Measurement of serum concentrations of free triiodothyronine (FT
3) is considered to be an accurate index of thyroid function in the patient. In this study, we measured serum concentrations of FT
3, free thyroxine (FT
4) and reverse triiodothyronine (rT
3) by radioimmunoassay in blood samples taken from the navel cord of 20 newborns as well as 20 nonpregnant women, 20 pregnant women, 10 patients with liver diseases, 25 patients with diabetes mellitus, 65 patients with hyperthyroidism, 30 patients with primary hypothyroidism and 29 normal subjects.
In pregnant women, serum FT
3 and FT
4 levels gradually decreased as the pregnancy progressed. In cord blood, FT
3 levels were less than a quarter of the values found during the first trimester of pregnancy or that of non-pregnant women, whereas serum rT
3 levels were drastically increased.
In chronic hepatitis, liver cirrhosis and diabetes mellitus, serum FT
3 and FT
4 levels were significantly lower than that in the controls.
In thyroid diseases, serum FT
3 levels varied parallel to other thyroid hormone levels. In primary hypothyroidism, however, serum FT
3 levels were still lower than these in the controls after treatment with 1-thyroxine, whereas other thyroid hormone levels and TSH levels returned to control levels.
The remarkable decrease in serum FT
3 and the increase in serum rT
3 observed in pregnant women and especially in fetuses may imply that even a low serum FT
3 level is enough to keep intracellular metabolism in a euthyroid state. Still lowered FT
3 levels in primary hypothyroidism even after treatment with 1-thyroxine suggest that in order to treat the hypothyroid patient sufficiently, it is necessary to normalize the serum FT
3 levels and that, in fact, the serum FT
3 level is a more useful indicator for medication in primary hypothyroidism.
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