T4 (Total)

ThyroidThyroidBlood

Total thyroxine (T4) measures all T4 in blood — both the free, active fraction and the larger fraction bound to carrier proteins. T4 is the main thyroid hormone produced by the thyroid gland; the body converts it to T3 as needed.

Why it matters: Total T4 can shift when binding-protein levels change (during pregnancy or with certain medications) without an actual change in thyroid function. For specifically evaluating thyroid status, free T4 is generally preferred.

Reference Range
66.0 – 181.0nmol/L
66
181LowNormalHigh
Symptoms of Low T4 (Total)
Fatigue
Weight gain
Cold intolerance
Dry skin
Symptoms of High T4 (Total)
Anxiety or restlessness
Heart palpitations
Weight loss
Heat intolerance
What Moves It

May increase with:

Hyperthyroidism
Pregnancy
Estrogen
Thyroid hormone replacement

May decrease with:

Hypothyroidism
Chronic illness
Malnutrition
Associated Conditions
HyperthyroidismHypothyroidism
Related Markers
TSHFree T4T3 (Total)Free T3
Common questions

What is T4 (Total)?

Total thyroxine (T4) measures all T4 in blood — both the free, active fraction and the larger fraction bound to carrier proteins. T4 is the main thyroid hormone produced by the thyroid gland; the body converts it to T3 as needed.

What might a high or low T4 (Total) mean?

Total T4 can shift when binding-protein levels change (during pregnancy or with certain medications) without an actual change in thyroid function. For specifically evaluating thyroid status, free T4 is generally preferred.

What is the typical reference range for T4 (Total)?

The general-population reference range shown here is 66 – 181 nmol/L. Reference ranges describe the general population and are not a personal target — discuss your results with your physician.

What can affect T4 (Total)?

It may be higher with: Hyperthyroidism, Pregnancy, Estrogen, Thyroid hormone replacement. It may be lower with: Hypothyroidism, Chronic illness, Malnutrition.

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