GPs in Gloucestershire can't order F4/F3 test!

Just asked for a load of blood tests from my GP. He was able to comply with a lot of them but the computer system literally won't let him tick the box for F4/F3 hormones, I think it may be the same for thyroid antibodies, only an endo can do that. Luckily I've been referred to an endo because of a multi nodular goiter. Hopefully he'll order those tests. If it wasn't for my goiter, I'd have no option but to go private!

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  • My GP just writes it on the blood request form, although if TSH is in range the labs overrule it, she then gets in touch with them telling them full thyroid panel essential and they do t4, they have only once done t3 and that was when I was first diagnosed and TSH couldn't be detected.

  • I recently saw an new Endo- trad, but quite responsive to my situation. He diagnosed Sub Clinical HypoT and asked for FT4 /FT3 tests. Mmmm-7 years in...

    I never saw the any result for T3 in those sent to me [on my request] - I will check it out when I see him in a few weeks time, on follow up.

    My Vit D was over 100 however - whoop!

    I've just done my own tests on remaining queries I have inc T3/RT3- and hope to get results tm.

    Also,I did Iodine, Zinc, Copper and Selenium + the all important RBC Magnesium, as I suspect they are out of whack and best not to take long term supps unless some testing done.

    Serum Mag has risen from the botton line [no comment from anyone there] supplementing for yonks with that

    New work not cheap,though- with blood draw, Private GP consult[ to come] and tests-£500. Gulp.

    Health is too important to leave to others to pox about with -like NHS rule books or whatever, probably based on cost and backside covering.

    Me- Cynic. :) I need to know..

    PS: RevT3 test is ~£90 now [gone up in a year from £70] done through a private hospital- but it's unarguable data- as the GPs also use the same Lab in London!

  • I'd be interested to know if this is the case in other parts of the country? It may be a recent thing due to a new IT system perhaps.

  • Don't think it's recent. I had a request for T3 snuffed out by local NHS lab years ago- and head of practice refused to fight for it. Sad!

    I'll get there..

  • I live in Gloucestershire and at my previous GP surgery the nurse would tick T3 but the lab refused to do it. I have now changed GP and get TSH, T4 and T3 without any problems but have I noticed that the nurse ticks 'consultant requested' even though it is me who is asking for them.

  • Interesting. The GP said to me 'I could lie and say that a consultant has requested them, but that would put my job in danger'.

  • Winegum, I suspect this is due to the CCG clamping down on GP practices to cut testing costs.

    My previous GP (3 years ago) was able to order (and got) FT3 tested. 10 months ago GP surgery ordered TSH and FT4 which were done.

    My NHS endo's hospital lab tests TSH and FT4 but only tests FT3 when TSH is suppressed.

  • The lab at my local hospital have been testing my FT3 and FT4 ever since my TSH disappeared on thyroid hormones, this is without my GP asking them to. Once they even tested a lot of other pituitary hormones too. When I phoned them to query it and thank them they said all my GP has to do is write on the blood form 'taking T4/T3 combination' to ensure a full TFT is done every time. The last test results came back with a comment about 'known TSH suppression, other levels in normal range', which immediately stopped any discussion about taking too much :) This is a Surrey hospital.

  • That's great Framboise. Good to hear something good about the NHS in regards to thyroid. I expect though that you have to get diagnosed first.

  • I was diagnosed by Dr Skinner and no-one in the NHS has ever agreed with him but my GO has agreed to do blood tests for me.

  • My doctor said the labs won't do T3 if the T4 is 'ok' :(

  • I knew that they didn't do T3 as standard, but my GP can't order T4. Even though this is what it says in the guidlines;

    Throughout these guidelines we have highlighted the clinical situations where

    measurement of both serum TSH and FT4 is required; these are principally where the

    pituitary-thyroid axis is not intact or is unstable. These situations include relatively

    common situations such as optimising thyroxine therapy in the early months of

    treatment of newly diagnosed patients with hypothyroidism, diagnosing and

    monitoring thyroid disorders in pregnancy and monitoring patients with

    hyperthyroidism in the early months after treatment. Rare situations include diagnosis

    and monitoring treatment for central hypothyroidism, end-organ thyroid hormone

    resistance and TSH-secreting pituitary adenomas. If clinical details are not available

    that allow the identification of the above categories of patient, then it may be prudent

    for laboratories to measure serum TSH and FT4 on all specimens rather than embark

    on a first-line serum TSH testing strategy.

  • I live in Gloucestershire. Your GP needs to state on the blood form that 'Consultant Requests' F3 and F4. That's what mine did after the lab refused to do it and that did the trick. He puts that every time now and I get the results no problem.

  • He said that he could do that, but he didn't want to lie. I'll hopefully get a referral soon due to my goitre, and he/she'll be able to order those tests. I expect a lot of people with thyroid problems are being missed because of this rule.

  • I'm near Gloucester and I've come across this too - although now I'm on a T4/T3 combo my FT3 and FT4 get tested, along with TSH.

  • Are you being treated by a GP or Endo Starflower? If endo, I'd be interested in any endo recommendations. I live in Cheltenham.

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