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Final Grade Calculator

Final Grade Calculator

Enter Final Info

My final exam is worth:

I want (at least) this in the class:

Enter Class Grades

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  • In the top part of the form, enter how much your final exam is worth and the grade that you would like to get in the class. For example, your final test might be worth 20% of your overall grade and you want to get at least a 93% in the class. You would enter these numbers into the form.
  • In the bottom half of the form, enter a description (optional) of the classwork, the grade received for that classwork, and the weight of the classwork. Most class grades are made up of several components such as homework assignments, tests, exams, quizzes, class participation, attendance, etc. For example, a class exam might be worth 10% of your grade and you received a 95% on the test. You would enter those values into the form.
  • If you need more than four rows, press the "Add Row" button to add an additional line. You can add as many rows as you need.
  • Once you have finished entering your grades, press the "Calculate" button and the grade you need on the final exam will be displayed.

Final Grade Formula

final grade = ((g wanted x w total ) - gw) / w final

w total = w 1 + w 2 + w 3 + ... + w final

w 1 = weight of assignment #1

w final = weight of final exam

gw = g 1 x w 1 + g 2 x w 2 + g 3 x w 3 + ...

g 1 = grade for assignment #1

g wanted = grade wanted in the class

Example Calculation

Let's say your class has the following grading plan.

Assignments Weight
Project #1 10%
Project #2 10%
Quiz #1 20%
Quiz #2 20%
Mid-Term Test 20%
Final Exam 20%

Now let's assume you received the following grades on your classwork.

Assignments Grade Received
Project #1 91%
Project #2 85%
Quiz #1 75%
Quiz #2 95%
Mid-Term Test 97%
Final Exam Not Yet Taken

Finally, let's assume that you want to get a 90% in the class. To determine what you need to get on your final exam in order to get a 90% in the class, let's do some math using the formula above.

First add the weight of all the class assignments together including your final:

w total = 10% + 10% + 20% + 20% + 20% = 100%

Next, multiple the grade you received on each assignment by the weight of the assignment.

gw = (91% x 10%) + (85% x 10%) + (75% x 20%) + (95% x 20%) + (97% x 20%) = 7100%

Now, calculate what you need on the final exam:

final exam grade = ((90% x 100%) - 7100%) / 20% = 95%

This is how you manually calculate your final grade. Of course, you can make your life a little easier using the calculator above!

What if my class grade is based on points rather than percentages?

Let's assume you have the following class syllabus that is based on points.

Assignments Possible Points
Project 100
Homework #1 100
Homework #2 150
Quiz 200
Mid-Term Test 200
Final Exam 250

Let's assume you received the following grades.

Assignments Points Earned
Project 91 out 100
Homework #1 85 out of 100
Homework #2 120 out of 150
Quiz 180 out of 200
Mid-Term Test 190 out of 200
Final Exam Not Yet Taken

To enter these grades in the calculator above, you first need to calculate your grade percentage for each assignment using the following formula:

grade percentage = points earned / possible points x 100

So taking your mid-term test grade as an example, we get the following:

mid-term test = 190 points earned / 200 possible points x 100 = 95%

In the weight column of the calculator, you would enter the possible points for each assignment.

Assuming you wanted to get at least a 90% in the class and your final exam is worth 250 points (i.e.the weight), you would enter the following information into the calculator.

Classwork Grade Weight
Project 91% 100
Homework #1 85% 100
Homework #2 80% 150
Quiz 90% 200
Mid-Term Test 95% 200

In this example, you would need to get a 93.6% on your final in order to get a 90% in the class.

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homework 75 t4

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New Holland T 4.75 - Expensive lesson on why I should have bought a Deere?

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Long story follows. Exactly this week last year, after looking at all the competitors in the ~75 HP tractor space, I chose a NH T4.75. And for the first year, it was a great tractor. Used it some this spring, and then a couple weeks ago, with a total of 50 hours on it, I started it up and there was fuel leaking all over the engine compartment. I should say that I did not buy this from my closest dealer, Zimmer Tractor in Monroe, OH. I had tried to buy a tractor there, and could not get the time of day from them looking at $50K tractors, except to determine they didn't have one new with the features I wanted. I called the next closest dealer, 2 hrs. away. They had what I wanted, were open Memorial Day weekend, and would love to show me anything I wanted to see. Went down there, bought it, they delivered it for free, 2 hrs. away. Anyway, had to call the local dealer to take a look at this. They sent a service tech out, he said it was a fuel line near the top of the engine, they'd have to get it back to the shop, but that he thought is should be covered by warranty. He did mention that a mouse might have chewed it. Keep in mind, I've been driving this thing (this year) since March. With no problems. On that basis, I let them take it away, and heard nothing for two weeks. I didn't want to hassle them too much, since I'm expecting a free repair. Finally, I've got fields that need cut, so I call. Service mgr tells me they're waiting on a part, don't know when it will be done yet. I hadn't ever gotten a call with an estimate, and asked about that. He tells me, that's because he doesn't know yet how much it will be, but should know in the next day. Fine. Next day, he calls to tell me that NH North America called him to tell him not to warranty the line if it was mice, so he called to tell me the same thing, and that if it's full price, will probably cost "$1600-$1800". Holy crap. On a tractor with 50 hours, I am not expecting to get into a $2000 repair already. But, he says, NH NA is going to call me. I did not, at that point, say, "Do it.". I was hoping to hear some better news from NH. Addy from NH called several hours later, and went over the same info. I expressed my dissatisfaction (nicely) with a $50K tractor that needs a $2K repair already, and that BTW, I still don't have an estimate on what the cost will be. She says to me that the dealer has the discretion on what they submit for warranty - which conflicts what the service manager said, and she's going to talk with him, but if it is submitted for warranty, that process might take "weeks". Fields, growing longer. This was all last Thursday. Heard nothing on Friday, yesterday was a holiday. Today, service mgr calls and says my tractor is all back together. Uhh... And it's $1876.74 with tax. Uhhh, what?? My wife calls NH NA, and gets a run around, they will not transfer her to a supervisor, and they insist that everything is up to the dealer. So, now I don't know when I'm getting a tractor back, but at this point, I just want to dump this thing, for as close to what I owe and be done with it. I will never deal with NH or that dealer again. Buyer beware.  

I wouldn't be too quick to go JD. From much of what I have heard and read, JD dealers are not any better at taking care of their customers.  

homework 75 t4

K1UWJ said: I wouldn't be too quick to go JD. From much of what I have heard and read, JD dealers are not any better at taking care of their customers. Click to expand...

