Total over Free Thyroxine Ratio: Prediction of Thyroxine Binding Globulin

Both total thyroxine and free thyroxine concentrations are measured in the Immophase free thyroxine assay. These total and free thyroxine results allow a prediction of the accessory concentrations of thyroxine-binding globulin (TBG). Since abnormal concentrations of TBG often cause problems in the evaluation of thyroid function, we evaluated the possibility of predicting these abnormal values from total and free thyroxine results. Two ways of predicting abnormal concentrations of TBG were evaluated on statistical grounds. The first method, a simple total thyroxine/free thyroxine ratio, proved to be better than the second method, which corrected for the influence of the other thyroxine binding proteins (result: a calculated concentration of TBG). The total thyroxine/free thyroxine ratio predicts abnormally low TBG values, below a ratio fo 4,000 (certainty 45%) and abnormally high TBG values, above a ratio of 6,400 (certainty 89%).