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HelpTest ID FRT3 T3 (Triiodothyronine), Free, Serum
Reporting Name
T3 (Triiodothyronine), Free, SUseful For
Free T3 (triiodothyronine) is a second- or third-level test of thyroid function; it provides further confirmation of hyperthyroidism, supplementing the T4 (tetraiodothyronine), sensitive thyrotropin, and total T3 assays
Evaluating clinically euthyroid patients who have an altered distribution of binding proteins
Monitoring thyroid hormone replacement therapy
Specimen Type
SerumSpecimen Required
Patient Preparation: For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | |
| Frozen | 90 days |
Reference Values
≥1 year: 2.8-4.4 pg/mL
For SI unit Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Day(s) Performed
Monday through Saturday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84481
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| FRT3 | T3 (Triiodothyronine), Free, S | 83127-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| FRT3C | T3 (Triiodothyronine), Free, S | 83127-1 |
Interpretation
Elevated free T3 (triiodothyronine) values are associated with thyrotoxicosis or excess thyroid hormone replacement.
Cautions
Free T3 (triiodothyronine) is not a sensitive test for hypothyroidism.
Some patients who have been exposed to animal antigens, either in the environment or as part of treatment or imaging procedures, may have circulating anti-animal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.
Clinical Reference
1. Welsh KJ, Soldin SJ: DIAGNOSIS OF ENDOCRINE DISEASE: How reliable are free thyroid and total T3 hormone assays?. Eur J Endocrinol. 2016;175(6):R255-R263. doi: 10.1530/EJE-16-0193
2. FT3 Validation 2005 and AIA Retrospective Validation V-139, 2009. Unpublished data
Method Description
The instrument used is a Beckman Coulter DxI 800. The Access free triiodothyronine (T3) assay is a competitive-binding immunoenzymatic assay. A sample is added to a reaction vessel with an anti-T3 monoclonal antibody conjugated to alkaline phosphatase. During the incubation, free T3 in the sample reacts with the anti-T3 antibody. Particles coated with streptavidin and biotinylated T3 analog are added to the mixture. Unoccupied binding sites on the anti-T3 antibody are bridged to the particle through the T3 analog. After incubation in a reaction vessel, materials bound to the solid phase are held in a magnetic field, while unbound materials are washed away. Chemiluminescent substrate is added to the vessel and the light generated by the reaction is measured with a luminometer. The light production is inversely proportional to the concentration of free T3 in the sample. The amount of analyte in the sample is determined from a stored, multipoint calibration curve.(Instruction manual: Beckman Coulter Instructions for Use. Beckman Coulter, Inc; 2020)
Report Available
1 to 3 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | Reject |
Clinical Information
Normally T3 (triiodothyronine) circulates tightly bound to thyroxine-binding globulin and albumin. Only 0.3% of the total T3 is unbound (free); the free fraction is the active form.
In hyperthyroidism, both T4 (thyroxine, tetraiodothyronine) and T3 levels (total and free) are usually elevated, but in a small subset of hyperthyroid patients (T3 toxicosis), only T3 is elevated. Generally, free T3 (FT3) measurement is not necessary since total T3 will suffice. However, FT3 levels may be required to evaluate clinically euthyroid patients who have an altered distribution of binding proteins (eg, pregnancy, dysalbuminemia).
Some investigators recommend the FT3 assay for monitoring thyroid replacement therapy, although its clinical role is not precisely defined.
Method Name
Immunoenzymatic Assay