What Is the T3 Resin Uptake Test?

What to expect when undergoing this test

The T3 resin uptake (T3RU) test is a test of thyroid-related proteins in the blood. It's used to help healthcare providers interpret the results of other thyroid tests, namely the T3 and T4 tests, which show how much thyroid hormone is available to the body in free form. However, it's used less than it used to be due to the development of the free T4 and serum TBG (thyroxine-binding globulin) tests.

Alternate names for this test include resin t3 update, T3 uptake, and thyroid hormone-binding ratio.

Thyroid neck check
Creative RM / BURGER/PHANIE / Getty Images

Purpose of Test

Your thyroid is a gland that sits in the front of your throat and is shaped like a butterfly. It produces hormones and regulates a lot of important functions in your body, including energy use, weight, mood, and body temperature.

Two key thyroid hormones are:

  • T3 (triiodothyronine)
  • T4 (thyroxine)

Both exist in two forms. A protein in your blood called thyroxine-binding globulin (TBG) binds to the more abundant forms of both T3 and T4 and helps it move through your bloodstream. The other types are left circulating without this protein and are called "free" T3 and T4. The free forms are available to help regulate your bodily functions.

The T3RU test is an indirect measurement of how much TBG binding is going on. It's helpful for your healthcare provider to know this information because very often, abnormal T4 test results can be an indication of TBG imbalance rather than a problem with the production of T4 itself. That can lead to misdiagnosis of a thyroid problem.

Your healthcare provider may order a T3RU test if you have symptoms that may be caused by hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid), especially if you have other risk factors, which include:

  • Being female
  • Being under age 40
  • Family members with thyroid disorders

This test is intended to be done alongside T3 and T4 tests to help your healthcare provider get a complete picture of your thyroid function.

It may also be done to check for:

The T3RU and other thyroid tests are done on blood samples. Taking blood samples generally is a quick, simple, and low-risk procedure.


For most people, the only risk from a blood test is mild pain or light bruising that goes away quickly.

Some people, especially those with a fear of needles, may experience side effects such as dizziness, nausea, or ringing in the ears during or right after having their blood drawn. If you experience this, let someone know. Most places where blood is drawn are equipped to deal with this kind of reaction. You'll usually be asked to drink some water and lie down until you feel better, which normally takes just a few minutes.

If you know you're likely to have a negative reaction, it's a good idea to arrange for someone to give you a ride.

To Minimize Risks

Let the nurse or phlebotomist drawing your blood know if:

  • You've had bad reactions to blood draws in the past
  • You have a bleeding disorder or are taking blood-thinning medications
  • Your skin tears or bruises easily

They can take steps to lessen any risk these factors create.

Before the Test

No preparation is necessary prior to a T3RU blood test, but you should talk to your healthcare provider about any medications you're taking, as some of them may alter your test results. Don't stop taking anything unless your healthcare provider tells you to.

Medications that may alter T3RU levels high and low include:

  • Anabolic steroids
  • Blood thinners including Heparin and Warfarin
  • Seizure medicine including Phenytoin
  • Birth contorl pills

Over-the-counter medicines and supplements may also interfere with your results, so make sure you tell your healthcare provider about everything you're taking.

Pregnancy can throw off results as well, so if you're pregnant, make sure you're healthcare provider knows.

Timing and Location

A blood draw should only take a few minutes. Some healthcare provider's offices may draw the blood while you're there for an appointment. In that case, your appointment might be slightly longer than is typical.

Going to a lab for the test involves more time. If you have a scheduled appointment for your test, arrive early enough to check in and take care of co-pays. If you're nervous about the blood draw, you may also want to give yourself a few minutes to sit and relax after you get there.

Labs can be busy and wait times may be hard to predict. If you're dropping in, it's a good idea to call ahead to see how long the wait is. Certain times of day, especially early mornings, may be better than others.

What to Wear

You shouldn't need to change out of your regular clothes for this test. However, make sure you can expose most of your arm without too much trouble.

In case you get dizzy afterward, flat shoes and non-restrictive clothing may be good choices.

Food and Drink

Remember to follow any fasting instructions you're given.

Any time you're having blood drawn, you want to be well hydrated. It makes your veins easier to find, which helps avoid problems with inserting the needle.

It's a good idea to take a snack with you so you can eat right after the test.

Cost and Health Insurance

Most of the time, insurance does cover thyroid-function tests that are deemed medically necessary. You should check with your insurance company ahead of time, though, so you're aware of any expenses you could face.

Without insurance, laboratory costs for a package of thyroid tests, which may or may not include a T3RU, typically costs between $150 and $180 dollars. If a radioactive iodine uptake test is also ordered, it could push the total cost up over $500.

Your insurance company, healthcare provider's office, and the lab should be able to help you figure out what, if any, costs you'll need to cover. Be sure to take your insurance card with you as well as any written orders your healthcare provider may have provided.

