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Serum levels of thyroxine (T4)-binding globulin (TBG) were determined by a radioimmunoassay using cellulose-linked antibody to TBG. Values obtained in healthy young adults averaged 1.62 +/- 0.25 (SD) mg/100 ml, and no significant difference wwas detected between males and females. The TBG levels remained within the normal limit in hyperthyroidism while they were significantly increased in hypothyroidism. Interestingly enough, TBG levels were significantly elevated in chronic thyroidities with no overt hypothyroidism. In normal pregnancy, TBG was increased slightly in the first trimester, and markedly in the second and third trimesters. In one case of congenital TBG deficiency, no immunoreactive TBG was detected. It was demonstrated, further, that an inverse relationship (r = -0.7593) existed between the TBG level and serum triiodothyronine uptake index, and that a direct relation (r = +0.6557) was present between the TBG level and T4 in sera from normal subjects and pregnancy. Ratios of T4/TBG were markedly increased in hyperthyroidism, and decreased in hypothyroidism, showing no overlap with the normal subjects, whereas they were below the normal limit in half the cases in the second and third trimesters of pregnancy. The radioimmunoassay for TBG was useful in evaluating hypothyroid states, because it could differentiate the increase in T4 associated with elevated TBG from hyperthyroidism.

Measurement for Serum Thyroxine-Binding Globulin (TBG) and Its Clinical Assessment in Diagnosis of Thyroid States