Wife here ..... actually we have not paid anything yet. There is no way we're paying $1900 for a repair we didn't authorize, for a tractor we just bought, for a simple fuel line. I can't even begin to describe how terrible New Holland corporate was through this situation. Basically stepped off completely on quality and completely bailed on the whole thing. Said it was entirely between us and the dealer. My concern really is the tractor itself (which I no longer want). Who builds a tractor with a plastic fuel line? Every other tractor we own has a metal fuel line. I'm sure even if I paid for the repair it would take a whole 20 minutes for another mouse to do same. And I can't be up all night worrying that there might be a mouse in the barn, one that will could cost me another $2000 repair and a month downtime during the growing season. I called the dealer we bought it from and he had never ever heard of this happening. Especially since you want a fuel line that is durable enough it can withstand impact from bumping up on stumps or rocks doing typical farm stuff. A fuel line that can be chewed is probably fragile enough that it could be damaged easily by regular work, and that would also lead to a serious fire risk. In fact, the Ohio mechanic told me his boss said for him not to start it or it might catch fire. Has anyone here ever had one of these tractors and had the fuel line be damaged in this manner? Is this a problem with New Hollands?  

Lazarus said: Wife here ..... actually we have not paid anything yet. There is no way we're paying $1900 for a repair we didn't authorize, for a tractor we just bought, for a simple fuel line. I can't even begin to describe how terrible New Holland corporate was through this situation. Basically stepped off completely on quality and completely bailed on the whole thing. Said it was entirely between us and the dealer. My concern really is the tractor itself (which I no longer want). Who builds a tractor with a plastic fuel line? Every other tractor we own has a metal fuel line. I'm sure even if I paid for the repair it would take a whole 20 minutes for another mouse to do same. And I can't be up all night worrying that there might be a mouse in the barn, one that will could cost me another $2000 repair and a month downtime during the growing season. I called the dealer we bought it from and he had never ever heard of this happening. Especially since you want a fuel line that is durable enough it can withstand impact from bumping up on stumps or rocks doing typical farm stuff. A fuel line that can be chewed is probably fragile enough that it could be damaged easily by regular work, and that would also lead to a serious fire risk. In fact, the Ohio mechanic told me his boss said for him not to start it or it might catch fire. Has anyone here ever had one of these tractors and had the fuel line be damaged in this manner? Is this a problem with New Hollands? Click to expand...

homework 75 t4

I can add that it could just have easily been a $2000 wire harness if not a fuel line. Mice will find something to chew, and they rarely pick anything easy to replace or cheap. I'd also suggest this as a legal issue if you can PROVE you did not authorize the repairs and you were not provided with any kind of written estimate, but I can't believe it would come down to that. Did they show you how the line had to be replaced? For $1900, I'd expect they had to tear in awful far or the line is made of gold, not plastic. It might also be a valid homeowner's insurance claim if it isn't too late to start that process.  

They did not show us, but they said they had to take the tractor apart and it took 8 hours to replace. Even then, I know the parts only cost $140, so they would have had to be charging $200/hr for the labor. They never gave us a quote for the cost, only a range while they were still trying to validate whether it was under warranty. In fact, asked specifically for an exact number they said they couldn;t say until they heard back from New Holland on the warranty. Then all of a sudden it was fixed, like the very next day, which says to me they fixed it before they knew it wasn't going to be warrantied. In talking with New Holland, they said the dealer insisted it was mice damage with no question, and of course based on that, it would not be under warranty. It was dealer's choice what to turn in for warranty. It feels to me like the dealer suggested it was under warranty to get the business to begin with, then did everything they could to prevent it from being warrantied, and then tried to get us to pay directly. I know they make more on a direct billing than warranty. The whole thing stinks.... so yes, this is probably going to get a whole lot worse for everyone before it is resolved. If you are interested, I put the tractor up for sale here: New Holland T4.75 with <50 hrs Not sure whether I will get any takers, but I feel better anyway. :sidelaugh  

I have owned a T4.75 for over two years. Cab, Loader, 4wd, epto, etc., now has over 800 hours on it. Had a few warranty issues with cable connections ( loader controls and PTO). that were fixed rather quickly by my New Holland Dealer. I could have paid less for my T4.75 if I purchased from a dealer an hour plus away..but decided that probably wouldn't be a smart move. Anyway I was a died-in-the-wool green man until a few years ago and switching was somewhat painful at first. However, the tractor and dealer have been outstanding. As I do all of my annual maintenance, I'm familiar with the T4.75. I can't imagine a plastic fuel line issue requiring the expenditure of 1900 bucks to fix. In my judgement this is a made up story, something else is the culprit..if you have mouse damage to the wiring than it's your fault. I use mouse repellant on all my seasonal tractors. As my T4.75 is my daily chore tractor it's being used 7 days per week and is parked in the farm shop with cats, etc....  

Longmeadow Farm said: I use mouse repellant on all my seasonal tractors. As my T4.75 is my daily chore tractor it's being used 7 days per week and is parked in the farm shop with cats, etc.... Click to expand...

So, after my experience, a friend of mine recommended this stuff. He has classic cars, and swears by it. Puts packets in all the cars when sitting, inside and in the engine compartment, and in the building. He says his success rate has been 100%. They carry them at Rural King, and I ordered a 12-pack online. Scattered them around the barn, put two in the engine compartment, and one in the cab. We'll see how they work. Just have to remember to take them out before I start the tractor. Fresh Cab® Rodent Repellent | earthkind  

And, sorry, I thought I had followed up here, ultimately, though it took 5 weeks to resolve, apparently some deal was struck between NH corporate and the dealer, but the end result was that I ended up paying nothing for the repair. Now, if someone can tell me what kind of coolant this thing needs... but that's a different thread.  

homework 75 t4

Glad you didn't pay, From what I understand with Ohio law with Auto repairs, if you are paying for a repair ( not warranty) , you are to get the old parts returned to you or at least offered to inspect replaced parts.  

homework 75 t4

Glad you didn't pay, From what I understand with Ohio law with Auto repairs, if you are paying for a repair ( not warranty) , you are to get the old parts returned to you or at least offered to inspect replaced parts. Click to expand...
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Brand New T4.75 already having major issues

