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Free Thyroxine (T4)

Hormonal Health
38.00

This test measures Free T4, a key thyroid hormone circulating in the blood. It supports accurate assessment of thyroid function and metabolism.

Turnaround time

2-3 days

Biomarkers count

1

Same-Day Appointments
UKAS Accredited Labs

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Details about Free Thyroxine (T4)

Free T4 Blood Test | London Blood Tests UK

Measure active thyroid hormone levels with our Free T4 blood test from £38. UKAS-accredited testing, fast results, optional GP consultation.

The Free Thyroxine (Free T4) Blood Test measures the unbound, biologically available form of thyroxine, helping assess thyroid function, metabolism, and hormonal balance. Available for £38, analysed in a UKAS-accredited laboratory, with results typically ready within 2–3 business days and an optional GP consultation for result interpretation.

 

What is a Free Thyroxine (T4) Test?

Thyroxine (T4) is the primary hormone produced by the thyroid gland and serves as a precursor to triiodothyronine (T3), the more active thyroid hormone. Although most circulating T4 is bound to proteins, only the free (unbound) fraction is biologically active and able to enter tissues.

The Free T4 test measures this active hormone directly, providing a clearer picture of thyroid output than total T4 testing. Free T4 plays a crucial role in regulating metabolic rate, energy production, temperature control, heart function, and neurological activity.

Free T4 testing is a cornerstone of thyroid assessment and is commonly requested alongside TSH and Free T3 to diagnose thyroid disorders, monitor treatment response, and investigate persistent symptoms of thyroid imbalance.

 

Benefits of the Free T4 Blood Test

  1. Measures Active Thyroid Hormone Output
    Reflects the amount of biologically available thyroxine, offering an accurate indicator of thyroid gland function.

  2. Key Test for Hypothyroidism Diagnosis
    Low Free T4 supports the diagnosis of hypothyroidism, particularly when TSH is elevated.

  3. Supports Hyperthyroidism Detection
    Elevated Free T4 may indicate hyperthyroidism or excessive thyroid hormone replacement.

  4. Monitors Thyroid Treatment Effectiveness
    Essential for patients receiving levothyroxine or other thyroid hormone therapies.

  5. Identifies Central Thyroid Disorders
    Helps detect pituitary-related thyroid dysfunction when TSH does not respond appropriately to Free T4 levels.

  6. Explains Persistent Thyroid Symptoms
    Clarifies hormonal status in individuals with ongoing symptoms despite borderline or normal TSH.

  7. Optional GP Consultation for Interpretation
    Results can be reviewed with a GP to ensure appropriate diagnosis and management.

 

Why Do I Need a Free T4 Blood Test?

You may benefit from a Free T4 test if you experience symptoms or clinical concerns such as:

  • Persistent fatigue or low energy

  • Weight gain or unexplained weight loss

  • Cold or heat intolerance

  • Hair thinning or hair loss

  • Dry skin or brittle nails

  • Palpitations or anxiety

  • Menstrual irregularities

  • Monitoring known thyroid disease

Free T4 is especially important when investigating suspected hypothyroidism, hyperthyroidism, or when monitoring thyroid medication dosage.

 

How the Test Works

In-Clinic Blood Test

  1. Book Your Appointment

    • Schedule online or by phone; no referral required.

  2. Pre-Test Preparation

    • No fasting required.

    • Inform the clinician if you are taking thyroid medication or supplements (especially biotin).

  3. Blood Sample Collection

    • A trained phlebotomist collects a venous blood sample.

    • The procedure takes approximately 5–10 minutes.

  4. Sample Handling

    • The sample is labelled and transported under controlled conditions to a UKAS-accredited laboratory.

  5. Laboratory Analysis

    • Free T4 is measured using sensitive immunoassay techniques.

  6. Quality Control

    • Strict internal and external quality checks ensure result accuracy.

  7. Results Delivery

    • Results are typically available within 2–3 business days via secure online access.

  8. Optional GP Consultation

    • A GP can review your results and advise on further thyroid testing or treatment if required.

At-Home Blood Draw (Home or Hotel Service)

  1. Book a Home Visit

    • Choose a convenient time and UK-wide location.

  2. Professional Phlebotomist Visit

    • A certified phlebotomist attends your home or hotel.

  3. Blood Collection

    • A venous blood sample is collected safely and professionally.

  4. Courier to Laboratory

    • The sample is transported the same day to the laboratory.

  5. Analysis & Reporting

    • Free T4 levels are analysed promptly.

  6. Optional GP Review

    • Discuss your results with a GP if required.

 

Your Free T4 Test Results – Explained

Free T4 levels are reported in pmol/L.

Typical UK Reference Ranges

  • Normal: 12–22 pmol/L

  • Low: < 12 pmol/L

  • High: > 22 pmol/L

Interpretation

  • Low Free T4
    Suggests hypothyroidism, iodine deficiency, pituitary dysfunction, or under-replacement with thyroid medication.

  • High Free T4
    Indicates hyperthyroidism or excessive thyroid hormone replacement.

  • Normal Free T4
    Suggests adequate thyroid hormone production, though symptoms may still require further evaluation.

Free T4 should always be interpreted alongside TSH, Free T3, and clinical symptoms.

How It Works

Simple steps to get your results

1

Book Online

Choose your test online and book in seconds. Select your preferred clinic location or home visit option.

2

Visit or Test at Home

Attend one of our UK or London clinics, arrange a home nurse visit, or use a finger-prick kit where available.

3

Get Your Results

Your sample is analysed by accredited UK laboratories, with secure results delivered directly to you.

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How to Prepare for Your Test

Follow these guidelines for accurate results

Sample Timing

Where possible, attend your blood test between 7am and 12pm. Please wait until any short-term illness or infection has fully resolved before testing. Avoid intense exercise for 24–48 hours beforehand, as this can affect certain markers.

Fasting & Hydration

Fasting is not always required, but some tests may recommend it. If fasting is advised, avoid food for 8–12 hours before your appointment and drink water only. Stay well hydrated, as this helps with sample collection and accuracy.

Medications & Supplements

Continue prescribed medications unless advised otherwise by your clinician. Avoid vitamin, mineral, or biotin supplements for at least 24–48 hours before your test, as these can interfere with results. If you are unsure about any medication or supplement, please let us know before your appointment.

Hormones & Menstrual Cycle

For hormone-related tests, timing within your menstrual cycle may be important. If relevant, follow any specific guidance provided on your test page.

If you have any questions or special circumstances, our team is happy to advise before your appointment.

Frequently Asked Questions

It measures the unbound, biologically active form of thyroxine circulating in your blood.

Yes. Free T4 is not affected by protein-binding changes and gives a more accurate reflection of thyroid function.

No fasting is required.

Yes — biotin can interfere with thyroid assays. You may be advised to stop biotin 24–48 hours before testing.

Yes. It is essential for monitoring levothyroxine and other thyroid hormone therapies.

Yes. Symptoms may be related to Free T3 levels or non-thyroid causes.

Results are usually available within 2–3 business days.

Yes — clinic testing and at-home phlebotomy services are available across the UK.

Follow your clinician’s instructions; many recommend taking medication after the blood draw on the day of testing.

An optional GP consultation is recommended for abnormal results or ongoing symptoms.

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