HELP.. GP will not test t3. No thyroid.

[maddie512]

Hi I am looking for some suggestions as i have felt awful for some time and my gp will not test t3.

Any ideas on papers etc I can present to her .

Much appreciated.

[SeasideSusie Remembering]

maddie512

If it's your GP refusing to test FT3 then I would say he has no understanding of total thyroidectomy or how patients need to be treated with replacement thyroid hormone, or even how important T3 actually is.

Often it's the lab that makes the decision whether or not FT3 is tested. The hospital lab which does my surgery's tests will do FT3 if TSH is suppressed - mine always is so I get FT3 tested every time as well as FT4 (but I am in Wales so it may make a difference).

The only paper that I know of that mentions testing T3 (other members may have other information) is the article in Pulse magazine (the magazine for doctors) by Dr Toft, past president of the British Thyroid Association and leading endocrinologist:

"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).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. So obviously T3 has to be tested to know this.

You can obtain a copy of the article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor.

If that doesn't help then you could do a private test with MonitorMyHealth which is a home testing service promoted by the NHS and carried out by an NHS lab which doctors should accept. The thyroid test is for TSH, FT4 and FT3 and costs £29. If your GP wont accept them then personally I would argue the case that it is a service offered and promoted by the NHS to complement the tests offered by a GP.

monitormyhealth.org.uk/thyr...

The only other thing is you could offer to pay for the test if your GP orders it himself. Each individual thyroid test costs the surgery around £1-ish.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Ask GP to test vitamin D and Ft3 levels

B12and folate are likely too low

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood 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

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

For thyroid including antibodies and 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

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

[SlowDragon Administrator]

Important to test TSH, Ft4 and ft3 together

Always get all thyroid tests as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

[maddie512 in reply to SlowDragon]

My last test was taken at 3pm although I did not take my levo the night before. Thank you.

[Wetsuiter]

I d be tempted to pay £29 for the NHS Monitor My Health Thyroid Test. If it shows low T3, you then have some evidence.

[maddie512 in reply to Wetsuiter]

I have just ordered a test from there. Thank you

[SlowDragon Administrator in reply to maddie512]

Also look at getting vitamin D tested £29

vitamindtest.org.uk