Am I missing something here?

[markwsteele]

So this letter was sent from my Endo to my somewhat uneducated (as far as thyroid problems go) GP. I’d asked my GP about ft3 test and because they weren’t sure an enquiry was made to my Endo.

Can I have your thoughts please?

Thanks

[RedApple Administrator]

markwsteele,

Sadly, the endo appears to be as clueless about the value of T3 testing as your GP is.

That said, my suggestion would be to go through with trialing the inreased levo dose of 100mcg. Raising the dose may solve your issues. If it doesn't, that would be the time to collate plenty of available research documentation to give to both GP and endo, backing up your request for FT3 testing.

[markwsteele in reply to RedApple]

Thanks, I’ve already told the gp I might have to resort to private testing if they’re not going to play ball

[MaisieGray]

It's somewhat contradictory to be open to considering prescribing Liothyronine, but not to testing FT3. Equally though, I'm not sure what you expect to gain by saying that to your GP, about private testing; more helpful to just do the testing I would have thought. If it were me, I would accept the Levo dose increase but before starting it, would have a full set of private tests carried out; and then at what ever point you are reviewing that with your GP, I'd have a second set done for comparison. Only then will you know the effect of having the higher dose, and whether nevertheless, you still have too low a level of FT3 in comparison to the FT4 level.

[MissGrace in reply to MaisieGray]

Yes - well spotted - an innate contradiction. But not surprising. It shows a total lack of awareness of possible conversion issues. T4 is pretty useless if not converted to T3.

Sigh. It’s a terrible situation. The endo sounds a bit clueless. 🤸🏿‍♀️🥛

[Hidden]

No point to test T3???!!!!!!!

[markwsteele in reply to Hidden]

That’s what I thought...

[Fruitandnutcase in reply to markwsteele]

I thought that too - but perhaps the doctors in question have decided there is no point testing T3 when they have no intention of prescribing it anyway. Who knows - perhaps that’s how they look at it these days.

[markwsteele in reply to Fruitandnutcase]

I know...the nhs is...well let’s just say I’m not impressed

[markwsteele]

That’s what I thought too...thanks

[SlowDragon Administrator]

Grab the offer to increase Levothyroxine dose to 100mcg

Then get FULL Thyroid and vitamin testing privately after about 8 weeks

Has GP tested vitamin D, folate, ferritin and B12 ?

As you have Hashimoto's low vitamin levels are EXTREMELY common

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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

Is this how you do your tests?

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

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

Are you on strictly gluten free diet? Or considering it?

[markwsteele in reply to SlowDragon]

I’ve a blood test next week, then I’m increasing to 100mcg as agreed with my doctor...then repeat bloods probably privately then see where I’m at.

I’m not finding that any food I’m eating is affecting me so for now the gluten free route is just an idea that I’ll revisit periodically.

[SlowDragon Administrator in reply to markwsteele]

If your vitamin levels turn out to be low, then it's a higher possibility

Getting Levothyroxine dose increased and vitamin levels optimal is first steps

NHS doesn't want to test FT3 because they don't want to recognise how many thousands of people need at getting addition of small dose of T3

[Hashihouseman]

If that idiot endocrinologist tested your free T3 he might discover why your TSH is still too high and yet your free T4 is also probably too high! Levothyroxine is far too often used to push the body into reducing TSH and produce more T3 by t4 conversion over and above what it probably would prefer to do and what would probably make you feel better!

[Hidden in reply to Hashihouseman]

Lol "idiot" made me laugh , I have a endo appt in May and she is testing my tsh T4 and T3 . Will be interesting as never had my T3 tested before ?

Tam x

[Hashihouseman]

And I should add that the normal healthy thyroid produces that extra straight t3 precisely to compensate for any needs not met by t4 conversion, this is an evolutionary given and probably a necessity so to ignore ft3 status and hang about on t3 replacement in the face of supra-physiological fT4 and tsh is blind stupidity. It’s all in the name of the great god levothyroxine and the devil that is tsh (the one legged stool of thyroid function tests).

[markwsteele in reply to Hashihouseman]

Thanks.

[SilverAvocado]

Its actually quite comical to see it all written out in black and white! I'm surprised someone with so little knowledge wanted to make a record of it! It's especially funny how they keep saying 'biochemical' to make it all sound legit

I agree with others that you should jump through the hoop that's been put on front of you. The letter actually puts you in quite a good position, because it does say IF symptoms don't improve on the 100mcg dose, THEN T3 replacement can be discussed. It doesn't completely condemn the T3.

Often with doctors we have to jump through a lot of hoops to prove to them that their useless offering hasn't worked out, and then we go on to the next possible treatment.

Even though it might not be the right thing to do, I think even trying things that don't help are somewhat useful, as we're on a long road to get better. You will have more results to keep in a folder, and they might come in handy sometime years in the future.