Test Catalog

Test Id : FRT4

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T4 (Thyroxine), Free, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating suspected thyroid function disorders using free thyroxine measured together with thyroid-stimulating hormone

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For more information see: Thyroid Function Ordering Algorithm

Method Name
A short description of the method used to perform the test

Electrochemiluminescence Immunoassay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

T4 (Thyroxine), Free, S

Aliases
Lists additional common names for a test, as an aid in searching

Free T4 (Thyroxine)

Free Thyroxine

FT4, Serum

Non-Protein Bound Tetraiodothyronine

T4 Free, Serum

Thyroxine, Free

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For more information see: Thyroid Function Ordering Algorithm

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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: 1 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 30 days
Ambient 72 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating suspected thyroid function disorders using free thyroxine measured together with thyroid-stimulating hormone

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For more information see: Thyroid Function Ordering Algorithm

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Free thyroxine (FT4) comprises a small fraction of total thyroxine. FT4 is available to the tissues and is, therefore, the metabolically active fraction.

 

Elevations in FT4 cause hyperthyroidism, while decreases cause hypothyroidism.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Pediatric

0-5 days: 0.9-2.5 ng/dL

6 days-2 months: 0.9-2.2 ng/dL

3-11 months: 0.9-2.0 ng/dL

1-5 years: 1.0-1.8 ng/dL

6-10 years: 1.0-1.7 ng/dL

11-19 years: 1.0-1.6 ng/dL

 

Adult (> or =20 years): 0.9-1.7 ng/dL

 

For SI unit Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html

Interpretation
Provides information to assist in interpretation of the test results

Elevated values suggest hyperthyroidism or exogenous thyroxine.

 

Decreased values suggest hypothyroidism.

 

Free thyroxine (FT4) works well to correct total T4 values for thyroxine-binding globulin alterations but may give misleading values when abnormal binding proteins are present or the patient has other major illnesses (euthyroid sick syndrome).

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Of 26 commonly used pharmaceuticals tested in vitro, only furosemide caused elevated free thyroxine (FT4) findings at the daily therapeutic dosage level.

 

The test cannot be used in patients receiving treatment with lipid-lowering agents containing dextrothyroxine (D-T4). If the thyroid function is to be checked in such patients, the therapy should first be discontinued for 4 to 6 weeks to allow the physiological state to become re-established.

 

Binding protein anomalies seen with familial dysalbuminemic hyperthyroxinemia, for example, may cause values which, while characteristic of the condition, deviate from the expected results.

 

For assays employing antibodies, the possibility exists for interference by human anti-animal antibodies (ie, heterophile antibodies) in the patient sample. Patients who have been regularly exposed to animals or have received immunotherapy or diagnostic procedures utilizing immunoglobulins or immunoglobulin fragments may produce antibodies, eg, human antimouse antibodies (HAMA) that interfere with immunoassays. This may falsely elevate or falsely decrease the results.

 

Interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Melmed S, Polonsky KS, Larsen PR, Kronenberg H. Williams Textbook of Endocrinology. 12th ed. Saunders Company; 2011:348-414

2. Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023

Method Description
Describes how the test is performed and provides a method-specific reference

In the Roche free thyroxine (FT4) assay, the determination of free thyroxine is made with the aid of a specific anti-T4 antibody labeled with a ruthenium complex. After addition of biotinylated T4 and streptavidin-coated microparticles, the still-free binding sites of the labeled antibody become occupied, with formation of an antibody-hapten complex. The entire complex becomes bound to the solid phase via interaction of biotin and streptavidin. The reaction mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Unbound substances are then removed with ProCell. Application of a voltage to the electrode then induces chemiluminescent emission which is measured by a photomultiplier.(Package insert: Elecsys FT4 II. Roche Diagnostics; 01/2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84439

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
FRT4 T4 (Thyroxine), Free, S 83122-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
FRT4 T4 (Thyroxine), Free, S 83122-2

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports