Story so far: T3 removed and T4 increased (against my wishes). After 6-8 weeks blood test taken. Form requested T4, TSH, T3?
Results returned for T4 and TSH only and a letter asking if I had stopped taking T3. I replied that as instructed I had but queried absence of T3 result. The reply that has arrived states that the lab rejected the request as I was on T4 therapy alone and that there is no means to check free T3 at a cellular level.
I am anticipating a follow up appointment and would like some guidance on what questions to ask, how to get some clarity and satisfaction here.
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Chillymortal
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How do they check T4 at cellular level? T4 enters the cell and is converted to T3 by D2. Thus, for tissues that use D2 to regulate local T3 measuring cellular T4 is as important as cellular T3. Serum fT3 tells you as much as serum fT4 does, neither measures cellular levels. I make a formal complaint if they refuse fT3, it's the only way to bring them into linne.
No, it's not nonsense. It can't be measured inside the cell. A blood test is exactly what it says: a test of what is in the blood. But that doesn't mean that it's not valuable and necessary to test is.
That’s kind of what I meant. It’s still necessary to test for it surely. Not change the parameters and say we would have to test inside the cells instead.
Well, none of that made any sense at all. They were just trying to blind with science. I don't suppose for one minute they believed what they were saying. They just thought you would be so ignorant that you would accept anything they said, because they are the 'experts'. It didn't have to make sense. They haven't yet cottoned on to the fact that patients are becoming more and more informed.
I’ve been thinking about your situation Chillymortal. How do you feel? Are you well? If not then I’d be tempted to say at your follow up appointment that it’s no good, you need to return to taking T3 because your FT3 Level is now too low for you. Oh whoops, they have no evidence to refute your claim... because they didn’t test it! If they don’t do the tests, the only alternative is adjustment by how you feel / symptoms.
I wish I did feel well. I’ll heed your advice, after all their evidence is flimsy. They are insisting that our CCG will not prescribe T3. Again that contravenes recent NHS advice. It’s a battle of wills.
The 'professionals' have misinterpreted the advice about T3 and it should not have been removed from patients. You can tell Endocrinologist/doctor that the case is before the House of Lords about the withdrawal of T3 from patients who were well on it. Send a copy to both:-
Extremely common for vitamin levels to crash right out when T3 is removed
Ask GP for coeliac blood test and to test vitamin D, folate, ferritin and B12
Clearly they MUST test FT3 too
For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If also on T3, make sure to take last dose exactly 12 hours prior to test
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins
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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
New NHS England Liothyronine guidelines November 2018
North Essex. I’ve already had D102 done but it’s not an issue here. I think the issue is other prescription meds causing conflict. I’m awaiting a private blood test to arrive.
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Seeking advice
I’m seeking advice re interpreting my results and dosing T3 medication. 
Advice before GP phone consultation, please?
New to forum and seeking advice
Thyroid UK's Response to NHS Consultation