During the Test

Your blood will probably be drawn by a nurse if it's done in a healthcare provider's office, or by a phlebotomist if it's done at a lab. Before the test, they may ask you to confirm certain information, such as your name, birth date, the healthcare provider who ordered the test, and what you're being tested for. This is to ensure they're doing the correct test(s) on the correct person.


You'll be asked to expose your arm, and then the nurse or phlebotomist will clean the insertion site with alcohol. Next, they'll tie a band around your upper arm to trap the blood and get your veins to stand out. If this isn't working well, they may ask you to pump your fist.

Throughout the Test

Once they find a good vein, they'll insert the needle. It'll probably sting just a little, but this usually hurts less than a shot, since nothing is being injected.

They'll release the band to get the blood flowing, and blood will start flowing through the needle to an attached vial. Depending on how many tests are ordered, you may need to fill up more than one vial.

Once enough blood is drawn, they'll withdraw the needle and bandage the insertion site.


You should be able to leave right away after your blood is drawn unless you have a negative reaction. Even then, it usually only takes a few minutes of rest before it's okay for you to leave.

After the Test

You may notice a little tenderness and possibly bruising around the insertion site. This should go away quickly.

If you have any problems or questions after a blood test, contact your healthcare provider.

Managing Side Effects

If pain at the site bothers you, ice or an over-the-counter pain medication should help. You shouldn't have any other lingering effects.

Interpreting Results

The chief usage of the T3 RU test is to calculate (along with the T4 value) the Free Thyroxin Index. Although the T3 RU result itself is not very useful (and is not usually considered) as a stand-alone value, the normal range for adults is generally considered to be 24% to 37%.

Not every lab uses the same ranges or measurements, so ask your healthcare provider if you're not sure what your results mean.

If your results are higher than normal, it could indicate:

  • Hyperthyroidism
  • Protein malnutrition
  • Kidney problems

Results that are lower than normal may indicate:

Some people have an inherited condition that involves high TBG levels despite normal thyroid function.


After your results are in, your healthcare provider may want you to come in to discuss treatment options or further testing, depending on whether a diagnosis can be made.

If you don't hear back about your results for a long time, or if you don't understand the results, contact your healthcare provider's office.

If you do become diagnosed with a thyroid disorder, then it's time to start considering your treatment options.

A Word From Verywell

No one wants to have a chronic condition like a thyroid disorder, but sometimes a diagnosis can actually be a relief because you finally know what's going on. Keep in mind that thyroid disorders are common and highly treatable. Many people manage them by taking medication and maybe making some dietary changes.

Once you start treatment, it shouldn't take long for you to start feeling better.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. The Nemours Foundation/Kidshealth.org. Blood Test: T3 Resin Uptake (T3RU).

  2. U.S. National Library of Medicine MedlinePlus. Triiodothyronine (T3) Tests.

  3. American Cancer Society. Thyroid Cancer Risk Factors.

  4. Jaroudi S, Gavin M, Boylan K, Peiris AN. Transient T3 toxicosis associated with Hashimoto’s disease. Baylor University Medical Center Proceedings. 2019;32(1):80-81. doi: 10.1080/08998280.2018.1503480

  5. Sriphrapradang C, Bhasipol A. Differentiating Graves’ disease from subacute thyroiditis using ratio of serum free triiodothyronine to free thyroxine. Ann Med Surg (Lond). 2016;10:69-72. doi: 10.1016/j.amsu.2016.07.024

  6. UpToDate. Amiodarone and thyroid dysfunction.

  7. U.S. National Library of Medicine. Thyrotoxic periodic paralysis.

  8. U.S. National Library of Medicine MedlinePlus. Toxic nodular goiter.

  9. The Nemours Foundation/Kidshealth.org. Is it Normal to Feel Sick During a Blood Draw?

  10. Moradi S, Gohari MR, Aghili R, Kashanian M, Ebrahimi H. Thyroid function in pregnant women: iodine deficiency after iodine enrichment program. Gynecological Endocrinology. 2013;29(6):596-599. doi: 10.3109/09513590.2013.788640

  11. U.S. National Library of Medicine. T3RU test.

  12. U.S. National Library of Medicine MedlinePlus. Triiodothyronine (T3) Tests.

  13. Shehab-Eldin W, Shaaban MA, Atia MAS, Zewain SK. The association between thyroid function and nutritional status in patients with end-stage renal disease on hemodialysis. Alexandria Journal of Medicine. 2020;56(1):220-225. doi: 10.1080/20905068.2020.1863040

  14. Mohamedali M, Reddy Maddika S, Vyas A, Iyer V, Cheriyath P. Thyroid disorders and chronic kidney disease. International Journal of Nephrology. 2014;2014:e520281. doi: 10.1155/2014/520281

  15. Babiker A, Alawi A, Atawi M, Alwan I. The role of micronutrients in thyroid dysfunction. Sudan J Paed. Published online 2020:13-19. doi: 10.24911/SJP.106-1587138942

Additional Reading
  • Dunlap DB. Thyroid Function Tests. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 142.Available from: https://www.ncbi.nlm.nih.gov/books/NBK249/

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.