Which condition is typically associated with elevated T3 and T4?

• A. Graves' disease
• B. T3 thyrotoxicosis
• C. Toxic adenoma
• D. Subacute thyroiditis

Answer: (A)

In Graves' disease, autoimmune stimulation of the TSH receptor drives increased production and release of thyroid hormones, so both T3 and T4 become elevated. This simultaneous rise is the hallmark of active Graves' hyperthyroidism, and you typically see suppressed TSH with high free T4 and sometimes high free T3, along with clinical hyperthyroidism.

Other patterns exist: a T3-predominant thyrotoxicosis can raise only T3 with normal or low T4, and a toxic adenoma can cause excess hormone from a single hyperfunctioning nodule, which may elevate both hormones but is not as classically associated with the dual elevation as Graves'. Subacute thyroiditis causes a temporary thyrotoxic phase from hormone release due to glandular inflammation, often followed by a return to normal or hypothyroid function and with low uptake on radioactive iodine studies, rather than sustained overproduction of both hormones.