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Craig, You may be dealing with a case of antbody interfererence, possibly anti-T4, anti-T3 antibodies that are more prevalent in autoimmune thyroid disease, although results are usually falsely elvated Suggest getting TFT assays checked by another sytem. I also would measure the SHBG level as it is a sensitive peripheral marker of thyroid hormone activity and levels are usually 2-3 times raised in hyperthyroidism.(we would be happy to measure this for you), Regards, Roy Fisher, Royal Cornwall 01872 252546 -----Original Message----- From: Craig Webster <[log in to unmask]> To: Acb-Clin-Chem-Gen <[log in to unmask]> Date: 18 November 1998 10:44 Subject: ? Thyrotoxicosis >We have a patient with some signs of thyrotoxicosis > >Lid retraction >Weight loss > >However his thyroid function results are as follows (typical example) > >Total T4 70 >Free T4 19.5 >TSH < 0.03 > >The TSH has been consistently suppressed during the last two to three >months. Thinking this may be a T3 toxicosis we had a total T3 measured which >came back 1t 1.50 (1.20 - 2.20). > >He also has strongly positive thyroid autoantibody titres. > >What's the next step ? >Is this patient toxic ? >Should we consider measuring LATS ABs ? >What about a TRH test ? > > %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%