  • Thread starter voltedge
  • Start date Mar 24, 2016

Hi, I have progressively moved up in tractor size from the start 20 years ago with my Kubota B Series up through the JD 4105 and now the NH T4.75 Cab. I went all out and ordered the tractor last October after attending the Sunbelt Ag Expo and actually drooling over all of the latest tractors. Well, we just picked up the new T4.75 2 1/2 weeks ago and it was pretty much awesome from the onset, on the surface that is. I finally got my new 3 pt tiller hooked up and attempted to till a trial 1/2 acre vegetable plot on Monday. It worked fine for about 45 minutes, although I hate the manual engaged PTO lever. I had to stop and take a phone call, and when I restarted, the PTO would not restart! Again, I actually hate the manual PTO, heck, my lawn mowers even have an electric engaged system! Why would NH put all of the bells and whistles on this cab tractor and skimp here? Anyway, I am 50 miles to the closest two dealers and they're both backed up two weeks plus. That's not including the wait for parts etc. We are a growing vegetable farm and don't have two weeks to wait, considering that we must get the spring cool weather crops sewn asap before it gets too hot here in N GA. Both dealers agreed that I could and should remove the left side trim panel and check the lever and cable mechanism for any issues. I attached a pic of the unit and I adjusted the cable both ways and it still seems to engage the PTO whenever it feels like it. I got under the tractor and traced the cable to the point that it enters into the trans/case and there is no visible adjustment there. Unfortunately, while under the tractor, I found a fairly messy fluid leak where the diff/trans housings join together. It has blown fluid all over the underside of the tractor, but not enough that it has visible dripping on the ground. It does have fluid accumulated that is ready to drip though. Anyway, for a brand new tractor that msrp was $66k and I paid $52k, I am not at all happy at only 13.6 hours! I ordered this tractor specifically with every available option and this is what I end up with! Is there any type of lemon law such as vehicles on tractors? Anyone else have similar issues and what did you do to resolve them? Thanks for your time and input.  

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Gary Fowler

Super star member.

Perhaps the dealer will loan you a tractor to do the tilling with while he works on yours. Little small problems can sometime be aggravating and costly due to down time. Sometime it is better to buy a slightly used tractor that already has all these small issues fixed. I would be talking to the dealer quickly and see about getting your tractor in and a loaner while he works on it. Even if a lemon law existed for tractors (I don't think they come under a lemon law) you haven't had enough problems to even be considered a lemon. Lemon laws affect repetitive problems that don't get fixed satisfactorily. You problems might all be fixed at your farm by a service guy. I would discuss that with the dealer first before hauling it in.  

TSO

Elite Member

I wouldn't call it a lemon yet! It's very likely that these are very minor issues, and this is what you have a warranty for. Let the dealer fix out and enjoy your new tractor... those are nice looking machines.  

  • Thread Starter

I love forums! Always gotta be a smart mouth with something to say about how someone posts. If you don't like it, don't read it and move on. Thank You for your advice.  

kf4uda

Veteran Member

I too would check with the dealer that you purchased from and see if they will loan you a tractor to get your work done while they resolve your issues. If you cant get any satisfaction from the dealer, I would contact New Holland and discuss your problems with them. Good Luck  

voltedge said: I love forums! Always gotta be a smart mouth with something to say about how someone posts. If you don't like it, don't read it and move on. Thank You for your advice. Click to expand...

I think he meant the person who commented about "paragraphs" Edit: looks like that post was already deleted  

ovrszd

Epic Contributor

mkr7734

Gold Member

Jerry/MT

voltedge said: Hi, I have progressively moved up in tractor size from the start 20 years ago with my Kubota B Series up through the JD 4105 and now the NH T4.75 Cab. I went all out and ordered the tractor last October after attending the Sunbelt Ag Expo and actually drooling over all of the latest tractors. Well, we just picked up the new T4.75 2 1/2 weeks ago and it was pretty much awesome from the onset, on the surface that is. I finally got my new 3 pt tiller hooked up and attempted to till a trial 1/2 acre vegetable plot on Monday. It worked fine for about 45 minutes, although I hate the manual engaged PTO lever. I had to stop and take a phone call, and when I restarted, the PTO would not restart! Again, I actually hate the manual PTO, heck, my lawn mowers even have an electric engaged system! Why would NH put all of the bells and whistles on this cab tractor and skimp here? Anyway, I am 50 miles to the closest two dealers and they're both backed up two weeks plus. That's not including the wait for parts etc. We are a growing vegetable farm and don't have two weeks to wait, considering that we must get the spring cool weather crops sewn asap before it gets too hot here in N GA. Both dealers agreed that I could and should remove the left side trim panel and check the lever and cable mechanism for any issues. I attached a pic of the unit and I adjusted the cable both ways and it still seems to engage the PTO whenever it feels like it. I got under the tractor and traced the cable to the point that it enters into the trans/case and there is no visible adjustment there. Unfortunately, while under the tractor, I found a fairly messy fluid leak where the diff/trans housings join together. It has blown fluid all over the underside of the tractor, but not enough that it has visible dripping on the ground. It does have fluid accumulated that is ready to drip though. Anyway, for a brand new tractor that msrp was $66k and I paid $52k, I am not at all happy at only 13.6 hours! I ordered this tractor specifically with every available option and this is what I end up with! Is there any type of lemon law such as vehicles on tractors? Anyone else have similar issues and what did you do to resolve them? Thanks for your time and input. Click to expand...

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T4, Total (Thyroxine)

Thyroxine (T4) is a hormone produced by the thyroid gland. It is sometimes called total thyroxine because it includes both free T4 and T4 bound to proteins. Thyroxine is only one-tenth as potent as the other major thyroid hormone, triiodothyronine (T3). Moreover, the portion of thyroxine that is biologically active is free T4, that is, the portion of T4 that is not bound to proteins in the blood. Greater than 99% of thyroxine is bound to serum proteins. Thyroxine acts on almost every cell in the body. It sets the metabolic tone of cells. Thyroxine is critically important for the growth and development of fetuses, neonates, and children. The thyroid gland produces and stores thyroxine until it is needed for release. The thyroid gland releases T4 when it is stimulated by thyroid-stimulating hormone, also known as TSH or thyrotropin. Free thyroxine is often more useful than total thyroxine (total T4) in assessing thyroid function, but total T4 can be a useful biomarker in some cases.

