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Thyroid UK
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Which tests to request?

I have booked a phone consultation with my GP on Monday. I'm going to ask her to do the form for T3 and T4 tests - the ones I should have asked for last month, but only got TSH because I only told the nurse "thyroid". (I'm supposed to get my levels checked yearly since a bout of hyperthyroidism in 2012/13.)

Since finding Thyroid UK i've been reading a lot, as you do. I am going to ask her for my B12 and ferritin levels to be tested too. I don't know this GP but I doubt she'll want to put all the possible checks that I know can be asked for. Which should I focus on?

I did a questionnaire for adrenal fatigue yesterday, came out very high, well into the severe range. Yet the more I read on thyroid, the more boxes I tick; this forum covers so many topics that feel like "me"! (Oestrogen; glandular fever in my teens; sensitivity to light; struggle much more in winter...) Beginning to suffer with information overload and not sure whether adrenal fatigue could be the cause of my thyroid trouble, or an effect, or something that mimics it meaning it wasn't my thyroid at all... though carbimazole did do the trick four years ago, but now I'm not sure what to think.

I had decided to put off getting this blood test - I was going to wait till the new year, meaning probably February, unless symptoms got a lot worse. But something is telling me to hurry this up even though I'm not feeling much different. Just a nagging sense that I shouldn't put it off that many weeks.

My blood pressure started going up this year, having been borderline high but stable on low-dose meds for many years. The GP told me it "just happens" when enough time passes. The next step would be beta blockers but I think I had those in 2006 or 2007. and I think they didn't suit me but I don't know in what way (I was post-stroke and don't remember much from those years). I would far rather determine what's making it go up now, I don't believe it's just going to start suddenly when I've got through periods of much higher stress in the past with no effect on b/p, and lost more than a stone in 2016/17. I started taking hibiscus last month which apparently works well, and fast, to lower b/p, but it hasn't made much difference to mine. I now suspect this is all about the thyroid too (if thyroid it is).

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The preferred blood tests are Free T3 and Free T4 (rarely tested) in preference to T4 and T3. This is a link and you will see the reason:-

thyroiduk.org.uk/tuk/testin...

The Full Thyroid Blood test is:-

T4, T3, Free T4, Free T3 and thyroid antibodies.

Also ask for:

B12, Vit D, iron, ferritin and folate if you've not had them for a while.

The blood test has to be at the earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take afterwards.

Get a print-out and post results with the ranges for comments.

p.s. If GP or lab wont do all of these, the ones not tested you can get from one of the Private Labs which do all of them.

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Muddlemand,

TSH, FT4, FT3, Thyroid peroxidase antibodies (TPOab) and thyroglobulin antibodies (TGab) are the recommended thyroid tests but primary care rarely orders FT3 or TGab.

Serum cortisol is likely to be the only 'adrenal' test your GP will order.

Ask for ferritin, vitamin D, B12 and folate to be checked too.

All of the above are available privately if your GP declines to order. A cortisol saliva test is more informative than a serum cortisol test.

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Thank you both. I'll re-read that page you link to, shaws, when I get over this information overload! :D

If my GP is reluctant, I'll focus on the thyroid-specific ones and probably will be able to get ferritin added as I showed up "low iron" (sic) from a full blood count two or three years ago. Took myself off the iron tablets after a bit, and now I treat myself to 2-3 days bingeing on liver n bacon when I feel I need it.

Two things concern me. (1) I have no income, so private testing is going to be a big deal. I get no disability benefits either and most of my income is maintenance, but that halves next year when my youngest turns 18 (also child benefit and tax credits)... I haven't found a way I'm able to earn, yet, and my spending is already a bit higher than what comes in. On the other hand, no question I will spend what I must on my health - fingers crossed that this makes me able to earn money which makes it a good investment financially. (As well as wellbeing-ly.)

(2) Tests first thing in the morning. I have morning stiffness. My usual morning, I sit doing nothing for about 2 hours, gradually starting to be strong enough to look at emails on my phone; after 2-3 hours I have breakfast, and after that a brief lie-down to recover, and get dressed. To be safe driving at 10am, I must set my alarm for 5am and that's the quick-start version. ;) Until recently I got all blood tests taken at home by the community nurses, but now you have to be completely housebound which I'm obviously not, I do drive.

Will this make the tests too unlikely to show a true picture? Or... if I fast, would that help? If I don't have breakfast, I'd need an extra hour to build up to getting to the surgery, but I could do it.

B****, I sound dramatically disabled when I list my morning start-up like that. Mostly I don't notice it, I count "first thing" counting from when I'm dressed. :-|

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I've just gone over this again. I seem to need to look at things twice with an interval between, to take them in - any kind of thing.

So here's what I shall request - but please tell me whether I've got this right.

T4, T3, Free T4, Free T3 and thyroid antibodies.

plus ferritin, vitamin D, B12 and folate

TSH was done in October. I'm also going to get a copy of those results.

Question - Do I need FT3 and FT4 as well as T3 and T4? Won't just the "free" ones do?

And what if the GP is very resistant to anything more than T3 and T4, which is what I was told by endocrinology when they discharged me in 2013? If i beg what should I prioritise, in case I only get one extra (as it were)? I'm thinking the B12.

she's going to call on Monday and I want to be thoroughly prepared. I don't know her and fingers crossed she's amenable to everything I want, but I want to be ready in case she's the opposite. Thanks :)

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