Direct immunoassay of triiodothyronine in human serum

A sensitive and precise radioimmunoassay for the direct measurement of triiodothyronine (T(3)) in human serum has been designed using sodium salicylate to block T(3)-TBG binding. This assay is sufficiently sensitive to quantitate T(3) accurately in 50-100 mul of normal serum and to measure quantities as small as 12.5 pg in 0.2 ml of hypothyroid serum. The T(3) values observed in euthyroid subjects and in patients with various thyroid diseases are as follows: euthyroid (38) 1.10+/-0.25 (SD) ng/ml, hypothyroid (25) 0.39+/-0.21 (SD) ng/ml, and hyperthyroid (24) 5.46+/-4.42 (SD) ng/ml. The levels of T(3) parallel the thyroxine (T(4)) concentration in the sera of these subjects. In eight pregnant women at the time of delivery, T(3) concentrations were in the upper normal range (mean 1.33 ng/ml). The levels of T(3) in cord serum obtained at the time of delivery of these patients (mean 0.53 ng/ml) are distinctly lower and close to the hypothyroid mean. Administration of 10 U of bovine thyroid-stimulating hormone (TSH) to euthyroid subjects causes a two-fold increase in serum T(3) levels within 8 hr. At this time, the increase in serum T(4) concentration is only 41%. In two subjects in whom thyroid secretion was acutely inhibited, one after pituitary surgery and another after thyroidectomy, the serum T(3) fell into the hypothyroid range within 1-2 days. Thus, serum T(3) concentrations appear to be a sensitive index of acute changes in thyroid hormone secretion and should prove to be a useful adjunct to both the clinical and physiological evaluation of thyroid function.