What is Total Triiodothyronine (TT3) test? 

T3 is a hormone secreted by the thyroid gland - a butterfly-shaped gland present in your throat. It affects all the major processes in the body like temperature, growth and development, heart rate and metabolism.

Most T3 is synthesised in various body tissues from thyroxine (T4), which is the main hormone produced by the thyroid gland. Only some T3 is directly made by the thyroid gland. T3 is present in the blood in two forms:

  • Bound T3: About 99.7% of T3 hormone is bound to proteins (e.g. thyroxine-binding globulin or TBG) in the blood that carry them throughout the body.
  • Free T3: The remaining unbound T3 hormone circulates freely.

This test measures the levels of total triiodothyronine (T3) hormone in the blood - both bound and total. It is mainly performed to assess thyroid function and diagnose thyroid problems, mainly hyperthyroidism that is marked by excess production of thyroid hormones in the body.

Some other names for the total T3 test are T3 test, Thyroid function test, Triiodothyronine test, Toxic nodular goitre - T3, Thyrotoxicosis - T3, T3 radioimmunoassay, Thyroiditis - T3, Graves disease - T3.

(Read more: Free T3 test)

  1. Why is a Total Triiodothyronine (TT3) test performed?
  2. How do you prepare for a Total Triiodothyronine (TT3) test?
  3. How is Total Triiodothyronine (TT3) test performed?
  4. Total Triiodothyronine (TT3) test results and normal range

Your doctor may order this test if you have the following symptoms of hyperthyroidism:

You may also have to undergo this test if you are at a high risk of hyperthyroidism. 

The following factors put you at risk of hyperthyroidism:

  • If you have any other thyroid problem
  • If you have a history of long-term illnesses, such as: 
  • If you take a lot of iodine-rich foods or iodine-containing medicines
  • If you recently had a delivery
  • If you are 60 years or older
  • If you have a family history of thyroid problems 

You may have this test if you have symptoms of hypothyroidism (thyroid gland does not make sufficient thyroid hormone) which include:

Additionally, your healthcare practitioner may perform this test if:

  • You are on medications for hypothyroidism
  • Your pituitary gland does not function normally (a condition called hypopituitarism)
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No prior preparations are needed before this test. Inform your healthcare provider about all the herbs, vitamins, supplements, medicines (including over-the-counter drugs) and illegal drugs that you may be taking.

This is because certain medications can alter the blood TT3 levels and affect the test results. Medications that may increase TT3 level in the blood include:

  • Clofibrate
  • Amiodarone
  • Methadone
  • Cytomel
  • Birth control pills
  • Phenothiazines
  • Terbutaline
  • Tamoxifen
  • Valproic acid
  • Thyroxine
  • Oestrogens
  • Certain herbal medicines

Medications that may decrease TT3 level in the blood include:

  • Anabolic steroids
  • Antithyroid drugs (e.g., methimazole, propylthiouracil)
  • Phenytoin
  • Amiodarone
  • Androgens
  • Lithium
  • Propranolol
  • Aspirin
  • Carbamazepine
  • Atenolol
  • Corticosteroids
  • Theophylline
  • Furosemide

You may have high or low levels of TBG protein due to genetic or acquired conditions, which may also alter your TT3 values.

Some conditions that show false high TT3 level include:

A laboratory technician will withdraw a blood sample, most commonly from your arm, to perform this test.

You may feel slight pain when the needle pricks your arm. The site may be sore afterwards for a while. If you notice a persistent bruise or an infection, talk to your doctor at the earliest.

Normal results:

The normal level of TT3 in the blood is 75-195 ng/dL (nanograms per decilitre). If you were asked to get this test done to monitor the efficacy of hyperthyroidism treatment, a normal value would indicate that the medicine is effectively controlling the disease.

Abnormal results:

Increased levels of TT3 are seen in conditions such as:

  • Thyroid cancer
  • Thyroiditis (inflammation of thyroid gland)
  • Hyperthyroidism
  • T3 thyrotoxicosis, a condition in which a person’s blood has high levels of T3 but normal levels of T4

Decreased levels of TT3 are seen in conditions such as:

  • Anorexia nervosa (an eating disorder)
  • Congenital TBG deficiency
  • Liver disease
  • Starvation
  • Acute illness
  • Long-term illness
  • Hypothyroidism
  • Kidney failure
  • Thyroidectomy (surgical removal of a part/all of thyroid gland)

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Free and Bound Triiodothyronine (Blood)
  2. Nemours Children’s Health System [Internet]. Jacksonville (FL): The Nemours Foundation; c2017; Blood Test: T3 Total (Triiodothyronine)
  3. HealthyWA [internet]. Department of Health: Government of Western Australia; The thyroid gland
  4. Wilson D. Manual of Laboratory and Diagnostic Tests. 2008. The Mc Graw Hills companies Inc., p.569-70.
  5. Guber HA, Farag AF. Evaluation of endocrine function. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 24.
  6. Salvatore D, Davies TF, Schlumberger MJ, Hay ID, Larsen PR. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 1
  7. Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013.
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests
  9. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Adrenal Insufficiency (Addison's Disease)
  10. National Health Service [internet]. UK; Blood Tests
  11. Amaral CG, Silva PCL, Sterian WL. The clinical use of thyroid function test. Arq Bras Endocrinol Metab. 2013 Apr;57(3):193-204.
  12. Konrády A. T3-thyrotoxicosis: incidence, significance and correlation with iodine intake. Orv Hetil. 2000 Feb 13;141(7):337-40. PMID: 10703222.
  13. Mental Health.gov [Internet]. U.S. Department of Health & Human Services. Washington, D.C. US; Anorexia Nervosa
  14. Harvard Health Publishing. Harvard Medical School [internet]: Harvard University; Thyroidectomy
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