Normal Ranges for Total T4:

Adults: 4.5-111.7mcg/dL

0-5 days: 5.0-18.5 mcg/dL

6 days-2 months: 5.4-17.0 mcg/dL

3-11 months: 5.7-16.0 mcg/dL

1-5 years: 6.0-14.7 mcg/dL

6-10 years: 6.0-13.8 mcg/dL

11-19 years: 5.9-13.2 mcg/dL

http://www.ncbi.nlm.nih.gov/books/NBK285568/

http://www.uptodate.com/contents/laboratory-assessment-of-thyroid-function

http://www.ncbi.nlm.nih.gov/pubmed/12625976

https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8724

http://dx.doi.org/10.1001/jama.1990.03440110095035

http://www.uptodate.com/contents/thyroid-function-in-nonthyroidal-illness

http://www.ncbi.nlm.nih.gov/pubmed?term=7920008

http://www.ncbi.nlm.nih.gov/pubmed/6687730

http://www.uptodate.com/contents/overview-of-thyroid-disease-in-pregnancy

http://www.uptodate.com/contents/diagnosis-of-and-screening-for-hypothyroidism-in-nonpregnant-adults

https://www.uptodate.com/contents/diagnosis-of-hyperthyroidism

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Elevated thyroxine levels may indicate hyperthyroidism, thyroid hormone resistance syndrome, or thyroxine toxicosis. Elevated thyroxine may cause symptoms of hyperthyroidism including excessive appetite, anxiety, heart palpitations, sweating, shortness of breath, weight loss, and intolerance to heat. 

Some specific causes of high thyroxine are:

  • Hyperthyroidism
  • Euthyroid hyperthyroxinemia
  • TSH-mediated hyperthyroidism
  • Acute thyroiditis
  • Familial dysalbuminemic hyperthyroxinemia

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What does it mean if your T4, Total (Thyroxine) result is too low?

Decreased thyroxine levels in the serum usually indicate hypothyroidism or chronic or subacute thyroiditis. Abnormally low thyroxine may cause symptoms of hypothyroidism including weakness and fatigue, cold intolerance, shortness of breath, weight gain, constipation, cognitive problems, dry skin, hoarseness, and swelling (edema).

Some specific causes of low thyroxine are:

  • Hypothyroidism
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  • Subacute thyroiditis
  • Congenital thyroid agenesis, dysgenesis, or defects in hormone synthesis
  • Synthetic triiodothyronine treatment
  • Medications anabolic steroids such as glucocorticoids, phenytoin, carbamazepine, phenobarbital, lithium

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Why is My T4 Low (and What Can I Do About It)?

  • Lab Tests     Thyroid
  • / By Dr. Jeff Whelchel
  • / 46 COMMENTS

Do your lab tests show that your T4 level is low?

What does that mean exactly?

Do you also have symptoms such as fatigue, weight gain, hair loss, constipation, and depression?

If you answered yes, you most likely have hypothyroidism which usually causes a low T4 level.

In this article, I will discuss the T4 lab test, what it means when it is low, symptoms that may be associated with a low T4 level, and I will also give some treatment tips that will help raise it to an optimal level.

Let's get started...

What is T4?

So what is T4 anyway? 

In order to answer that question, we need to talk about the thyroid gland and how it works.

The thyroid gland primarily produces 2 types of thyroid hormone - Thyroxine (T4) and Triiodothyronine (T3) .

The vast majority of the thyroid hormone produced is thyroxine (T4).  Not nearly as much triiodothyronine (T3) is produced.

Both of these hormones are produced in response to a hormone secreted by the pituitary gland called Thyroid Stimulating Hormone (TSH).

The association of TSH and T4 gives us valuable information about how well the thyroid gland is working. That is why these tests should always be tested together.

So what is the purpose of T4 in the body?

T4 is not nearly as biologically active as T3 , but it still helps regulate how much T3 is available in the body.  

Most of the T3 in the body is actually produced from peripheral conversion of T4.  

More specifically, as the body needs T3, an enzyme called a deiodinase will cleave off an iodine molecule from T4 which converts it into T3.

You can therefore think of T4 as a storage reservoir for the body to use to make T3 as it needs it.  This is the primary purpose of T4.

Causes of Low T4

So what happens if the T4 level is low?

If the reservoir of T4 becomes low in the body (sort of like most of the lakes in the Texas Panhandle where I live), then there is not enough substrate that the body can use to produce T3.

The T3 levels then also drop, and symptoms of hypothyroidism develop.

Why does the T4 level drop?

Let's discuss the most common causes:

1.  Autoimmune Thyroiditis (Hashimoto's) -

There are many theories about how and why autoimmune disorders develop.

It is generally accepted that 3 things must be in place for an autoimmune disorder to develop.

  • Genetic Predisposition - You have a variation in one of your genes that may make it more likely to develop an autoimmune condition.
  • Leaky Gut - The bacterial levels and types of bacteria in your GI tract may be inadequate.  Also, gaps between the cells in your intestines may widen which allows foreign proteins and toxins to enter the bloodstream that wouldn't normally get through.
  • Trigger - A physical or emotional event may occur (injury, surgery, major life stress, etc.), or you may be exposed to an environmental toxic of some sort which can damage your immune system and cause it to function improperly.

A common theory is that some of these foreign proteins that enter our bloodstream look similar to proteins in our body.  As a result, as our immune system makes antibodies against these foreign proteins, it in effect also unintentionally makes antibodies against parts of our body.

This is called molecular mimicry .

This appears to be what happens in Hashimoto's Thyroiditis.

The result is these auto-antibodies continuously attack parts of our thyroid gland, gradually destroying it.

As the cells of the thyroid gland are destroyed, its ability to produce thyroid hormone is impaired and hypothyroidism will develop.

This typically occurs slowly over many years.

Often patients will have classic symptoms of hypothyroidism, but their labs will remain relatively normal until late in the process.

Hashimoto's is an extremely common condition .  In fact, in my medical practice I typically diagnose one or more people with it every week!  It is by far the most common autoimmune disorder.

Many experts believe that the vast majority (over 90%) of hypothyroidism in the United States is actually caused by Hashimoto's.

If you have hypothyroidism, you should periodically have your thyroid antibody levels checked.

Click here to read more .

2.  Hypothyroidism -

Hypothyroidism refers to the condition of low levels of thyroid hormone in the body.

The majority of cases are due to issues with the thyroid gland itself.  Rarely, it can be caused by issues in the brain ( hypothalamic dysfunction ).

Since most thyroid hormone in the body is T4, if you are hypothyroid, you will have low levels of T4.

