Disappointed but not surprised !

Had blood test Tuesday doctor requested T3 as my ESR, CRP and LFTs have been abnormal for some time now but written on report was "T3 was also requested but as not indicated as TFTs done on 12/11/13 are normal. Please contact Biochemist if you would like to discuss this request further"

What gives the biochemist the right to refuse to do a T3 test that was a special request by the doctor. I am hoping that the doctor has rung them to say she wants the T3 done but will have to wait till next week to find out.

18 Replies

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  • The lack of communication between the lab and the medics is quite astonishing.

    If a medic has to jump through hoops to get an FT3 test done, so be it. But make it clear what those hoops are.

    If a medic has jumped through those hoops, then the lab has no right to stymie the request!

    About the only good thing is that the lab has been clear that they have not done it - unlike so many reports we have seen where the test reports simply fail to mention FT3 at all!

    Rod

  • my own/ladys doctor always marks on the blood test form ' all tests requested by consultant ' ---- he has had only 1 problem in the past 18+ months ...and followed up and them received the results within 24 hrs .....the lab now ALWAYS do all of the required tests every time......alan

  • Hi Here the Lab refuse all Free T3 tests, without fail. It is disgusting as they are only scientist, usually without even good degrees, or would not be there! They decided that it was not needed it is because it is "termed" expensive.T3 is essential for me, treatment and my end stage heart failure., etc. I pay for the 3, have for years, as essential and am treated on the results. This will only work if you use a well known ,well researched lab on line.Other wise not acceptable to a doc. This is why I use Blue Horizon.Main site. Quote TUK 10. for a discount. Finger prick slightly dearer, than venous, £60-£70 . However, only use venous if you can get " some one",, say GP, to fill their phial, ie draw the blood. Never go through a private hospital, very expensive.Even my GP will do mine with other tests. TSH, T4 and Free T3 need to be done together, either part GP and part venous blood. So, long as you have the ranges. I just do the 3, that is the price ,I have given

    Jackie

  • Time before last my doctor requested T4 along with my TSH and the Lab didn't do it. I then went head of our practice and he did TSH, ft4 and ft3 but I had to persuade him, I suggested I may not be converting t4 to t3 and he did it. Just a little knowledge goes a long way he was dumbstruck and for a GP who normally waffles and thnks he know it all, that's saying something ha ha. Best wishes.

  • Path labs seem to be on a hidden cost saving agenda based on nonsense from RCP

    my grandaughter is far more sick because the path lab refused to do free t4 and thyroid antibodies back in may when her tsh was 2.1 despite a family history of hashimotos and central hypothyroid

    but were happy to do lupus, RA, epstein barr,and lord knows what else tests which are far more expensive

    august when i find out the gp needs to specifically ask for free t4 and thyroid antibodies +tsh they do it the girls tsh is 3.5 and freet4 mid range and antibodies fairly high

    here we are in nov and despite thyroxine she is worse not better so suspect she needs t3 or armour or has serious adrenal issues

    5 months delay in diagnosis i could have made on symptoms alone is about to cost that girl her first years place at uni

  • This reluctance to test T3 levels is beginning to look suspicious. Is the NHS on a cover up mission to hide the extent of latent Under-diagnosed [&treated] thyroid disorders resident in the whole population?

  • Hi Meant to add this morning. I your LFT`s are much out, it can be diabetes. or cholesterol. High cholesterol goes with untreated or under treated thyroid disease. Diabetes is also autoimmune and hormonal. The liver is a remarkable organ so unless very painful, and protruding, the usual policy is "wait and see". if you want to see any one, be sure it is a Hepatologist, ( liver, gall Bladder and Pancreas), much more specialised and in my experience tons better than any Gastro. Some of the other bloods, may well be low ferritin/iron and B12 + Foliates, separate tests preferable

    if soB12 autoimmune and hormonal needs to be high in range. iron/ferritin, fairly well in range.

    Best wishes,

    Jackie.

  • Hi Jackie, my Cholesterol is 5.7 mmol/L (<5.2) so not too bad . My LFTs have come down a bit from last week

    ALT was 96 now 46 iu/L (<33)

    Gamma GT 132 now 118 iu/L (<40)

    CRP 12.0 now 11.0 mg/L (<5)

    ESR 26 mm (4.00-12.00) but not repeated this test even though requested on form.

    Blood sugars in past have been fine. Had a Liver scan which came back that liver was normal. I think I am having trouble converting T4 to T3 and my ferritin has been low as 20 ug/L now up to 49 (25-300.00) after been on 325mgs Ferrous sulphate iron tablets since May .

    B12 was 333 ng/L (180-800) Folates 3.5 ug/L (3.00-20.00) in May blood tests. I have taken my own B12 tablets myself but doc not tested B12 and Folates this time.

