It is important to remember that there can be paucity of symptoms as well as atypical symptoms, particularly in the elderly. After clinical examination, blood should be checked for thyroid function test (TFT). A standard check is for T₃ (Triiodothyronine), T₄ (Thyroxine) and TSH. By T₃/T₄ we mean total T₃/T₄, that is the total amount of thyroid hormone in the blood, both free and bound forms [bound to binding proteins like thyroid binding globulin (TBG), albumin, prealbumin]. It is the free hormone that is metabolically active, usually 0.05% of the total hormone². This is important in interpreting the thyroid function report because any factor, which increases or reduces TBG in the blood, would increase or reduce the total thyroid hormone respectively but the free hormones will be normal (Box-3).