The influence of thyroxine on the serum free triiodothyronine concentration

By means of measurement of the serum free triiodothyronine fraction (%FT3) by equilibrium dialysis, the influence of varying serum concentrations of thyroxine (T4) on %FT3 was studied in conditions associated with lack or excess of serum T4 and in serum enrichment with T4 in vitro. The enrichment of pooled serum with T4 caused significant increases of %FT3 with T4 was added to elevate its T4 content between 10 and 25 mug/dl. In 4 subjects with primary hypothyroidism treated with T3 (25 mug once daily for two weeks, twice daily thereafter), progressive increases of serum T3 were observed while their T4, free T4 and T3 fractions remained unchanged. Consequently, the serum free T3 and thyrotropin concentrations became normal after the serum T3 concentrations became hypernormal. When comparisons of the serum thyroid hormone levels were made between 6 subjects with T3 toxicosis and 8 with a usual variety of hyperthyroidism matched for serum T3 concentration, the former sub-group of hyperthyroidism showed significantly lower serum free T3 concentration (0-51 +/- 0.22 ng/dl versus 0.79 +/- 0-21 ng/dl, p less than 0.05). The amount of T4 in serum is considered to affect its free T3 concentration by virtue of sharing serum-binding proteins.