize diagnostic error.

For example, quite often working nodes in nodular toxic goiter reproduce the hormone T3. Its amount can also increase in diseases such as diffuse toxic goiter and Graves' disease. If the test result shows a significant increase in the amount of triiodothyronine, then doctors diagnose T3 toxicosis. This condition is quite difficult to treat with medications.

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Increased T3 hormone

Many pathological conditions of the thyroid gland are accompanied by an increase in triiodothyronine. Often a person does not even notice such a deviation from the norm. Since T3 is a very active hormone, an increase in its amount in the blood causes the following symptoms:

• A person gets irritated by everything, he becomes nervous, aggressive, and gets excited very quickly. This condition is accompanied by a feeling of constant fatigue.
• Fingers begin to shake.
• The patient experiences increased heart rate, tachycardia, and the heart begins to work intermittently. T3 is a hormone that promotes extrasystole. A person feels this condition very well and often complains to the doctor about problems with the heart.
• The patient begins to lose weight rapidly.

Analysis to determine the level of triiodothyronine is a rather complex procedure. It is not uncommon for laboratories to make mistakes. You can additionally conduct a test to detect the level of two other hormones - T4 and TSH. If the results obtained indicate that TSH is normal, but T3 (the hormone) is elevated, then this usually indicates an error.

Also, the analysis will be unreliable if the T4 value is normal, and TSH and T3 are elevated. If exactly these results are obtained, then the test should be retaken, because when the T3 hormone increases, the TSH level decreases, and T4 increases.

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What is free and total T3?

Gland cells are capable of producing the required amount of triiodothyronine with three iodine atoms. Having penetrated the bloodstream, this hormone binds to transporter protein molecules and is transported through the vessels to the tissues that need its work. However, a small amount of triiodothyronine, not bound to protein molecules, remains in the blood. This is the free T3 hormone.

The remaining free T3 hormone in combination with the one that is bound to proteins is called total. It is its quantity that is considered indicative in determining thyroid pathologies.

References

1. Hypothyroidism. Clinical recommendations. Association of Endocrinologists of Russia, 2021. - 38 p.
2. Federal clinical guidelines for the diagnosis and treatment of thyrotoxicosis with diffuse goiter (diffuse toxic goiter, Graves-Bazedow disease), nodular/multinodular goiter, 2014. - 45 p.
3. Encyclopedia of clinical laboratory tests / ed. WELL. Titsa. - M.: Labinform, 1997. - P. 461-465.
4. Kumar, V., Abbas, A., Fausto, N. et al. Robbins and Cotran Pathologic Basis of Disease, 2014. - 1464 p.