Telling GP that you are taking T3

Apologies if I make this sound really longwinded! I had a partial thyroidectomy seventeen years ago and was on 100mcg levo until two years ago when an endo let me try 10mcg T3 added to 75mcg. However, after a year he said that the government was pulling the plug on T3, although he acknowledged that it could be bought on the internet and seemed to imply that it was my choice whether or not to go down that route. I assumed that he would see me again (next October) and as the prescription from my own GP surgery continued for 75mcg Levo, I sourced Tiromel and have been continuing with 10mcg, planning to explain this to the endo when I see him. However, I have never told any GPs at my local surgery and now they are insisting that I take their annual thyroid blood test before they can continue issuing my Levo. I made an appointment for next Tuesday morning….but now I’m wondering if I should discuss it with a GP first, as the T3 will cause the TSH to be extremely low and this will raise alarm bells, although I don’t feel confident that there is anyone in my surgery who is really clued in about the thyroid. Also, if I do go ahead with the blood test should I take both T4 and T3 24 hours before it (I normally take them both at 7.30 am …the test is at 10.30am) or should I take the T3 at 10.30pm the evening before i.e. 12 hours before it? I do realize that they will only test TSH and T4. Thanks for any feedback.

13 Replies

I'd take it the evening before. Assuming you take it once daily you will then have a reasonably accurate blood test. As an aside I have found that the evening dose of L-T3 has more beneficial effect, giving deeper sleep and feeling more alert the next day.

Thanks jim, that's interesting, as I'm not a great sleeper!

Just remember to have the earliest possible appointment and allow a gap of 24 hours as you are taking a combination, between last dose and test. I wouldn't bother saying anything about taking T3 as you are sourcing your own (they don't understand about T3 giving us relief of clinical symptoms) The test may not show a high T3. I take T3 only every a.m. and leave 24 hours between dose and test. My GP knows I take T3 and have never had problems with the doctors.

As you've had a partial thyroidectomy my personal view is that everyone should be given a combination of T3/T4 - even researchers say so and not only for thyroidectomy patients but all hypothyroid ones.

I'd change the appointment time and make it at the earliest possible as that's when the TSH is highest and that's all they look at, whereas the most important two, Free T4 and Free t3 are rarely tested.

TSH is highest early a.m. and drops throughout the day, so the earlier the appointment the better for you. It may also prevent an unnecessary adjustment in your dose of levo. The trained personal seem to believe in some 'old wives' tales that too much will cause osteo or heart problems but if we took too much the effect will not be nice and we'd reduce it ourselves.

The blood tests were introduced along with levothyroxine. Before that we were diagnosed upon clinical symptoms alone and given NDT which contains all of the hormones a healthy gland would produce.

Thanks Shaws. The receptionist said that 10.30 was the earliest she could give me. Should I then take both T4 and T3 24 hours before that? I suppose I'm concerned that the TSH will be very low (because of the T3) but and the gps will not factor that in and want to lower my Levo even further.

Cancel the appointment and make a new one, even a few weeks ahead for the very first appointment. Don't worry too much as I take T3 only and haven't had a problem with doing the above procedure.

At 10.30 am your TSH is going to be quite low, anyway. TSH is highest first thing in the morning, and drops during the day, and it also drops after eating. So, on here, we usually advise a test before 9 am - as early as you can - and fasting over-night. Leave 24 hours between your last dose of levo and the blood draw, and 12 hours for the T3. But, doctors don't know anything about any of that. :(

Thanks Greygoose. I'll try to get an early appointment, but can't guarantee it. since they won't be testing T3 anyway, will it make much difference if I take it 12 hours before test... or 24 hours? Would it affect the TSH much either way?

It is the TSH which doctors look at and I doubt they know what T3 is in the first place. Usually the test consists of TSH and T4 only. So you should have no problem if TSH is at its highest (for you on your dose\)

That's a very good point! No, I doubt if they will test the FT3. Which means that the testing is a waste of time, anyway, and a good reason for you to tell your doctor that you are taking T3. The TSH and FT4 are more or less irrelevant when taking T3, so testing them is just a waste of NHS money. I think you should come clean to your doctor. :(

That probably is the wisest course. Thanks.

You're welcome. :)

Definately tell your doctor/endo, it is most important it is on your records for your healthcare (especially in case of emergency) and also that it is on NHS records for possible stats purposes. I told my GP & endo, both were supportive and it ended up with me being prescribed.

You should tell your doctor as your results are going to be strange! TSH will be suppressed and FT4 could have dropped down to halfway plus the only important result when taking any for of T3 is the FT3 reading which must not consistently be over range so he needs to request that reading and tell the lab why it should be done.

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