Theoretical consideration of the effects of dilution on estimates of free thyroid hormones in serum.

When concentrations of free thyroid hormones in serum are measured by equilibrium dialysis, the serum sample is diluted by dialysis buffer, resulting in a new equilibrium for distribution of these hormones that differs from that in the original serum sample. We have derived a mathematical formulation, based on an equilibrium model for multiple ligands and multiple binding sites, to determine the effect of dilution on the concentrations of free hormones in serum. Computer simulations based on the formulation indicate that both free thyroxin (T4) and free triiodothyronine (T3) are decreased by dilution of serum, free T3 being affected more than free T4. This dilution-related decrease is more prominent in hyperthyroidism than in euthyroidism, and even more striking for sera in which binding capacities for thyroid hormones are decreased (e.g., in thyroxin-binding globulin deficiency or hypoalbuminemia). These simulations can provide a basis for minimizing experimental errors in the estimates of concentrations of free thyroid hormones by equilibrium dialysis.