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Conditions associated with hyperthyroxinemia

Conditions associated with hyperthyroxinemia
Thyroid function tests
Defect T4 T3 rT3 TSH FT4 direct FT4 dialysis Prevalence*
Increased T4-binding globulin ↑ ↑ ↑ N N N Common
Increased transthyretin ↑ N ↑ N N N Rare
FDH ↑ ↑ or N ↑ N ↑ N Rare or commonΔ
RTH
(usually due to a mutation in the TR-beta gene [RTH-beta])		 ↑ ↑ or N ↑ sl ↑ or N ↑ ↑ Uncommon
TSH-producing pituitary adenoma ↑ ↑ ↑ sl ↑ or N ↑ ↑ Rare
SBP2/SECISBP2 mutation
(causes a thyroid hormone metabolism defect)		 ↑ ↓ ↑ sl ↑ or N ↑ ↑ Unknown
Acute nonthyroidal illness ↑ ↓ ↓ ↑ N ↑ or N N Common
TSH: thyroid-stimulating hormone; FDH: familial dysalbuminemic hyperthyroxinemia; SBP2/SECISBP2: selenocysteine insertion sequence-binding protein 2; sl: slight; N: normal; ↑: increased; ↓: decreased.
* "Common" indicates >1:300, "Uncommon" indicates >1:50,000, "Rare" indicates <1:50,000.
¶ Refers to transthyretin with increased affinity for T4 and rT3.
Δ Depending on the ethnic origin.
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