I have to clarify my previous remark. It seems that 1 in 15,000
individuals (in most countries) does not have "measurable" TBG, in other
words absence of TBG is not exceedingly rare. Therefore, it appears
reasonable to have some laboratories able to perform TBG quantitation (not
TBG affinity for T4 or TBG binding capacity). The cases with strong
suspicion of complete TBG deficiency (in contrast with merely decreased
TBG) could be referred to some research labs that can easily find out the
mutations in the TBG gene or alterations of its promoter. The "abnormal"
TBG often have "geographical" names (similar to hemoglobins of the past).
TBG is X-linked, therefore complete TBG deficiency is found mostly in
males. I do not think that TBG quantitation should be performed in all
individuals with decreased T4 and measurement of "free T4" is more common.
The Valentine' Day poetry of Prof. Ekins is greatly appreciated!
AOV
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