Development of Certified Reference Material of L-Thyroxine by Using Mass Balance and Quantitative Nuclear Magnetic Resonance.

L-thyroxine (T4) is an important hormone for diagnosing and evaluating thyroid function disorders. As outlined in ISO17511, having a certified reference material (CRM) is crucial for ensuring that the results of clinical tests are traceable to the SI-unit. This study employed two principal methods to evaluate the purity of T4, mass balance (MB) and quantitative nuclear magnetic resonance (qNMR), both of which are SI-traceable (International System of Units) approaches. The MB method involved a detailed analysis of impurities, including water, structurally related compounds, and volatile and non-volatile substances. A variety of techniques were employed to characterize T4 and its impurities, including liquid-phase tandem high-resolution mass spectrometry, ultraviolet spectrophotometry, infrared spectroscopy, and both (1)H-NMR and (13)C-NMR. Additionally, impurities were quantified using Karl Fischer coulometric titration, ion chromatography, gas chromatography-mass spectrometry, and inductively coupled plasma-mass spectrometry. In qNMR, ethylparaben was used as the internal standard for direct value assignment. The results showed T4 purities of 94.92% and 94.88% for the MB and qNMR methods, respectively. The water content was determined to be 3.563% (n = 6), representing the highest impurity content. Ten structurally related organic impurities were successfully separated, and five of them were quantified. Ultimately, a purity of 94.90% was assigned to T4 CRM, with an expanded uncertainty of 0.34% (k = 2).