Why do labs not test T3 when it has been ticked... - Thyroid UK

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Why do labs not test T3 when it has been ticked on the request form?

Fruitandnutcase
Fruitandnutcase

I've just realised that I don't have any results for T3 even though every blood test I have had done so far has requested that T3 , T4 and TSH are all tested so why do the labs not test T3 even though a consultant has requested that they do it?

Liz

26 Replies
oldestnewest

Hi Liz i was told by an endo i took my daughter to that if TSH in range( whatever they think range should be) lab wont do it i told her this was rubbish because T3 can tell a lot i would ask for it to be repeated x

helvella
helvellaAdministrator

If I were you, I would ask the lab!

You might be able to contact them directly, or through the PALS unit at your local hospital.

We can (of course) speculate and assume, but only the lab can answer properly.

(My guess is that they think it is not worth doing at the cost. Which is another way of saying, to save money.)

Rod

Aurealis
Aurealis in reply to helvella

I have contacted a lab directly for just that reason. If I hadn’t felt so cross I would have laughed at their indignance that a patient had telephoned them. They regarded it as a telephone line for medics only, but the number was published on the internet.

I pointed out that it would waste more money for me to have another blood test for them to analyse, than if they analysed the one they already had. They wouldn’t. I had another, and somehow on the second occasion it was tested. Think it depends on exactly what GP writes on form.

Oh, and I also pointed out that I regarded the blood test as an assault, as I had allowed it only on the understanding that my T3 was being tested! He didn’t like that either...

helvella
helvellaAdministrator in reply to Aurealis

It might be a difficult case to argue, but I agree that appears technically to be true. "Informed consent" is a vitally important doctrine.

Here it is the Labs who refuse, due to costs, they will never do it now, although a few years ago standard.

Best wishes,

Jackie

Hidden
Hidden

I got FT3 done under a consultant (ENT) not GP 'tho, worrying that consultants can't get labs to test now? as Rod says worth asking the lab why not? J x

Hi Liz . I have had my t3 tested about 5 times in the last year . I have found through this exerience that even though it is on the blood form as a request from your g.p . the lab will only do the test if you ring them and discuss it with someone in the lab in authority . sometimes this is the consultant only who can authorise it. Sometimes when I ring they say the g.p has to ring them and discuss rationale for the test etc.

I presume policy also differs from county to county . They agreed to test mine even when tsh and ft4 normalised through levothyroxine because i was still symptomatic . It came back below normal range . I have been told that this can happen as the ft3 in your body alternates throughout the day considerably . However mine was consistently low on several occasions so my g.p and i concluded that i dont convert levothyroxine effectively to ft3 (the energy provider ultimately) hence i am now on liothyronine.

do feel better than i did but still getting my optimum dose right . if you want more info on this there is loads on here . but i will tell u more if u reply xxxx . good luck .its a rocky road to health with hashimoto etc but this site is a god send of advice and inspiration as you know.

Shellypie
Shellypie in reply to poppppy

Me too. I don't convert either. I take direct T3 now and my Integrative gp dropped the thyroxine completely. It's changed my life. Thyroxine is a crock and so is the TSH test. It says nothing about the thyroid because it comes from the pituitary gland!! Go figure.

poppppy
poppppy in reply to Shellypie

Hi nice to hear from you. How did urine out u don't convert. Was yr t3 too low even though your t4 was top of range on thyroxine dose .or did u have more tests .

Hope you feel much better now .I wish u all the best

Poppy

Hidden
Hidden

The same in my area, no T3 or T4 if TSH is in normal range. In fact I only saw my doctor 2 days ago asking for another test because I feel so awful and her words were, if your TSH is in range the labs won't test for anything else. I assume the lab is part of the NHS and it is a cost cutting exercise. Also TSH is the NHS gold standard - so I assume they feel there is no need.

Thanks everyone, it was just that it only dawned on me the other day that while T3 had been requested each time I only had T4 results. They aren't even there from the first time when my results were all well out of 'the (famous) range'.

So it looks like they don't do them if they are within range but the also don't always do them when they are out of range.

I will ask 'why' next time I see one of the people who has requested T3 testing although Jan is probably correct with what he says about 'cost cutting' and TSH.

Liz

I have it in writing from our lab that TSH is the only test necessary and FT3 is of 'little diagnostic value', so that's what you're up against. Our lab will also not test ferritin more than once a month or vitamin D more than once a year!

AN

PS, but although I tried, I could not get them to admit that money is at the back of this!

AN

Hidden
Hidden

Two or three years ago I persuaded my endo to give me a trial of T3. I was absolutely fine with it but noticed every time my doctor put T3 on my blood test form it wasn't done. I rang the hospital to ask why the lab technicians took it upon themselves to decline the request.

My endo then made an excuse that it was dangerous for me to take it and immediately it was stopped. You can't win. I have now put on two stones, my memory is rubbish and I fall asleep all day.

Thought it couldn't get worse but I recently moved to an area and my new surgery only do TSH !!

Shellypie
Shellypie in reply to Hidden

That sucks! The TSH is a useless test! It comes from the pituitary gland. Not even the thyroid. Grrrrr. It's madness. Speaking of madness...please google Stop the thyroid madness ( sttm). I promise you will see what's going on through this.