That, however, does not give you enough information.  You need to investigate WHY you have hypothyroidism so that you can be appropriately treated.

As we discussed earlier, the majority of hypothyroidism is caused by Hashimoto's Thyroiditis.

3.  Nutrient Deficiencies -

There are multiple (at least 13) nutrients that are needed for proper thyroid hormone production and conversion.

A deficiency of even one of them can result in a significant reduction in thyroid levels which will cause symptoms of hypothyroidism.  It can also cause an increase in thyroid antibody levels if you have Hashimoto's.

These nutrient deficiencies can include (click on the names for my preferred brands):

  • Vitamin B12 - up to 40% of hypothyroid patients are deficient in vitamin B12 .
  • Iodine - Iodine deficiency is common in the US due to the Standard American Diet and soil depletion from over-farming.  Iodine is essential for normal thyroid production.
  • Iron - Iron deficiency is common in women due to menstrual issues and poor gut absorption.
  • Selenium - a selenium deficiency impairs conversion of T4 to T3 .  Supplementing selenium can also help reduce thyroid antibodies if you have Hashimoto's.  Read more about it here .
  • Zinc - Zinc is required for T4 to T3 conversion.  A deficiency causes elevated reverse T3 levels which can reduce thyroid function .  It is also a great anti-inflammatory and boosts immune function .  It should usually be taken with selenium.
  • Vitamin D - Vitamin D deficiency has been associated with several autoimmune disorders , including Hashimoto's.
  • Magnesium - Magnesium is essential for thyroid hormone production and conversion of T4 to T3.

So, should you just blindly supplement with all or most of these supplements if you have thyroid issues?

Of course not!

You should always see your doctor and be tested for any nutrient deficiencies before supplementing, or at least look for common symptoms associated with particular deficiencies.  If you have a symptom or symptoms commonly seen with one of these nutrient deficiencies, then a trial of supplementation is reasonable to consider.

It is also always best to start with your diet.  Eat a diet high in nutrient-dense, organic foods which will contain a much higher nutrient content than the Standard American Diet.

4.  Taking a T3 Only Medication -

If you are taking a T3 only medication, it will often result in a drop in your T4 level.

T3 only medications include Cytomel and liothyroinine.  

Why?  It makes sense if you think about it.

Like we learned earlier, T4 acts as the storage reservoir for T3 in the body.

If you are taking a T3 only medication, then your need for that reserve of T4 decreases because you have bypassed the conversion process.  This therefore results in less T4 production by the thyroid gland.

Taking a T3 only medication will typically cause the free T4 level to decrease, the TSH level to decrease, the reverse T3 level to decrease, and the total T3 and free T3 levels to increase.

This can also happen to a lesser extent if you are taking a natural dessicated thyroid (NDT) such as Armour Thyroid, NP Thyroid, or Nature-throid.  That is because these medications contain about 20% T3 and about 80% T4.

The drop in T4 level in this case is expected and what you want.   It is not a sign of inadequate thyroid levels like it is in the other situations.

Symptoms of Low T4

Having a low T4 level typically results in all of the classic symptoms of hypothyroidism.  

The list of symptoms can be quite exhaustive, but the most common include:

  • Weight Gain
  • Constipation
  • Cold Intolerance
  • Brittle Nails
  • Menstrual Irregularities
  • Infertility

For a more extensive list, click here .

The vast majority of doctors have been taught to use the TSH as their sole means of evaluating thyroid function.

In many cases of hypothyroidism, the TSH will remain normal until it has been present for many years. This is true with Hashimoto's as well.

The T4 and T3 levels will typically drop earlier in the process than will the TSH.

That is another reason why you should ALWAYS ask for a complete thyroid panel when your thyroid is being evaluated.

How to Raise Your T4

Fortunately, raising your T4 level is usually straight-forward.

Reversing what is causing your low T4 is the key to successful treatment.

You will either want to increase the thyroid hormone your body produces itself, or you will need to supplement what your body produces with a thyroid hormone medication.

1.  Lifestyle Interventions -

Improving your diet, beginning an exercise program, improving gut function, and reducing stress should always be the first steps taken when treating ANY condition.  The thyroid is no exception.

2.  Correct Any Nutrient Deficiencies -

Identifying and correcting any of the nutrient deficiencies we discussed earlier will result in an increase in your body's natural thyroid production and T4 to T3 conversion.

3.  Supplement with a T4 Thyroid Hormone - 

Taking a T4 only medication such as levothyroxine, Synthroid, or Tyrosint will result in an increase in the T4 level in the body.  

Keep in mind that if you have T4 to T3 conversion issues because of a nutrient deficiency or inflammation in the body (insulin resistance, leptin resistance, an autoimmune condition, etc), raising your T4 level may still not result in adequate T3 levels reaching the cells.  Symptoms of hypothyroidism may still not improve.

4.  Reduce Thyroid Antibody Levels -

If you have Hashimoto's, there are dietary, supplement, and medication therapies that can help reduce thyroid antibody levels.  This will improve thyroid function and will help to raise the T4 to an optimal level.

5.  Take T3 Thyroid Hormone -

In addition to or even in place of T4 thyroid hormone, T3 hormone medication can be taken.

That may cause the T4 level to drop, but that is not a bad thing in this case.

There is an art to using T3 medication, so it is important that you find a medical provider with experience in using it.

Click here to read more.

A low T4 level is commonly seen in hypothyroidism.  It is often present before the TSH level becomes abnormal.

A low T4 is associated with several symptoms that can dramatically alter your quality of life.

Treatment to increase T4 levels typically involves correcting nutritient deficiencies, reducing inflammation, and taking thyroid medication.

Now it's your turn...

Is your T4 level low?

Is your TSH level low, normal, or high?

Are you having symptoms of hypothyroidism?

What treatment plan are you using?

Leave any questions or comments below.

About the Author Dr. Jeff Whelchel

Dr. Whelchel is a family physician who specializes in functional medicine, especially hormone optimization. He has over 20 years experience in private practice managing patients with various medical issues. His passion is helping patients reach their full potential of wellness and quality of life. He grew up in the Texas Panhandle where he currently lives. He is married and has 3 awesome children.

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46 comments

Please add me to your comments when posting new thyroid updates.I had my thyroid taken out because of cold nodule

Hi Janice. If you will click on an article on my website, a popup window should appear asking if you want to join my newsletter for free. If you will sign up there you will get an email every time a release a new article. Take care.

