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Differential Diagnoses & T3-Resin Uptake – Euthyroid Conditions

by Carlo Raj, MD
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    Diagnosis – hyperthyroidism, hypothyroidism. Stop there. We haven’t gotten into great detail, specifically of Graves’ disease or Hashimoto to give you an example of hyper/hypothyroidism, but what we have done in this discussion is talk about TBG excess and TBG deficiency. At this point, I need you to focus upon the bottom two differentials. In addition, the topic is differential diagnosis in summary of results of T3-resin uptake. Stop. Resin. Picture that. I’ve shown you resin. What is it going to bind to? T3. Do not confuse the resin with your TBG. Where’s thyroglobulin bind to? T4. What you’re going to be using, as a clinician, is the T3-resin uptake to give you further confirmation for your diagnosis. Is that understood? None of this would make any sense to you, unless you’ve understood the discussions that we had prior. In TBG excess, think about a common example – pregnancy and estrogen. TBG deficiency – drugs that displace the T4 from your TBG or heparin that I showed you earlier that increases lipoprotein lipase activity. That increasing free fatty acid inhibits the binding of T4 to TBG. Those are your differentials. Let’s move on to next column. If it is pure hyperthyroidism, we know that the serum free T4 index is increased. Example – Graves’s disease. Graves’ disease. Hypothyroidism – as a differential –Hashimoto. We know that the free T4 index is decreased. The topic for this entire section was what? It wasn’t hyper or hypo. It was euthyroid. When you say euthyroid, what does that mean? Take a look. Either TBG excess or TBG deficiency showing you what with free T4? Notice. Normal. Normal. What’s the clinical representation of normal? Eu-. Eu-. So, how can you possibly tell what’s causing the normal, but yet resulting in hyperthyroxinemia or hypothyroxinemia? Let’s...

    About the Lecture

    The lecture Differential Diagnoses & T3-Resin Uptake – Euthyroid Conditions by Carlo Raj, MD is from the course Thyroid Gland Disorders.


    Included Quiz Questions

    1. Euthyroid hyperthyroxinemia
    2. Hyperthyroidism
    3. Hypothyroidism
    4. TBG deficiency
    5. Euthyroid hypothyroxinemia
    1. Euthyroid hypothyroxinemia
    2. Hyperthyroidism
    3. Hypothyroidism
    4. TBG excess
    5. Euthyroid hyperthyroxinemia
    1. Decreased; increased
    2. Increased; increased
    3. Decreased; decreased
    4. Increased; decreased
    5. Decreased; no change
    1. Increased; decreased
    2. Increased; increased
    3. Decreased; decreased
    4. Decreased; increased
    5. No change; decreased

    Author of lecture Differential Diagnoses & T3-Resin Uptake – Euthyroid Conditions

     Carlo Raj, MD

    Carlo Raj, MD


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