When I was first getting tested in the mid 1990s they wouldn't even test T4 if TSH was in range. I went to my surgery and looked through all my old notes and even when I was really unwell and they were saying my TSH was borderline the lab never tested T4. Where I am now in a different health authority they do T4 and T3 every time but that might be because I was taking T3 for short while and/or because my TSH is very low.

I heard a rumour that the NHS won't fund it (unless, perhaps, an endo requests it), so even if a GP specifies it the lab won't do it because they won't get paid. I don't know if that's true, though!

Hidden
Hidden in reply to Zabby

I have just sent an extensive complaint to the Chief Executive of my local Hospital regarding their Lab staff making decisions over my GP's requests by refusing my GP's blood test requests for specific tests without any good reason and therefore putting my health at risk and failing in their duty of care to me the patient. I have told them that I intend to pursue this to the nth degree. This letter is as a result of being stitched up and lied to previously when I made the first complaint regarding this. They've also told me that they "can't find the person responsible". I have told them that in that case they really need to review their "accountability" systems as this is a dangerous precedent!!! I told them that they need to update their safety systems as not being able to trace their medical staff who are doing work for them and advising GP's and Patients wrongly and making decisions that could adversley affect patients is NOT ACCEPTABLE. I am currently awaiting their reply.

Hidden
Hidden in reply to Hidden

just dug out a couple of my printouts, the headings are...

Report ID: [number]

Viewed by: [initials - BF]

Sample number, collected time, received time, report issued etc.

Serum TSH level 5.24 mu/L (0.35-5.50)

(BF)-Normal no action

viewed by: BF,MG,SJT

So would BF be the person responsible?

also got one from ENT consultant with similar fields except no initials just 'status SR' (although includes FT3 & FT4 too).

I wish you well, let us know how you get on, J x

Hypo22
Hypo22 in reply to Zabby

I believe it straight. I had lots of problems with my freeT3 and freeT4 tests. So often the results were missing. After questioning the nurse (because I remembered she wrote it on the Lab paper) she then ask a doctor and I got the message "If they (Lab people) think that your TSH is right they wouldn't make the other tests"

Very strange, because my Endo requested it. He is writing everytime a letter to my GP.

Since then I have to pay private for the tests.

I believe the same thing may have happened to me last week. Went to an endo appt and he requested that my FT3 and FT4 were tested. Picked up my results today and both were missing from my results. My TSH was showing as 3 and classed as normal. I rang my surgery to see if it was a mistake but i have to call again tomorrow - i bet thats what i will be told. Am furious as my T3 had never been tested and was hoping it was the key as to why i was feeling rubbish... Oh well looks like the mountain i am climbing has just git bigger!!!

Hidden
Hidden in reply to Poshbird

Like I said earlier this load of boloney is going on all over the country and it's about time it stopped. Instead of saying "we are not doing it because we have been advised to make excuses to save money", they don't say anything, they just leave it out and hope you won't notice and won't make a fuss, it's absolutely disgusting, underhand and just plain dishonest. We need to complain vigorously every time that this happens as it is important that we make ourselves heard in this respect. Just putting up with this is tantamount to saying "OK it's alright I agree that you only have to test for TSH"! So please everyone write your complaint to the hospital Chief Exeutive each and every time it happens, tell them that they have a duty of care to you the patient and that your GP's requests must not be ignored. Don't be put off. This charity is all about getting the right treatment and lobbying o get the correct blood tests to enable us to get the right treatment and all the time they are getting away with this crap that they are dishing out to avoid doing the tests we will go on suffering, It's a small step that each of us can do to keep chipping away and right this wrong!

sandywandy1
sandywandy1 in reply to Hidden

My requested free T3 test was not done on the last 2 occasions even though the GP requested it. He sent me back for a further blood test with a request for T3 only. He wrote "On liothyyronine - Please test T3" on one of the forms. Not sure what he wrote on the previous one. Two extra blood tests unnecessary and probably more expensive in total, but I did get the T3 results in the end.Sx

Hidden
Hidden

Ring your hospital, ask for the name of the Head Bio Scientist, that's the person in charge of the Lab and what it does and doesn't do. Write a letter asking exactly what you have asked on here (I actually rang mine up and got an immediate response and because they still had the blood, they keep it for three weeks, he did the T3 without me having to go back. Try it, it may get you results.

Ok quick question here. How do they know the others are ‘normal’ if they are taking them all at the same time! They wouldn’t know until it is tested. Blood tests can change so they couldn’t go by any previous results. So are they all blood readers now and can tell it is normal by looking at it. Personally I think it is neglect as GP has ordered test and they are going against his orders. If it were a nurse refusing to do something, without good medical cause, GP had ordered they would be struck off. Who gives the vampires the right to decide what they will and won’t test when the GP has requested it.

I have had my T3 tested twice, once by my endocrinologist to determine the need for T3 and by my GP after four or five attempts. Having self sourced T3 after it was stopped I am now prescribed it. Hoping you can all get a result, takes perseverance thought-provoking five years on my part to get T3 re instated

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