T3 or not T3

[eliet]

200 mcg Levothyroxine daily for over 20 years. Asked GP to test for T3 as I don't feel right and never have TBH. Struggled to get Levo in my 40s. GP says I can have T3 test but if I need meds will have to pay privately. I'm 67. Never had private med ins. What do I do if I need T3?

[Aurealis]

Don’t worry, cross one bridge at a time. Your GP needs to address the problem you have that you don’t feel well and never have on Levo. He’s decided to do the T3 test - could have refused!

If GP won’t treat you, which is almost certainly the case, then you’ll need a referral to an endocrinologist. May be wise to get the list of recommended ones so you can request the one you want. Some endos prescribe T3 or NDT.

IF T3 test isn’t done, or is negative, GP still has to find out what is causing your problems.

Good luck x

[SlowDragon Administrator]

First thing is, do you have any actual blood test results? if not will need to get hold of copies. You are legally entitled to printed copies of your blood test results

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need enhanced access to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up. They can make nominal charge for printing but many will do so for free (£10 max and can not charge at all after May 25th 2018)

Once you have results can you add most recent results and ranges for TSH, FT3 and FT4, plus have you also had thyroid antibodies tested

Also very helpful if had vitamin D, folate, ferritin and B12 tested. Add results and ranges if you have them

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4, plus vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting.

If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances too, especially gluten. So it's important to get tested.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

Also ask for list of recommended thyroid specialists, some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

rcpe.ac.uk/sites/default/fi...

[Judithdalston]

You are fortunate you have a GP who seems so understanding re a T3 test! Get this done along with TSH, T4 at the same time ( early am blood test with 24 hrs without levothyroxin etc) will he/ she also do the VitD , B12, ferritin and folate tests too that help with improving our thyroid health? I have gone down the T3 route privately, it is not very expensive from abroad - I pay more for supplements!

[silverfox7]

Yes you really need to find out if you have a problem first do accept the doctor saying you can have your T3 tested and post your results. However be prepared that the lab may still refuse to test it! So the option then is to ask to see an endocrinologist and depending who is on offer that's not always helpful or pay for private testing as detailed above butcask the doctorcifcthe nurse can take the bloods for you. He may help you with that.

Are you familiar with your past results. May be ask for your last reading if you aren't but another common problem is that you could have a conversion problem and thisexresults would show your FT4 is very high in the range and full testing wouldchave shown your FT3 is very low as you aren't converting much of your T4 to the T3 every cell in your body needs to function well. That can be improved or even reversed by testing Vit D, B12, folate and Ferritin. Those 4 help your thyroid to work better, help with conversion and can also help with some symptoms you may have. They all need to be optimal, not just in range and many of us take supplements for life. Although it sounds as though your GP wants to see you improve he may not know that your usual bloods needxto be higher than just in range so you need to start off looking at an increase in meds. So a few things that may be aren't right at the moment but full testing withvvitamins as well can tell us quite a lot.

[pennyannie]

Yes, it is a shock when in our " pensioner period " you hear words like this, isn't it. I felt this way about 18 months ago when I found this site - the T3 scandal may not even be your issue as first you need to try and get the relevant blood tests. I type the word try, as in my case, my doctor refused everything, and I paid to find out what I thought the doctor would have considered part of her responsibility in having me as a patient!

Anyway, you are now in the right place and things can only get better as you grow in knowledge and are able to follow through with what you know to be right. Should T3 be your answer, it doesn't need to be as expensive as the NHS prescription cost is : - what ? yes, I'm not making this up - 'tis a long story and it is truly unbelievable - !!!!!!

[eliet in reply to pennyannie]

Thanks pennyannie. I will come back to you for further info once I've had the blood test.

[Marz in reply to eliet]

How did your blood tests go ?

[pennyannie]

I'm still learning - wouldn't presume to advise anybody, but I'll keep a look out for your updates. Take good care, baby steps, gain knowledge and confidence, it'll all fall into place, in due course.