Segrestaa J M, Gueris J, Lajeunie E, Lamotte M
Sem Hop. 1980;56(1-2):73-81.
Clinical findings suggesting hyperthyroidism should be confirmed by the following basic tests of thyroid function: serum T3 and T4, and iFT4. In the case where there is contradiction between the T3 and T4 values, hyperthyroidism may be confirm by the absence of effect of TRH on serum TSH level. Clinical findings suggesting hypothyroidism should be confirmed by the following basic tests: serum T3 and T4, iFT4, and serum TSH which also will be greatly helpful in the differentiation of primary or secundary hypothyroidism. When there is an absence of parallelism between total and free T3 and T4 determinations, it is necessary to look for a possible abnormality in the binding protein. In vivo explorations (radio-iodine uptake, scintigraphy) and other assays should be proposed in view of clinical findings but should not be systematically prescribed.
血清总三碘甲状腺原氨酸（T3）、血清总甲状腺素（T4）和游离甲状腺素指数（FT4）。如果T3和T4值之间存在矛盾，可通过促甲状腺激素释放激素（TRH）对血清促甲状腺激素（TSH）水平无影响来确诊甲状腺功能亢进。提示甲状腺功能减退的临床发现应通过以下基本检查来确诊：血清T3、T4、FT4以及血清TSH，这对鉴别原发性或继发性甲状腺功能减退也非常有帮助。当总T3、总T4与游离T3、游离T4测定结果不平行时，有必要寻找结合蛋白可能存在的异常。鉴于临床发现，应进行体内检查（放射性碘摄取、闪烁扫描）和其他检测，但不应一概而论地进行常规检查。
