Free TFT (Free T3,Free T4,TSH)
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Quantifies thyroid-stimulating hormone; crucial in diagnosing hypothyroidism or hyperthyroidism.
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🧪 What is Free TFT (Free T3, Free T4, TSH)?
The Free TFT panel assesses the functional status of the thyroid gland. It includes:
- TSH (Thyroid Stimulating Hormone) – Secreted by the pituitary gland to regulate thyroid hormone production.
- Free T4 (Thyroxine) – The primary hormone produced by the thyroid; regulates metabolism.
- Free T3 (Triiodothyronine) – The active form of thyroid hormone; mostly converted from T4 in the liver and tissues.
These tests measure free (unbound) hormone levels — the biologically active forms.
❓ Why is the Free TFT Panel Done?
To:
- Diagnose hypothyroidism or hyperthyroidism
- Monitor thyroid hormone replacement therapy
- Evaluate goiter, thyroid nodules, or infertility
- Screen during pregnancy
- Investigate fatigue, weight changes, palpitations, depression, or hair loss
- Monitor effects of medications like amiodarone, lithium, antithyroid drugs
📊 Normal Ranges (may vary slightly by lab)
Test | Normal Range |
|---|---|
TSH | 0.4 – 4.0 mIU/L |
Free T4 | 0.8 – 1.8 ng/dL (or 10–23 pmol/L) |
Free T3 | 2.3 – 4.2 pg/mL (or 3.5–6.5 pmol/L) |
📈 Interpretation of Results
Condition | TSH | Free T4 | Free T3 | Notes |
|---|---|---|---|---|
Primary Hypothyroidism | ↑ | ↓ | ↓ or normal | Common, treatable with levothyroxine |
Subclinical Hypothyroidism | ↑ | Normal | Normal | Mild; often seen in early disease |
Primary Hyperthyroidism (Graves’, toxic nodule) | ↓ | ↑ | ↑ | Classic pattern |
Subclinical Hyperthyroidism | ↓ | Normal | Normal | Often medication- or nodule-related |
Secondary (central) Hypothyroidism | ↓ or normal | ↓ | ↓ | Due to pituitary or hypothalamic disease |
T3 Toxicosis | ↓ | Normal | ↑ | Early hyperthyroidism (T3 rises first) |
Euthyroid Sick Syndrome | Normal or ↓ | ↓ | ↓ | Seen in severe illness, not true thyroid dysfunction |
🧠 Associated Organs and Conditions
Organ/System | Relevance |
|---|---|
Thyroid Gland | Produces T3 and T4 hormones |
Pituitary Gland | Produces TSH to stimulate thyroid |
Liver & Kidneys | Involved in hormone metabolism and conversion |
Autoimmune System | Can cause Hashimoto's or Graves' disease |
🔄 Related / Follow-Up Tests
- Anti-TPO antibodies – For Hashimoto’s thyroiditis
- TSH receptor antibodies (TRAb) – For Graves’ disease
- Total T3 / Total T4 – If free hormone measurement is unavailable
- Thyroid ultrasound – To detect nodules or enlargement
- Radioactive Iodine Uptake (RAIU) – For hyperthyroidism cause
- Reverse T3 – Rarely used, in complex cases
- Lipid profile, cortisol – To evaluate related metabolic effects
✅ Fasting Required?
Test | Fasting Required? |
|---|---|
Free T3, Free T4, TSH | ❌ No fasting required |
(though some doctors prefer a morning, fasting sample for consistency in long-term monitoring) |
📝 Summary
Parameter | Summary |
|---|---|
What | Measures free (active) thyroid hormones and TSH to assess thyroid function |
Why Test | To diagnose hypo-/hyperthyroidism, guide treatment, evaluate fatigue, weight issues, or infertility |
Normal Ranges | TSH: 0.4–4.0 mIU/L, Free T4: 0.8–1.8 ng/dL, Free T3: 2.3–4.2 pg/mL |
High TSH + Low Free T4 | Indicates primary hypothyroidism |
Low TSH + High Free T4/T3 | Indicates hyperthyroidism |
Follow-up Tests | Anti-TPO, TRAb, ultrasound, RAIU, lipid panel |
Fasting Required | ❌ Not required, but optional fasting may be suggested for consistency |
How our test process works!
