Thyroxine (T4) Lab Values

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Abby Rose
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Study Tools For Thyroxine (T4) Lab Values

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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.

References:

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Endocrine

Concepts Covered:

  • Endocrine System
  • Tissues and Glands
  • Disorders of Pancreas
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Oncology Disorders
  • Pregnancy Risks
  • Respiratory Disorders
  • Terminology
  • Disorders of the Posterior Pituitary Gland
  • Eating Disorders
  • Medication Administration
  • Statistics
  • Female Reproductive Disorders
  • Renal Disorders
  • Substance Abuse Disorders
  • Renal and Urinary Disorders
  • Newborn Care
  • Studying
  • Urinary System
  • Noninfectious Respiratory Disorder

Study Plan Lessons

Pituitary Gland
Pancreas
Glands
Metabolic & Endocrine Module Intro
Metabolic/Endocrine Course Introduction
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Pituitary Adenoma
Thyroid Cancer
Glucose Tolerance Test (GTT) Lab Values
Thyroid Gland
Pituitary Gland
Free T4 (Thyroxine) Lab Values
Glucose Lab Values
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Hypoparathyroidism
Hyperthyroidism Case Study (75 min)
Metabolic & Endocrine Module Intro
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Thyroid Cancer
Pituitary Adenoma
Pituitary Gland
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Thyroid Cancer
Thyroid Gland
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Triiodothyronine (T3) Lab Values
Metabolic & Endocrine Terminology
Antidiabetic Agents
Hypoparathyroidism
Iodine Nursing Considerations
Hyperthyroidism Case Study (75 min)
Free T4 (Thyroxine) Lab Values
Levothyroxine (Synthroid)
Metabolic & Endocrine Module Intro
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Thyroid Cancer
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Thyroid Cancer
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Hypothyroidism
Pituitary Adenoma
Pituitary Gland
Thyroid Gland
Hypoparathyroidism
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Metabolic & Endocrine Terminology
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Thyroid Gland
Thyroid Cancer
Diabetes Mellitus Case Study (45 min)
Glucose Lab Values
Hypoglycemia
Glucagon Lab Values
Glipizide (Glucotrol) Nursing Considerations
Glands
Metabolic & Endocrine Terminology
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Hypoglycemia
Pancreas
Adrenal Gland
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Cortisol Lab Vales
Cortisone (Cortone) Nursing Considerations
Corticosteroids
Cushing’s Syndrome Case Study (60 min)
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Cushing’s Disease
Pituitary Gland
Diabetes Insipidus Case Study (60 min)
Free T4 (Thyroxine) Lab Values
Growth Hormone (GH) Lab Values
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Cortisol Lab Vales
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Pituitary Adenoma
Pituitary Gland
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Gland
Growth Hormone (GH) Lab Values
Pituitary Adenoma
Pituitary Gland
Cushing’s Syndrome Case Study (60 min)
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Glipizide (Glucotrol) Nursing Considerations
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Metabolic & Endocrine Module Intro
Metabolic/Endocrine Course Introduction
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Case Study for Diabetic Foot Ulcer
Nursing Case Study for Type 1 Diabetes
Pituitary Gland
Protein in Urine Lab Values
Urinalysis (UA)
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Cushing’s Syndrome Case Study (60 min)
Cushings Assessment Nursing Mnemonic (STRESSED)
Nursing Care Plan (NCP) for Cushing’s Disease
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Enuresis
Metabolic/Endocrine Course Introduction
Metabolic & Endocrine Module Intro
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Urinalysis (UA)
Nursing Care Plan (NCP) for Diabetes Insipidus
Diabetes Insipidus Case Study (60 min)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetic Ketoacidosis (DKA) Case Study (45 min)
DKA Treatment Nursing Mnemonic (KING UFC)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Case Study for Type 1 Diabetes
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Glucose Lab Values
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Adrenal Gland
Antidiabetic Agents
Blood Glucose Monitoring
Diabetes Management
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Glipizide (Glucotrol) Nursing Considerations
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypoglycemia
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin
Insulin Mixing
Insulin Drips
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Case Study for Type 1 Diabetes
Pancreas
Corticosteroids
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care and Pathophysiology for Cushings Syndrome
Cushings Assessment Nursing Mnemonic (STRESSED)
Cushing’s Syndrome Case Study (60 min)
Adrenal Gland
Addisons Disease
Addisons Assessment Nursing Mnemonic (STEROID)
Cortisol Lab Vales
Cortisone (Cortone) Nursing Considerations
Corticosteroids
Adrenal Gland
Addisons Disease
Cushing’s Syndrome Case Study (60 min)
Cushings Assessment Nursing Mnemonic (STRESSED)
Glucose Lab Values
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Pituitary Adenoma
Pancreas
Glucagon (GlucaGen) Nursing Considerations
Glucagon Lab Values
Hypoglycemia
Nursing Care Plan (NCP) for Hypoglycemia
Pancreas
Adrenal Gland
Antidiabetic Agents
Blood Glucose Monitoring
Diabetes Management
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Corticosteroids
Disease Specific Medications
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Glipizide (Glucotrol) Nursing Considerations
Glucose Tolerance Test (GTT) Lab Values
Glucose Lab Values
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypoglycemia
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Insulin Mixing
Insulin Drips
Insulin – Short Acting (Regular) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Case Study for Type 1 Diabetes
Pancreas
Pituitary Gland
Growth Hormone (GH) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Gland
Pituitary Gland
Nursing Care Plan (NCP) for Hyperthyroidism
Free T4 (Thyroxine) Lab Values
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Gland
Thyroid Cancer
Pituitary Gland
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Free T4 (Thyroxine) Lab Values
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Pituitary Gland
Thyroid Gland
Thyroid Cancer
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hyperparathyroidism