CASE 6 EDUCATIONAL OBJECTIVES

1. What is the level of thyroid function in this patient? Are additional diagnostic tests necessary to define the level of thyroid function and if so which one(s)?

Euthyroid, rule out hyperthyroid.
Yes, TSH.

2. What is the most likely cause of this patient's illness? What tests are necessary to confirm its cause? Are antithyroid antibodies helpful?

Anxiety and an elevated TBG, the latter due to estrogenic effect upon hepatic synthesis.
No.

3. What tests are necessary to confirm its cause? Are antithyroid antibodies helpful?

4. Explain total serum T4, binding proteins, free T4, T3 and their significance.

5. What are the treatment options?

No treatment necessary.