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Lars C. Moeller Department of Endocrinology and Metabolism, University of Duisburg-Essen, Essen, Germany

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Yaw Appiagyei-Dankah Medical University of South Carolina, Charleston, S.C., USA

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Birgit Köhler Institut für Experimentelle Pädiatrische Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany

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Heike Biebermann Institut für Experimentelle Pädiatrische Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany

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Onno E. Janssen Department of Endocrinology and Metabolism, University of Duisburg-Essen, Essen, Germany

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Dagmar Führer Department of Endocrinology and Metabolism, University of Duisburg-Essen, Essen, Germany

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Introduction In serum, thyroid hormone (TH) is mainly bound to transport proteins. The major proportion of circulating TH, 75% of T 4 and 70% of T 3 is bound to thyroxine-binding globulin [TBG; HUGO Gene Nomenclature Committee approved name

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Theodora Pappa Departments of Medicine, Chicago, IL, USA

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Lars C. Moeller Department of Endocrinology and Division of Laboratory Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Deborah V. Edidin Department of Pediatrics, Feinberg School of Medicine Northwestern University, Chicago, IL, USA

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Silvana Pannain Departments of Medicine, Chicago, IL, USA

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Samuel Refetoff Departments of Medicine, Chicago, IL, USA
Departments of Pediatrics, Chicago, IL, USA
Departments of Committee on Genetics, The University of Chicago, Chicago, IL, USA

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What Is Known about This Topic? • Partial thyroxine-binding globulin deficiency (TBG-PD) is an X-linked inherited TBG defect, which produces alterations in thyroid function tests, but no metabolic abnormality. • Clinical awareness is needed

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Kevin Stroek Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Annemieke C. Heijboer Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands

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Marja van Veen-Sijne Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Annet M. Bosch Division of Metabolic Disorders, Department of Pediatrics, Emma Children’s Hospital, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Catharina P.B. van der Ploeg Department of Child Health, Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands

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Nitash Zwaveling-Soonawala Department of Paediatric Endocrinology, Emma Children’s Hospital, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Robert de Jonge Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit & University of Amsterdam, Amsterdam, The Netherlands

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A.S. Paul van Trotsenburg Department of Paediatric Endocrinology, Emma Children’s Hospital, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Anita Boelen Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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concentrations, and in order to detect CH-C, thyroxine-binding globulin (TBG) is measured in the lowest 5% of T4 concentrations enabling calculation of a modified T4/TBG ratio that serves as an indirect measure of free T4 (FT4). With this approach, low T4 values

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Anita Boelen Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Nitash Zwaveling-Soonawala Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands

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Annemieke C Heijboer Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

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A S Paul van Trotsenburg Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands

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in detecting central CH as low blood T4 concentrations are also found in premature and sick neonates, and in thyroxine-binding globulin (TBG) deficiency, a harmless condition resulting in a high number of false-positive NBS results. With the advent of

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Françoise Brucker-Davis Department of Endocrinology, Diabetology and Reproductive Medicine
Institut National de la Recherche Médicale, UMR U895, Université Nice-Sophia Antipolis, Nice, France

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Patricia Panaïa-Ferrari Departments of Biochemistry, UMR U895, Université Nice-Sophia Antipolis, Nice, France

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Jocelyn Gal Departments of Biostatistics, CHU de Nice, UMR U895, Université Nice-Sophia Antipolis, Nice, France

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Patrick Fénichel Department of Endocrinology, Diabetology and Reproductive Medicine
Institut National de la Recherche Médicale, UMR U895, Université Nice-Sophia Antipolis, Nice, France

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Sylvie Hiéronimus Department of Endocrinology, Diabetology and Reproductive Medicine

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increased estradiol production (causing a rise in thyroxine-binding globulin - TBG), and the changes in iodine renal clearance and needs. Those changes result in a gradual increase in thyroid hormone production contrasting with a reported drop in free T4 (FT

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Heleen I Jansen Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands

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Marije van Haeringen Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Department of Computer Science, Vrije Universiteit, Boelelaan, Amsterdam, The Netherlands

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Marelle J Bouva Reference Laboratory Neonatal Screening, Center for Health protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

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Wendy P J den Elzen Department of Laboratory Medicine, Laboratory Specialized Diagnostics & Research, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Public Health, Amsterdam, The Netherlands

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Eveline Bruinstroop Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Endocrinology and Metabolism, Amsterdam UMC location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands

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Catharina P B van der Ploeg TNO - Child Health, Sylviusweg, Leiden, The Netherlands

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A S Paul van Trotsenburg Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Paediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands

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Nitash Zwaveling-Soonawala Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Paediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands

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Annemieke C Heijboer Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Annet M Bosch Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Pediatrics, Division of Metabolic Disorders, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands

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Robert de Jonge Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Laboratory Medicine, Amsterdam UMC, Vrije Universiteit, Boelelaan, Amsterdam, The Netherlands
Department of Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands

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Mark Hoogendoorn Department of Computer Science, Vrije Universiteit, Boelelaan, Amsterdam, The Netherlands

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Anita Boelen Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands
Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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deviation from the daily mean (T4_SD). In case of a T4_SD ≤ −0.8, TSH is measured (approximately the lowest 20% of the daily mean) and in case of a T4_SD ≤ −1.6, thyroxine binding globulin (TBG) is measured as well (approximately the lowest 5% of the daily T

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Alex Stagnaro-Green University of Illinois College of Medicine at Rockford, Rockford, Ill., USA

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Pregnancy is a stress test for the thyroid [ 1 ]. In a pregnancy in which the thyroid gland has a normal physiological response, it maintains the euthyroid state by increasing the production of thyroxine-binding globulin, total thyroxine, and

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Inge Bülow Pedersen Department of Endocrinology and Medicine, Aalborg University Hospital, Aalborg, Denmark

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Peter Laurberg Department of Endocrinology and Medicine, Aalborg University Hospital, Aalborg, Denmark

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concentration of T4 or T3. B = Biotin; R = ruthenium; SA = streptavidin; MAB = monoclonal antibody; Ab = antibody; ANS = 8-anilino-1-naphthalene sulphonic acid (to dissociate T4 from binding proteins); TBG = thyroxine-binding globulin; fT4 = free T4

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Giulia Brigante Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Giorgia Spaggiari Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Daniele Santi Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Katia Cioni Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Valentina Gnarini Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Chiara Diazzi Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Elisa Pignatti Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Center of Genomic Research, University of Modena and Reggio Emilia

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Livio Casarini Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Center of Genomic Research, University of Modena and Reggio Emilia

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Marco Marino Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Center of Genomic Research, University of Modena and Reggio Emilia

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Frank Tüttelmann Institute of Human Genetics, University of Munster, Munster, Germany

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Cesare Carani Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Azienda USL, Modena, Italy

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Manuela Simoni Unit of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences
Center of Genomic Research, University of Modena and Reggio Emilia
Azienda USL, Modena, Italy

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effects of genetic variation in these transporters. J Mol Endocrinol 2010;44:1-11. 10.1677/JME-09-0042 19541799 25 Refetoff S, Murata Y, Mori Y, Janssen OE, Takeda K, Hayashi Y: Thyroxine-binding globulin: organization of the gene and variants

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Dagmar Führer Department of Endocrinology and Metabolism, University Hospital Essen, University Duisburg-Essen, Essen, Germany

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Klaudia Brix Department of Life Sciences and Chemistry, Jacobs University Bremen, Bremen, Germany

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Heike Biebermann Institut für Experimentelle Pädiatrische Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany

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. A constellation of normal TSH and free T 4 but reduced total T 4 points to a deficiency in thyroxine-binding globulin (TBG), which is the main TH-transporting molecule in the blood. In this supplement, Moeller and colleagues [pp. 108-112] report

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