On levothyroxine…levels better but symptoms continue. Have all symptoms. Advice? Doctor only checks TSH and T4.

My advice is to ask your doctor to also check a free T3, reverse T3, TPO antibodies, and thyroglobulin antibodies. If they won’t, then find a different doctor. Your thyroid hasn’t been fully assessed yet.

You have simplified the answers I have been looking for. Thank you so much much for this!!

Diagnosed Hashimoto for 12 years. 42 years old. My tsh is 1.68, free t4 0.7, ft3 2.73, total t3 108. I am on np thyroid and lots of vitamins. My hair is thinning I feel anxious and have some insomnia. I stopped the selenium and iron for a bit bc I was on the high end but thjnking I should add back in. I also take a low dose of algazim (kelp iodine). My question is where should my free t4 be. Are my symptoms bc of the low free t4?

I think your issues are more low t3 which I like >3.5. You need to sit down with your doctor about it. I hope you feel better soon.

i have just been informed that my T4, free is 0.78 results low….what does this mean?

It is impossible for me to interpret just a single lab result. I would need to see the complete thyroid panel plus get a history of symptoms and other medical issues.

Thankyou for your thoughtful discussion of the delicate balance – I am using NP thyroid and now my all my levels are low TSH as well so my symp are hypo. And I’ve been treated for hypo but now my TSH seems to indicate Hyper! I need to find a good specialist to get on track and am not sure if I should just stop the NP thyroid until I do get to doctor -as it hasn’t been effective and it has been 6 months. I am at 90 mg . Do you think I should stop it I’ve now heard verybad reports 0f that particular drug.

Hi Christine. I would NOT stop the NP thyroid. In my experience, your TSH may have to be suppressed in order to get your free T3 and free T4 levels in the optimal range. Please follow up with you doctor and communicate any symptoms or side effects that you are having.

Dear Dr Whelchel, I understand what you said about T4 not being relevant if you are on T3, but I have not found this to be the case. i am hypopituitary and my T4 went down to 1 (the lowest in the Uk range is 12) and I have been very unwell for several years, thinking that my T4 did not matter. A new endicronologist said that this was not true and I was in real danger. I have now added T4 (as well as T3) and been working for months to bring myself into range (still not there) and still suffer extreme fatigue. I would be interested to know your thoughts. Kindest, Sophie

Hi Sophie. I did not mean that T4 is irrelevant. My intent was to say that I am not concerned if the T4 level drops a bit when someone it taking a T3 medication. Everyone is unique and different. If keeping your T4 level higher helps you, then great! I’m glad you found something that helps.

Hi my T4 levels are in 2013 8.9, in 2014 10.1, and in 2019 11.2, do you think this is low? my doctors are dismissive as the other level is normal, but i do have a few of the symptoms suggested and my mother was also given thyroid medication in her 60ies. I am 66.

Hello. It’s really impossible for me to answer that without knowing more of your history and seeing all of the lab results.

DR Jeff: Excellent article and really helped my understand the likely treatment path for my high TSH/low T-4 levels!

Thank you for the compliment. I’m glad it helped you.

Really enjoyed this article on thyroid levels. You explained it very well.

Is Armour Thyroid a T-3 only medication? I do not have Hashimoto’s and Synthroid and levothyroxine have not resolved issue of low T4. Switched to Armour Thyroid, but still low T4, so your helpful article caused me to wonder if it is a T3 only medication. Thank You for this helpful article.

Armour Thyroid is about 80% T4 and 20% T3. You likely need to increase the dose of your thyroid medication, even if it makes your TSH become suppressed.

my free t4 is 0.7 and my tsh 1.92 what should i be eating to get my free t4 up to normal

Diet alone may not be enough to raise your free T4 level. I would also recommend that you get a complete thyroid panel drawn – TSH, free T4, free T3, reverse T3, TPO antibodies, and thyroglobulin antibodies. The 2 lab results just don’t give enough information to know what is going on with your thyroid.

Hi Dr Whelchel, My free t4 is .6, tsh .010, thyriod perixdase antibody 198, free t3 is 3.8. I am on 25mcg of lio, 75mcg of levo both one per day. I am still flaring and get horrible facial swelling. What are your thoughts?

Sorry you are still flaring. Your lab results aren’t surprising in light of your Hashimoto’s and taking T3. I would be focusing on lifestyle issues – gluten-free, dairy-free, good sleep hygiene, stress management, etc. All of that should help.

I’m 35, and I had diagnosed with hypothyroidism five years. Though, the TSH level was 149. I had no symptoms of hypothyroidism. I repeated the test in different laboratories, but the result was the same. My doctor advised me to take thyroxin (100Mg) for three months, and I started medication based on that. Then the doctor advised me to check my TSH after one week. Surprisingly the TSH level dropped to 4.0. ( FreeT3 and T4 were also in the normal range). The doctor then advised me to stop the medication. Two days back, I again had a check-up. In the report, my TSH level was 93.97. But, still, I do not have any symptoms. Also, I have a deficiency of sodium and VitaminB12.

Below is my test report,

Thyroid Stimulating Hormone (TSH) 93.97ulU/mL (Ref range:0.450 – 5.330) Tri-iodothyronine – Total (TT3) 1.67nmol/L (Ref range:1.34 – 2.73) Thyroxine- Total (TT4) 54.69nmol/L (Ref range:78.38 – 157.40) Testosterone – Total 3.62ng/mL (Ref range:1.75 – 7.81)

I seek your advice.

Hello. I would need several other lab results before I could accurately assess your situation. I would need to know the free T4, free T3, reverse T3, TPO antibodies and thyroglobulin antibodies. Based on just the TSH alone you are hypothyroid, but more workup is needed.

Thank you, Dr Jeff. I will be back with the suggested test reports.

The requested lab reports are ;

Tri-iodothyronine – Free (FT3) 5.38 pmol/L(Ref3.80 – 6.00)

Thyroxine – Free (FT4) 5.00 pmol/L(Ref 7.86- 14.41)

Thyroid Stimulating Hormone (TSH) 78.480 ulU/mL(Ref 0.450- 5.330)

Thyroglobulin Ab (Anti-Tg) >2500 (Ref10000 (Ref<9)

The result, after appropriate dilution, is above the Clinically Reportable Range(CRR) of the assay. The upper limit of detection which is 10000 IU/mL have been Reported

Your labs look like severe Hashimoto’s thyroiditis with secondary hypothyroidism. You need to see someone near you that is a thyroid specialist.

