Well! Doc wasn't 'interested' just clueless!

So I posted a couple of weeks ago whilst I was waiting for another test and results. My doc had asked me to send in articles and information I'd been reading about T3. I took this as genuine interest on her part about an area she hadn't had much experience in. So I duly printed out articles and info from here and Dr Toft etc. I had my test, made sure to ask if t3 and T4 had been requested not just TSH (it hadn't but they changed it) and went yesterday for my results.

My TSH had gone from 1.53 to 4.3 (range 0.4 - 4.0) which at least makes me feel better about my brain fog, low mood and weight gain. The fun started though when she started 'explaining' to me.

First of all she said your TSH has gone up so we need to reduce your medication. I had to point out that I was ABOVE the reference range so needed a Levo INCREASE. Which she brushed of as 'oh yes that's what I meant'!

My t4 was 17.6 and I think the ref range was 14-24........they didn't do a T3 test!! She then proceeded to tell me that T4 is what your body uses and so only TSH and T4 matter. Then she said that it is the lab who decide if T3 should be tested and she can't make them do it only ask them to!

I have to have a test again in 4weeks because I've been increased to 100mcg Levo and she says she's asked for T3 but doesn't think the lab will do it!

I don't know what to make of the T4 result without the T3 but I definitely think I need to see a different doctor next time! She really had everything muddled about which thing does what, and claimed she never got my info and articles.

Eeeiuurrggh I don't know why I bother. I just hope the Levo increase works but from experience of the increases I've had so far, I'll feel better for a bit then it'll all start creeping back, hence wanting to know if I'm converting to T3 properly or if I might benefit from combined treatment!

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  • Harrisan, it can be difficult to persuade labs to test FT3 unless TSH is suppressed <0.04 as they are really testing for hyperthyroidism and not how well, or not, T4 to T3 conversion is happening. Until your TSH is lower, just above or below 1.0, a low T3 isn't indication of poor conversion, just undermedication. FT3 doesn't respond as quickly to dose adjustments and can lag several weeks behind TSH. GPs can request the lab tests FT3 but if they decline/don't, the GP may have to telephone the lab and be a little insistent while the lab still has the sample (a week usually).

  • Ahhh that makes much more sense. The way you've explained it makes sense.

    I guess ill see how I go with the increased dose and not worry about converting T3 unless I continue to get worse or not get better.

    I don't like to slate the doc like that but she really did seem clueless!

  • Harrisan, some are more knowledgeable than others but I wouldn't necessarily want to be the patient who expands her learning curve. On the other hand, she listened to you and increased your dose, so may have respect for what you say in the future too.

  • the only way many NHS labs will test T3 is if GP writes Central Hypothyroid om the form

  • I managed to get the first t3 test done by writing it on the form myself and circling it!

  • Ha I like your style. It's all computers at my docs though!

  • I'm afraid I gave up trying for T3 on the NHS - T3 was always requested by my endo but was never done - so decided to do the Blue Horizon home fingerprick test and get it done myself. BH use different lab ranges to what my endo uses but its all relative really so I can live with that.

  • I was told by 'vampires' taking my last bloods that a T3 has to be requested by a Partner at your surgery to begin with, then lab will probably phone & confirm to do it, probably because it cosys £250 in my area! Best wishes x Tricia

  • I don't know about that. T3 was on every request form I ever had when I was being treated yet it was never done - so even my endo didn't have the power, mind you I never actually questioned why it wasn't done.

  • Considering it's a 'National' health service there seems to be no 'rules' or cohesion where treatment etc is concerned! Some on here have said T3 test in their area is nowhere near £250, it's ridiculous, but then is the way Thyroid conditions are diagnosed and treated.

    Good luck in your fight x

  • I'm always saying the NHS - the only (massive, nationwide) business where bulk buying increases prices 😊

  • Doesn't fill you with confidence, does it?

  • Don't understand how NHS t3 test can cost £250 when Blue Horizon do finger prick test (I have done it) for about £80 and that is for TSH, T4 and T3. As fruit and nut case says, NHS is the only huge purchaser that has to pay more for bulk purchasing! What a mad world, but then someone has to pay for "kickbacks" to pharma!!

  • NHS labs will only do T3 if Central Hypothyroid is put on the request

    theres such complete ignorance from GPs to Endos about thyroid its criminal

    do not forget

    ferritin

    folate

    b12

    vit d3

    nEed to all be halfway in their ranges in order for your body to convert t4 into t3

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