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Thyroid Function Test — TSH, T3, T4

Complete guide to thyroid function tests: TSH, Free T3, Free T4 normal ranges, symptoms of thyroid imbalance, preparation tips, and online booking.

Key Takeaways

What you need to know at a glance

TFT measures TSH, Free T3, and Free T4 to assess thyroid gland function.
Thyroid disorders affect over 4 crore Indians, with hypothyroidism being far more common.
Early-morning testing (before 10 AM) gives the most accurate TSH reading.
Take thyroid medication after the blood draw, not before, on the day of testing.
Full Article

What It Measures#

A Thyroid Function Test (TFT) evaluates the performance of your thyroid gland — a butterfly-shaped gland in your neck that controls metabolism, energy, heart rate, and body temperature. The panel includes:

  • TSH (Thyroid Stimulating Hormone) — produced by the pituitary gland; the most sensitive screening test for thyroid disorders. See also: TSH Test.
  • Free T4 (Thyroxine) — the main hormone produced by the thyroid; regulates metabolism.
  • Free T3 (Triiodothyronine) — the active thyroid hormone; most T3 is converted from T4 in tissues.

Thyroid disorders affect an estimated 4.2 crore Indians. Hypothyroidism (underactive thyroid) is far more common than hyperthyroidism, especially in women and in iodine-deficient regions.

Who Should Get Tested#

  • Women above 30 years — thyroid disorders are 5–8× more common in women.
  • Pregnant women — uncontrolled thyroid can affect foetal brain development.
  • Anyone with symptoms: unexplained weight gain/loss, fatigue, hair loss, cold/heat intolerance, irregular periods, or mood changes.
  • People with a family history of thyroid disease or autoimmune conditions.
  • Patients with type 1 diabetes, PCOD/PCOS, or Down syndrome.
  • Newborns — TSH screening is part of neonatal screening programs.

How to Prepare#

  • No fasting required, but early-morning testing (before 10 AM) is preferred as TSH levels are highest in the morning and decline through the day.
  • If you are on thyroid medication (levothyroxine), take the sample before your morning dose.
  • Inform your doctor about biotin supplements — high-dose biotin can interfere with thyroid assays.

Understanding Your Results#

| Parameter | Normal Range | Low (Hypothyroid) | High (Hyperthyroid) | |-----------|-------------|-------------------|---------------------| | TSH | 0.4–4.0 mIU/L | > 4.0 mIU/L | < 0.4 mIU/L | | Free T4 | 0.8–1.8 ng/dL | < 0.8 ng/dL | > 1.8 ng/dL | | Free T3 | 2.3–4.2 pg/mL | < 2.3 pg/mL | > 4.2 pg/mL |

Subclinical hypothyroidism (mildly elevated TSH with normal T4) is very common in India and may or may not require treatment. Your endocrinologist will decide based on symptoms, antibody status, and TSH level.

Related Tests#

Booking & Home Collection#

Book a thyroid function test on PingMeDoc with convenient early-morning home collection. Fasting is not required, but early slots ensure the most accurate TSH reading.

Frequently Asked Questions

5 questions answered by our medical team

1
What is the normal TSH level for Indian adults?

The normal TSH range is 0.4–4.0 mIU/L. Values above 4.0 suggest hypothyroidism, while values below 0.4 suggest hyperthyroidism. Some experts recommend a narrower range of 0.5–2.5 mIU/L for pregnancy.

2
Can thyroid problems cause weight gain?

Yes, hypothyroidism slows metabolism and can lead to weight gain of 2–5 kg. However, significant obesity is rarely caused by thyroid alone. Proper treatment with levothyroxine usually helps normalise weight.

3
Should I take my thyroid tablet before the test?

No. Take the blood sample first, then your thyroid medication. Taking levothyroxine before the test can falsely elevate Free T4 levels.

4
How often should thyroid levels be checked?

If you are on thyroid medication, check every 6–8 weeks until stable, then every 6–12 months. For screening in women over 30 or at-risk groups, annual testing is recommended.

5
Can thyroid disease be cured?

Hypothyroidism typically requires lifelong medication (levothyroxine) but is very well controlled. Some causes of hyperthyroidism can be cured with radioactive iodine or surgery. Subclinical cases may resolve on their own.

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References & Sources

3 cited sources

  1. 1

    Thyroid Function Tests

    American Thyroid Association2023View source
  2. 2

    Prevalence of Thyroid Disorders in India

    Indian Journal of Endocrinology and Metabolism2021
  3. 3

    Subclinical Hypothyroidism — Review

    The Lancet Diabetes & Endocrinology2023

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