What does 'TSH - on T4 (TFTR)' mean?: Hi, I'm... - Thyroid UK

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What does 'TSH - on T4 (TFTR)' mean?

Spicer21
Spicer21

Hi,

I'm probably being very thick here, but could anyone help me with what 'TSH - on T4 (TFTR)' means? I know that TSH stands for Thyroid Stimulating Hormone and I know what T4 is, but what is TFTR?...I'm guessing the TF is probably thyroid function, but I don't know what the TR is...

My GP's suddenly decided to send me a blood test form for a thyroid check without me having to ask for one; he's asked for Free T4 (FT4) on the form as well as 'TSH - on T4 (TFTR)'.

Thanks in advance.

18 Replies
oldestnewest

At my GP’s, on the computer, TFT stands for ‘thyroid function test’. I think your doctor is indicating he wants TSH and T4 testing. 🤸🏿‍♀️

TFT is Thyroid Function Test and I imagine R is review, but I'm not certain. What he seems to be doing is making the case for both TSH and FT4 to be tested since he wants to check the effect of you taking T4 - ordinarily many labs will test only TSH.

Spicer21
Spicer21
in reply to MaisieGray

Thank you, MaisieGray. I think you must be right about that - makes perfect sense.

My GP's gone up in my estimation if we're right and that's what he's trying to achieve...A friend of mine's GP keeps asking for her FT4 to be tested too, but the lab on the NHS just totally ignores him and only tests for TSH...I'll post up again if my FT4 does get tested as maybe my GP has found a way around the system (and it'll be useful for others to know about it). Cheers! :)

MaisieGray
MaisieGray
in reply to Spicer21

My friend's GP draws a thick red box around "FT3" to make sure it's tested, as she takes NDT.

I could be entirely wrong about the R though, so fingers crossed!

Spicer21
Spicer21
in reply to MaisieGray

I'll mention about highlighting it in red to my friend - I think her GP would be up for trying that.

Hi Spicer

TSH on T4 (TFTR) is asking for a thyroid function test review and telling the lab you are taking thyroxine (on T4)

He’s also requested FT4 as they don’t normally do it routinely 😊

Ah, yes - I see it now, i.e about him telling the lab that I'm 'on T4' :) . Here's hoping that they do as he asks and don't just do the TSH. Many thanks for your help, Eladee.

Eladee
Eladee
in reply to Spicer21

Hope so 😊

SlowDragon
SlowDragonAdministrator

How much Levothyroxine are you currently taking?

just testing TSH and FT4 is inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

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)

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

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 are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

Spicer21
Spicer21
in reply to SlowDragon

Hi SlowDragon. I've had Hashimoto's (high TPOs) for 10 years now. I follow a gluten free diet and I have the vit D, B12 etc., situation all in hand - I use Medichecks to get my levels checked on a regular basis (as my GP doesn't usually bother). A very useful tip to get the blood taken early in the morning without T4 for 24 hours - I will definitely do that with this NHS blood test and with my Medicheck tests in future; I'm very glad of the advice - many thanks.

SlowDragon
SlowDragonAdministrator
in reply to Spicer21

TSH should be under 1.5

FT4 in top third of range and FT3 at least half way in range

New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be between 0.4 -1.5

Many need it right at low end, or lower in order to get FT3 high enough

sps.nhs.uk/wp-content/uploa...

Ps - my GP kindly allowed her nurses to do my MEDICHECKS blood draw for free 👍

SlowDragon
SlowDragonAdministrator
in reply to Avidreader

Wish mine would. But as she still prescribes T3, I don't rock the boat!

Spicer21
Spicer21
in reply to SlowDragon

At my GPs they never routinely take anyone's blood - we have to traipse up to the local NHS hospital, take a ticket and queue for ages :( . Thanks for the information about the optimum levels - it's really helpful.

SlowDragon
SlowDragonAdministrator
in reply to Spicer21

Many of us forced to test privately.

NHS rarely tests FT3, even if taking T3 on NHS prescription

Spicer21
Spicer21
in reply to SlowDragon

That's madness that they won't even test when taking T3 on NHS prescription - no wonder Medichecks are doing so well!

helvella
helvellaAdministrator

I am going to suggest Thyroid Function Test Reflex.

Slightly odd in the context you describe. Have a brief look here:

healthtap.com/user_question...

Spicer21
Spicer21
in reply to helvella

That actually seems highly likely to me, helvella. I just googled it as well and apparently a lot of health care systems use it to save money...T4 is not done if the TSH is within range, but it is automatically done if out of range, which negates the need for a second draw of blood for the T4 to be done (when out of range). Thanks for that.

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