Abstract
We studied the effect of adding purified human albumin to sera on free thyroxine (FT4) values obtained with Amerlex ® radioimmunoassays. Apparent FT4 values increased with progressive addition of albumin in vitro. The effect was smallest with low and greatest with high initial FT4 concentrations, which were also linearly correlated with the incremental increase in FT4 values per g/l albumin added. Wide variations in either endogenous thyroxine binding globulin (TBG) or albumin concentrations in patient serum had little effect on the rate of increase in FT4 values when albumin was added in vitro. From Mass Action theory, calculations of the binding affinity of the endogenous albumin for the analog (2.1 × 10 5 l/mol) gave values nearly half that of the added albumin (3.94 × 10 5 l/mol). Distortions in Amerlex FT4 values caused by adding albumin in vitro may exaggerate its importance as a tracer binder and such results may be unrepresentative of patient samples.
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