Which T3 Blood Test?

[brightsideoflife88]

Hello Everyone,

Had a partial thyroidectomy because of para thyroid cyst in Feb 2014. Went on 50mcg thyroxine in June 2014. Felt better but have been gradually feeling worse since Christmas 2014. Went to GP. TSH was 2.67. The lab refused to test T4 or T3. She agreed to increase to 75mcg and see what happened. No improvement.

In the last few months I have had severe pain in my upper right abdomen. It comes on suddenly and can be extremely painful for a good half an hour and then start to ease. I also get bouts of light headedness. My GP got an ultrasound which found something on my liver. I was referred to gastroenterology consultant. Another ultrasound and MRI found 2 small spots on liver, however I was told they couldn't be causing my symptoms.

When I returned to see the consultant she actually listened to my long list of the usual symptoms, extreme fatigue (I went for a 2 mile walk with my family and it took me a day and a half to recover, also naps most lunch times), pain in joints/bones, brain fog etc. Consultant was quite knowledgeable about thyroid and agreed to do full thyroid panel. She also increased my dosage to 100mcg before ordering the blood test.

She just rang and said TSH was 0.77, T4 15.5 and antibodies nil. I don't have the reference ranges as the results haven't been scanned to my record yet. T3 wasn't tested because consultant received a long email from the lab explaining why T3 doesn't need to be tested if TSH and T4 normal.

I'm not sure where to turn next. I feel awful and I'm only 27 years old. I want T3 tested just to rule it out. I have seen the private blood tests but do I need to get T3, Free T3 or Reverse T3. Also as I am on synthetic thyroxine could I possibly feel better on NDT.

Does anyone have information on which T3 test to get and where I can look into getting NDT.

Many thanks in advance for your help and advice.

[Clutter]

Brighsideoflife, you need FT3 to show how well you are converting. If FT3 is low the addition of Liothyronine (T3) to Levothyroxine (T4) can be helpful and can be prescribed on the NHS although it may need to be recommended by an endocrinologist. NDT contains T4 and T3 but is rarely prescribed on the NHS and most members using it buy online.

Reverse T3 and FT3 need to be done together and will show the ratios of rT3 to FT3 which can arise when Levothyroxine is pooling instead of converting. If rT3 ratio is high rT3 is cleared by stopping T4 and taking T3 only.

[waveylines in reply to Clutter]

You can get NDT on the NHS. However most GPS will not prescribe it so you wold need to see a NDT friendly endocrinologist. Ask Louise Warvil for her list of Endocrinologists Generally the NHS would want to see if they could get you well on their standard treatment before considering NDT- So they start of with Levothyroxine and then will try adding in some T3 before moving onto a NDT -there are not loads of Endocrinologists who will prescribe a NDT -many are anti the NDT but not all. Your GP surgery would then need to find a GP in your practice who will underwrite the prescription on a 'named patient basis.' This is what happened to me and i have to agree to see a specialist every year all they will not continue to prescribe a NDT.

Hope this helps.....

[Jazzw]

As it was originally treatment for a parathyroid cyst, has the doctor tested for hypoparathyroidism? It's just a thought...

[brightsideoflife88 in reply to Jazzw]

I have suggested this before. We tested calcium which was 2.22 on scale 2.2-2.6 and adj. calcium 2.25 on 2.20-2.60 scale. I do take calcium supplements already. But as usual if its within the range your 'normal'.

[greygoose in reply to brightsideoflife88]

Calcium supplements aren't a very good thing to take, there are better ways of raising your calcium.

You could start by getting your vit D, vit B12, folate, iron and ferritin tested. Then taking vit D3 according to the results, with vit k2, magnesium and a little zinc.

All these nutrients need to be optimal for you to be able to use the hormone you're taking. And if any are low, that is going to give you symptoms and make you feel bad.

I would love to read the letter the lab sent to your doctor explaining why it's not necessary to test T3. There is only one real reason why they don't test it, and that is because it's too expensive! But I'd love to read their excuses!

[brightsideoflife88]

Thank you all for your advice. I will get a FT3 test done privately and go from there. I may also look further into NDT.