I have hashimotos I take 75 mcg Tirosint and 40 mcg liothyronine .. my labs showed my free T 4 is below range . .. Do I increase the Tirosint ..? Thank you

That all depends on what the other labs show. Liothyronine tends to suppress T4 levels, so it may not be needed. However, in order to answer your question, I would need to know the TSH, free T3, and reverse T3 levels.

thx, very informative in layman’s terms.

Thank you for the compliment.

Is it normal for my FT4 to drop after starting Tirosint? I was at .82 and 6 weeks in it had dropped to .79. My FT3 did rise from 2.36 to 2.76 though. It just seems strange thistle I’m taking T4 meds and yet mt T4 is dropping. Some symptoms are still there, others seem to be a little better.

I would suspect that the slight drop in your FT4 is likely due to lab variance. If anything, taking T4 medication should raise your FT4.

My first results were high TSH and low FreeT-4, I had never been tested for this before, so before starting medication I requested a retest, My Dr. agreed, re-tested and free T-4 , .064, and TSH 10.3072, but I see nothing for T-3, reverse T-3, TPO, and thyroglobulin anti-bodies. Are these necessary for treatment?

Those results definitely fall in the hypothyroid range. I would insist on getting the other lab tests before starting any treatment, however. They will influence what your best treatment would be.

My tsh 8.600 , free T4 0.47, free T3 3.3 take np thyroid 60 because others side effects cant T the right level. Called Dr. today waiting for answer iam 83 , since fall 99 is 60 too high of mg or what

60mg is a very common dose. I have some patients that have to take 180mg or more. Just be careful at your age and notify your doctor if you develop any symptoms of hyperthyroidism – palpitations, shakiness, tremor, etc.

Hi Dr Whelchel , this are my recent labs, my t4 levels go up and down all the time and my Pcp doctor don’t see the necessity to treat it, so I went to an endocrinologist, and we will see what happen. I would like to know your opinion though, thank you. Trans. Growth Fact. beta 1* 01 7525 High, T4,Free(Direct) 02 0.77 Low, TSH02 3.470 ,Complement C4a03 1063.0 High, Reverse T3, Serum A, 03 10.6,MTHFR, DNA Analysis 04 Result: c.665C>T (p. Ala222Val), legacy name: C677T – Detected, Thyroid Peroxidase (TPO) Ab02 <9 ,Thyroglobulin Antibody 02 <1.0 ,Triiodothyronine (T3), Free 02 2.3

Hi Andrea, Those results would definitely fall into the hypothyroid range. If your doctor won’t offer a treatment, you may need to seek another medical provider.

Very informative easy to understand. Thank you!!!

I am on levothyroxin and Liothyronine. My new primary care physician reduced my levoththyroxin after lab results showed my T4 was “suppressed”. He said it would help my fatigue. My impression from this article is that information may not be correct. Am I interpreting it correctly?

Do you do phone consultations? No one can seem to get my hypothyroidism under control.

Hello, I have hashimotos, my TPO antibodies are well above 900 (labs max). I take NP thyroid 60mg daily. My question is would NP thyroid cause further increase in TPO antibodies? Since it’s similar to thyroid tissue. Wondering if going to levothyroxine would help reduce TPO for me. Thank you.

In all my seventy plus yrs on earth . No physician had taken time to break things down like Dr Whelchel.

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What to Know about the Free Thyroxine (T4) Index Test

Free Thyroxine Index Purpose, Risk, and What to Expect

Before the Test

During the test, after the test.

The free thyroxine index (FTI) test, also called the T4 index test, is a blood test used to diagnose thyroid disorders. Thyroxine (T4) is a thyroid hormone.

The test measures how much thyroxine is in your blood to help determine whether your thyroid gland is underactive ( hypothyroidism ) or overactive ( hyperthyroidism ). A normal free thyroxine index range is between .7 and 1.9 nanograms per deciliter.

This article discusses the free thyroxine index test, why it's done, and what the results can tell you.

Purpose of the Free Thyroxine Index Test

The thyroid is located in the front of your throat and is shaped like a butterfly. Its purpose is to make hormones and regulate several important bodily functions, such as energy use, weight, body temperature, and mood.

In your body, T4 functions in two different forms. One form bonds with a protein to perform certain tasks, and another form doesn't, which allows it to do different jobs.  

The FTI test checks only for the "free" form, which is the form not bonded with a protein. It's useful for evaluating thyroid function.

Your healthcare provider may order an FTI and other thyroid tests if you have symptoms that could indicate thyroid disease. Other risk factors that could influence this decision include:

  • Being female
  • Being under the age of 40
  • Having family members with thyroid disorders

The other thyroid tests include thyroid-stimulating hormone (TSH) and triiodothyronine (T3). The results of these tests are analyzed together to help with a diagnosis.

The FTI is not itself a separate blood test. It is calculated from the results of the total T4 test and the T3 resin uptake test. Because the FTI is often made inaccurate by medical conditions that change blood protein levels, it is not used very much in clinical medicine today. Instead, the free T4 level is now measured directly.

Low levels of free T4 could lead to more testing to determine whether you have an autoimmune thyroid disease called Hashimoto's thyroiditis . High levels may lead to testing for Graves' disease , thyroiditis , or goiter .

The FTI and other thyroid tests are performed on blood samples, which are fairly quick and simple to obtain and very low risk.

Risks of Thyroid Blood Tests

The only risk most people face from a blood test is mild pain or a little bruising afterward, which should go away quickly.

Some people, especially those who are afraid of needles, may experience dizziness, nausea, or ringing in the ears during or immediately following a blood draw. If this happens to you, tell the person drawing your blood. Typically, they'll have you lie down for a while and drink some water.

If you have a history of negative reactions, you may want to arrange for someone to drive you to and from the test facility.

Let the nurse or phlebotomist who's drawing your blood know before the test if:

  • You've had prior bad reactions to blood draws
  • You have a bleeding disorder
  • You're taking blood-thinning medications
  • Your skin tears or bruises easily

They can take steps to mitigate any risk these factors create.

Blood for FTI and other thyroid tests can generally be drawn at any time of day and doesn't require fasting (avoiding food) beforehand.

Be sure to have your insurance card and any written orders your healthcare provider may have given you.

