Mohammed,
The mean free T4 falls by about 25% in the third trimester of
pregnancy, independent of albumin, TBG and prealbumin (reference
Ballabio M, Poshyachinda M and Ekins RP JCEM 1991; 73:824) so it's a
little hard to interpret your results. I expect you'll have Roger
posting a reply in due course! How long is it since she delivered?
She may also be iodine deficient (preferentially synthesising T3 to
conserve iodine)....more than half the UK population appears to suffer
from mild to moderate iodine deficiency (by WHO criteria).
Nick Miller
London
On 06/02/2013, Mohammad Al-Jubouri <[log in to unmask]> wrote:
> I am not sure if FT3/FT4 ratio has any value when interpreting TFTs.
>
> A young lady who is breast feeding has developed weight loss and
> tachycardia. No information about the presence of painless or painful
> goitre, TFTs showed:
>
> FT3 23.1 pmol/L (3.5 - 6.5)
> FT4 29.2 pmol/L (10.0 - 20.0)
> TSH <0.05 mU/L
>
> The FT4 seems to be lower than I had seen associated with a FT3 of 23.1
> pmol/L, I would have expected it to be > 40 pmol/L. Is this thyrotoxicosis
> developing in iodine deficient subject? Graves ? or post-partum thyroiditis?
>
> Regards
>
> Mohammad
>
> Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
> Consultant Chemical Pathologist
>
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