    TPO antibodies test was positive in Jan 317 iu/mL (>75.00 positive)

    Taking 50mg Levothyroxine at present but think I need more as all symptoms coming back again but need to see the doctor next week.

  • Hi You seem to have a good GP, lucky you! It is unusual to have LFT`s go down that quckly, normally only repeated monthly. Your cholesterol at that would not cause your problem.I assume your U`s and E`s are still OK? I cannot convert my T4t to FT3 naturally, have armour and 3. However, to need this is unusual. It does not cause my LFT`s to be so bad. As got a lot worse ( inherited disease) long after my thyroid was stable.

    I assume you had an ultra sound, I hope it was a good hospital? makes a huge difference, as I discovered, long ago! Did they also scan your gall bladder? Is your billirubin out too? If so that is Gall Bladder. Are you jaundiced? Personally ,I would ask for either a CT or MRI and may be get the pancreas looked at, that is a special scope, done by a radiologist, in a large teaching hospital.Have you had an enzyme test, called Faecal Elastase? It shows the Pancreatic enzymes and absorption. It could be pancreas, just not working properly. You would not necessary be diabetic.

    Yes, you are right , at the moment not on much T4.However, my thyroid was extremely bad for 20 years before I managed to get treatment, I had no liver symptoms then.

    As I said , I would also ask to see a Hepatologist, There are only a few, so usually very good indeed. They mostly involved with transplants, although physicians.

    The B12 and Ferritin should make a difference., I hope so. Liver is very complex, I had seen 7 so called "top" Gastros, before I saw my Hepa, no diagnosis,I have all these problems and a lot more.Although , I have to say, very little treatment , as none!

    I assume you have ruled out Caeliac disease? Test not too reliable. If you suspect it ,you have to go on the disgusting diet for 6 weeks and see if it works!

    Best wishes,

    Jackie

  • I had a serum tissue transglutaminanase test test done last year for celiac. 0.4 [0-4]

    It can throw up false negatives according to the result sheet but this can be followed by an IgA measurement.

    Is this second test the one you refer to, Jackie?

  • Good Morning, tegz, Yes it is the second one However, my Endo says nothing for Caeliac is totally reliable, including biopsies ( endoscopy). She s not the only one. However, she had a paper printed last year on this subject, in the BMJ, has to be very good to be published. She says that the best guide is to go on the diet for 6 weeks, then you can tell yourself, She is a great believer in "You know best". On the other hand, it is not a nice diet,, so unless you think a problem, I would not try it!

    The faecal Elastase test, for the enzymes for absorption , is very simple , a one off, bowel test at home. Treatment is with replacement enzymes, not drugs. Must be taken 20 mins before food, or useless. Funnily enough, a lot of Caeliac people have this problem and take it., after test., although there are other causes. This test is foolproof, and result idiot proof, ie very clear!

    Best wishes,

    Jackie

  • Hi Jackie,Sorry to but in but can you tell me more about the faecal elastase test,I don't think I want to go through the biopsy. I did have the blood test at the GPs but as I had given up gluten it was useless.x

  • Hi The Faecal Elastase is a quick, stool test, at home, really simple. results come clearly defined ie in efficient absorption, various scale, adequate etc. It may be done NHS or privately, if asking GP do not be fobbed off, def9initely can be done but they may not have heard of it! I it comes low, it means you are not absorbing properly. particularly relevant with drugs eg thyroid. My Endo picked up on it long ago, but she is exception.

    It is really common, It does not mean any thing wrong with the pancreas, but is the pancreatic hormones.. They can cause lots of problems Originally my Endo said to just by the enzymes, Holland and Barrat, not drugs in any way, no bad side effects, even less so than vits etc., They are the same ones as on a script, which I have ,since my test, I had another one after 6 months, and had to double my enzymes ( unusual)..

    I hope that is clear. If not get back to me, I am dyslexic so sometimes it shows!

    Best wishes,

    Jackie

  • Thanks Jackie, That's very clear now.

    Can I come and live with you,you seem to know a lot and have similar problems. I am dyslexic so I know how long it takes to write these answers. x

  • Hi beaton, My body is a total wreck, which is why I have to be better educated than my docs. Hard work!

    Always happy to receive PM`s,if I can help.

    Jackie

  • Thanks Jackie.x

  • G'day J :) Do you mean ordinary GF diet is hard to do? I just 'cut back' gluten and feel better on that alone.[esp Wheat!]

    I had a walking friend, very fit doing 20+mile walks- and he lost 2.5 stone a couple of years ago and didn't know why. Turned out to be caeliac and he's OK now, but the limit is a miniscule amount of gluten before trouble kicks in for the full blown case like this.

  • Hi tegz, You have to cur out all gluten, it is in dozens of things, really tricky. . See the WEB. to start with , for 6 weeks everything, then you can slowly introduce a little, and see what happens! A friend also is caeliac, and found this out herself, like this, many years ago, She is violently ill if she takes any. gluten.

    Jackie

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