Tell your healthcare provider about any medications you're taking and whether they could alter your test results. You may need to take a break from certain medications, including:

  • Some cancer drugs
  • Thyroid medications (you may need to wait until after the test to take your daily medication)
  • Some supplements, particularly biotin supplements, which can alter test results

Other drugs may impact results, too. Let your healthcare provider know about everything you're taking, including any supplements and even herbal teas you consume regularly.

Pregnancy can also affect your thyroid hormone levels, so make sure your healthcare provider knows if you are or could be pregnant.

Timing and Location

The blood draw itself should just take a few minutes. If you're getting multiple tests, it could take slightly longer.

Some healthcare provider's offices will do the blood draw right there, during your appointment. In that case, it shouldn't add much time to the length of your appointment.

If you need to go to a lab for the test, it can require more time. If you have a scheduled appointment, arrive early enough to check in and pay any co-pays that may be due. If you're anxious about the test, you may also want to give yourself a few minutes to sit and relax.

Labs are often busy, so if you're dropping in, you may want to call ahead of time or aim for a time of day, such as early in the morning, when they tend to be less crowded.

What to Wear

You should be able to stay in your own clothing for the blood draw. Wear either short sleeves or long sleeves that can easily be pushed up past your elbow. Flat shoes and clothing that is not tight or constrictive are good choices in case you have a temporary dizzy spell.

Food and Drink

Any time you're having blood drawn, you want to be well hydrated. That helps your veins keep their shape, which means it's easier to find them and successfully insert the needle.

Since you don't need to fast before a T4 test, it's a good idea to have something in your stomach. It may help you avoid becoming nauseous.

However, if your healthcare provider is ordering other tests at the same time, some could require fasting. Be sure to follow all of the instructions you're given by the healthcare provider and/or the lab performing the test. If you do need to fast, try to take something with you so you can eat right after the test.

Cost and Health Insurance

Typically, thyroid function tests that are deemed medically necessary are covered by insurance. If you have any questions, be sure to call your insurance company ahead of time to see what, if any, out-of-pocket expenses you could face.

Laboratory costs for an FTI test can range from $45 to about $130. If you're not insured, you may face additional charges, especially if your healthcare provider is ordering numerous tests. A full set of thyroid tests may cost $500 or more.

Your healthcare provider's office, the insurance company, and the lab should be able to help you determine the cost before you get the tests.

A nurse or phlebotomist are typically the healthcare professionals who will perform a blood draw. They may ask you to confirm certain information, such as your name, birth date, healthcare provider ordering the test, and what test you've been sent for. This is to ensure the right tests are performed on the right people.

When it's time for the test, you'll be asked to expose your arm, and then the insertion spot will be cleaned with alcohol.

The person performing the draw will tie a band around your upper arm to trap blood in your veins, which makes it easier to find a good vein and insert the needle. If your veins aren't standing out well, you may be asked to pump your fist.

Once a good vein is found, the needle will be inserted. This is generally the most painful part of the test, but remember, it's only temporary. The band will then be released to get the blood flowing, and the vial attached to the needle will fill up.

Depending on how many tests are ordered, you may need to fill up two or more vials. After enough blood has been drawn, the insertion site will be bandaged.

Most of the time, you can leave right away once the test is over. If you have any kind of negative reaction, speak up so you can get proper care. Usually, even with a bad reaction, people are okay after a few minutes.

You may have a little soreness and bruising around the site where the needle was inserted, which typically goes away in a short amount of time. If you have any problems or questions, contact your healthcare provider's office.

Managing Side Effects

If the site is sore, you may want to ice it or take over-the-counter pain medication. You shouldn't have any other lingering effects from a simple blood draw.

Interpreting Free T4 Results

In an adult, the typical range for free T4 is between .7 and 1.9 nanograms per deciliter. An abnormally high free T4 level may indicate hyperthyroidism, thyroiditis, or goiter. It may also lead to additional tests for Graves' disease.

An abnormally low free T4 level can point to hypothyroidism, a problem with your pituitary gland, malnutrition or iodine deficiency, or other illness. It may lead to further tests for Hashimoto's thyroiditis.

An abnormal T4 level alone doesn't usually lead to a diagnosis. Your healthcare provider will likely analyze it along with T3 and TSH levels.

After the results come back, your healthcare provider may want you to come in to discuss further testing or treatment options, depending on your diagnosis.

If you don't hear back about your results in a timely manner, or if you don't understand what they mean, contact your healthcare provider's office. If you're diagnosed with a thyroid disorder, then it's time to talk to your practitioner about treatment options.

The free T4 index (FTI) is a blood test that can help diagnose a thyroid condition such as Hashimoto's thyroiditis or Graves' disease. 

The free thyroixine index test is typically done alongside other thyroid blood tests including the TSH and T3 tests. The results of these tests are analyzed together to help your healthcare provider arrive at a diagnosis.

UCLA Health. Normal thyroid hormone levels .

American Thyroid Association. Thyroid function tests .

Pantalone KM, Hatipoglu B, Gupta MK, Kennedy L, Hamrahian AH. Measurement of serum free thyroxine index may provide additional case detection compared to free thyroxine in the diagnosis of central hypothyroidism . Case Rep Endocrinol. 2015;2015:965191. doi:10.1155/2015/965191.

Sheehan MT. Biochemical testing of the thyroid: TSH is the best and, oftentimes, only test needed - A review for primary care . Clin Med Res . 2016;14(2):83-92. doi:10.3121/cmr.2016.1309

Klubo-Gwiezdzinska J, Wartofsky L. Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment . Pol Arch Intern Med . 2022;132(3):16222. doi: 10.20452/pamw.16222

Dhingra N. WHO guidelines on drawing blood, best practices in phlebotomy .

Akturk HK, Chindris AM, Hines JM, Singh RJ, Bernet VJ. Over-the-counter "adrenal support" supplements contain thyroid and steroid-based adrenal hormones . Mayo Clin Proc . 2018;93(3):284-290. doi:10.1016/j.mayocp.2017.10.019

Mahadevan S, Sadacharan D, Kannan S, Suryanarayanan A. Does time of sampling or food intake alter thyroid function test? .  Indian J Endocrinol Metab . 2017;21(3):369–372. doi:10.4103/ijem.IJEM_15_17

Ialongo C, Bernardini S.  Phlebotomy, a bridge between laboratory and patient .  Biochem Med (Zagreb) . 2016;26(1):17–33. doi:10.11613/BM.2016.002

By Adrienne Dellwo Dellwo was diagnosed with fibromyalgia in 2006 and has over 25 years of experience in health research and writing.

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