Thyroxine (T4) Lab Values

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Abby Rose
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Outline

Objective:

Determine the significance and clinical use of measuring T4 in clinical practice

 

Lab Test Name:

 Thyroxine

 

Description:

T4- Thyroxine is one of two thyroid hormones present in the bloodstream. It contributes to metabolism, digestive function, muscle control, brain development and function, cardiac function and maintenance of bone. 

 

T4 – Thyroxine

  • Prohormone requiring conversion for activity
  • Various tissues, glands and organs convert T4 to T3 
  • Contributes to:
    • Metabolism
    • Temperature regulation
    • Skin, hair and nail growth
    • Muscle control 
    • Cardiac function
    • brain development and function
    • Bone maintenance

 

Indications:

Indicated:

  • Hyper- and hypothyroidism
    • Diagnose
    • Evaluate function
    • Monitor therapy
  • Hypopituitarism

 

Normal Therapeutic Values:

Normal – 

  • 5-12 mcg/dL

Collection:

  • Serum separator tube

 

What would cause increased levels?

Elevated T4:

  • Hyperthyroidism
    • Graves’ disease
    • Thyroid nodules/inflammation
  • Medications
    • Birth control
    • Methadone
    • Estrogen replacement
  • Rare incidence:
    • Testicular or ovarian tumors
    • Administration of contrast dye

 

What would cause decreased levels?

Decreased T4:

  • Hypothyroidism
    • Underactive thyroid
    • Antithyroid medications
    • Hashimoto’s disease
  • Medications 
    • Amiodarone
    • Androgens
    • Lithium
    • Anabolic steroids
    • Phenytoin
    • Propranolol
  • Malnutrition

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Transcript

Hi there. My name’s Abby and I’m with nursing.com. In this lesson, we’ll discuss thyroxine, otherwise known as T4. It’s a thyroid hormone. We’ll talk about its normal value, and times when it might be increased or decreased. Let’s get started! 

 

Thyroxine, or T4, is evaluated or drawn to look at the function of the thyroid gland. It’s one of the thyroid hormones. It’s actually a prohormone to T3, the other thyroid hormone, and conversion is required for the T4 to actually be active in the tissues. So, there are tons of tissues and glands, organs throughout the body that actually convert T4 to T3, so that it can be effective to the tissues. It helps to contribute to metabolism, muscle control, cardiac function, brain development, and bone maintenance. It’s even good for hair and skin, she’s happy, and nails, beautiful nails. 

 

Some clinical indications for why we would take this lab are to look at hyper and hypothyroidism. 

It can be used for diagnosis, to evaluate function and to monitor therapy. We’ll also have this lab drawn or see it drawn in the case of hypopituitarism, because what does the pituitary gland produce? TSH, and what does TSH do? It stimulates our thyroid to produce T3 and T4. So, help us in clinical evaluation. 

 

Normal therapeutic values are between 5 and 12 micrograms per deciliter. This, uh, blood test will be collected in a serum separator tube, a gold top like this one. When lab values are increased for T4, that means likely there’s hypothyroidism, hyperthyroidism, excuse me, like graves’ disease, or there could be nodules, inflammation, right? And certain medications can even increase T4 like birth control, methadone and even some types of hormone replacement, like estrogen. In rare instances, but it is noted, there will also be a raised T4 value in gonadal cancers, or tumors like testicular or ovarian tumors. And it can also be increased, this would be quite acute, in the administration of contrast dye. If someone’s kidneys aren’t doing great, it could affect their values. Now, when it’s decreased, T4, that’s going to indicate hypothyroidism or an underactive thyroid. That thyroid isn’t producing as much of the T4, and that’s why the value is low. We see this in Hashimoto’s disease, it could also be an indication of malnutrition and certain medications. Amiodarone for rhythm issues, hormone replacement for androgens, or a lack thereof, it could also be in the face of lithium. Lithium actually affects our thyroid function. Also, in times of use of anabolic steroids, phenytoin, and propranolol. 

 

Thyroxine, or T4, is one of the thyroid hormones. It contributes largely to metabolism and functionality of mini body systems. It’s measured to evaluate thyroid function and recall, it’s inactive until it gets converted into T3. Normal values are between 5 and 12 micrograms per deciliter. When values are increased, we’ve got too much, we’ve got hyperthyroidism. When they’re decreased, there’s too little, that’s hypothyroidism. 

 

Now that wraps it up on our lesson for thyroxine or T4. You all did great. Remember, we know you can do it. Now, go out, be your best self today and as always, happy. Nursing.

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Study Plan Lessons

EKG (ECG) Course Introduction
01.01 CCRN Test Overview for CCRN Review
Electrical A&P of the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
02.01 Hypertensive Crisis for CCRN Review
The EKG (ECG) Graph
02.02 Cardiomyopathy for CCRN Review
EKG (ECG) Waveforms
Calculating Heart Rate
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.05 Calculating PAWP on PEEP for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.07 Reading “A, C, V Waves” & PAWP Waveforms for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
Normal Sinus Rhythm
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
Sinus Bradycardia
03.03 Hypoglycemia for CCRN Review
Sinus Tachycardia
Atrial Flutter
03.04 DKA vs HHNK for CCRN Review
Atrial Fibrillation (A Fib)
03.05 Endocrine Practice Questions for CCRN Review
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
04.01 Hematology for CCRN Review
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05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
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05.05 GI Practice Questions for CCRN Review
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
06.02 Poisoning for CCRN Review
06.03 Multi-System CCRN Important Points for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
07.02 Neuro Anatomy for CCRN Review
07.03 Uncal Herniation for CCRN Review
07.04 Supratentorial Herniation and Glasgow Coma Scale for CCRN Review
07.05 Supratentorial Herniation: Cushings Triad for CCRN Review
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
07.07 Cerebral Perfusion Pressure for CCRN Review
07.08 Basilar Skull Fracture for CCRN Review
07.09 Meningitis for CCRN Review
07.10 Neurologic Review questions for CCRN Review
08.01 Psychological Review for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.02 Acute Tubular Necrosis for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.04 Continuous Renal Replacement Therapy for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
09.06 Renal Practice Questions for CCRN Review
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
10.02 Breath Sounds for CCRN Review
10.03 Acute Respiratory Failure for CCRN Review
10.04 Pulmonary Question Review for CCRN Review
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
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Ammonia (NH3) Lab Values
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Antinuclear Antibody Lab Values
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C-Reactive Protein (CRP) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cholesterol (Chol) Lab Values
Coagulation Studies (PT, PTT, INR)
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Cortisol Lab Vales
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Dysrhythmias Labs
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
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Lab Values Course Introduction
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Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Sepsis Labs
Shorthand Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
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Urine Culture and Sensitivity Lab Values
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