T4 is produced by the thyroid gland and converted in body tissues into the more active hormone T3. Most circulating T4 is bound to proteins, with only a small free fraction biologically active. Total T4 measures both bound and free forms; free T4 isolates the active portion.
This test is ordered to evaluate suspected thyroid disorders, particularly when TSH is abnormal; monitor patients on thyroid hormone replacement or antithyroid medications; assess thyroid function during pregnancy; and investigate pituitary disorders that affect thyroid hormone production. T4 is often interpreted alongside TSH for the clearest picture. Sample type is serum.