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If the pituitary sees very little T4, then it produces more TSH to tell the
thyroid gland to produce more T4. Once the T4 in the blood stream
goes above a certain level, the pituitarys production of TSH is shut off.
T4 and T3 circulate almost entirely bound to specific transport proteins, and there
are some situations which these proteins could change their level in the blood,
producing also changes in the T4 and T3 levels (it happens frequently during
pregnancy, women who take control birth pills, etc)
The T4 test is known as the thyroxine test. The TSH test measures the
level of thyroid-stimulating hormone in your blood. These are the two
most common thyroid function tests and are usually ordered together.
For example,a low T4 levelcould mean a diseased thyroid gland ~OR ~a non-functioning pituitary
gland which is not stimulating the thyroid to produce T4. Since the pituitary gland would normally
release TSH if the T4 is low, a high TSH level would confirm that the thyroid gland (not the pituitary
gland) is responsible for the hypothyroidism.
Pituitary gland failure means that the other glands may also be failing and other
treatment than just thyroid may be necessary. The most common cause for the
pituitary gland failure is a tumor of the pituitary and this might also require surgery to
remove.