Total T4 — lab reference
In the reference guideAffected by thyroid-binding globulin, pregnancy, estrogen, and medications.
THE PURSER WELLNESS LIBRARY
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What’s searchable?Affected by thyroid-binding globulin, pregnancy, estrogen, and medications.
Correct for albumin when appropriate or measure ionized calcium.
Fasting, Gilbert syndrome, hemolysis, and liver disease may alter result.
Review albumin, globulin, and electrophoresis when indicated.
Screening measure, not a stand-alone treatment target.
Binding abnormalities and severe illness may affect some free-hormone assays.
Affected by binding proteins and nonthyroidal illness.
Interpret with iron, transferrin saturation, and ferritin.
No universal wellness target. Interpret with B12, folate, B6, kidney, thyroid, genetics, and medications.
<10 severe deficiency; 10-19 mild-moderate deficiency. Toxicity assessment requires clinical context.
Morning collection preferred for men. Method and age matter; confirm unexpected low values.
No single normal cutoff fits every patient. Use age, baseline, trend, prostate size, risk factors, and shared decision-making.
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