I have a friend who is quite obviously suffering form thyroid troubles: dry skin, oedema, fatigue etc etc. However, he has been to his GP in Wales and they are consistently refusing to test his FT3 levels. his is obscuring an overall diagnosis. He has had it done, in the past, privately and there is definitely something wrong but he cannot afford to have it done privately again. He is hoping to move out of Wales soon, as there are other anomalies that the GP practice simply refuse to look at; quite shocking really. Can anyone tell me what and whether there is a legal requirement to undertake such an analysis if it is requested by the patient?
Thank you.
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Eloisesupergirl
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They are not allowed to any more in England for at least the last 5 years, my GP said if they ask for it the lab are told to refuse. I expect Wales is the same.
Where I am in Scotland the GP practice will not do T3 testing unless requested by an endo. The reason they say is because they are not allowed to prescribe T3 and neither do they have the knowledge to monitor patients on T3. All that is endo territory.
I live in North Wales and the hospital lab which does my surgery's tests does test my FT3. It is never requested, as far as I know they just ask for "Thyroid Function Test".
As far back as 2000 they were including FT3 test, not every time so I don't know what reason they included it sometimes, but my TSH was always, and still is, suppressed.
Since 2017 it has been done every time.
It's very likely not the GP refusing to do it, it tends to be down to the lab who decides, and it seems that they can override a GP request.
Not sure if it's something to do with the Health Board, but mine is Betsi Cadwallader.
Considering that it is T3 that enables our bodies to function 'normally' so if it is low (is rarely tested) and I think it would be very beneficial - for everyone who is complaining and is symptomatic - that doctors should do a 'Full Thyroid Function Test' initially i.e. T4, T3, Free T4, Free T3 and thyroid antibodies. All of the latter should be optimal but the 'frees in particular' are necessary and for us to be well FT4 and FT3 are needed to be towards the top part of the ranges. I doubt any doctor is aware that it is T3 which is the 'engine' and brain and heart contain the most T3 receptor cells.
Of course, all our older doctors (now retired) who diagnosed us due to our symptoms aone, are no longer practicing.
Instead of our treatment pf replacement hormones) being prescribed we are given levothyroxine alone - that is T4. Thousands appear to do fine on this but when I trave by public transport I can guess who has an underactive thyroid hormone . Many recovered on NDTs (removed).
In the past - before blood tests for thyroid hormones were instigated - we were diagnosed upon our clinica symptoms alone and given a trial of NDT (natura dessicated thyroid hormones) but - for some unfathomable reason - this was withdrawn a short while ago without notice and with a complete disregard that those who should make these decisions should be the patients themselves and, in particular, on this forum many members know far more than the medical professionals.
Hypo patients who were well upon had NDT withdrawn without notice as they did T3. That just shows the capability to ignore patients when making decisions that can affect someone's health badly and who may even lose their livelihoods altogether.
Why should patients be forced to get medication outside of the UK - if possible. Many people cannot afford to do so and I have read a 'Last Testament'for the coroner to read of why the person made a decision that she could no longer continue living. How could that happen in the UK?
I am myself having to leave the country for this very reason. The Medical service here is becoming ever more bureaucratic and unreasonable. One doctor I know looked at this site and described it as 'dangerous' and 'ignorant' and yet she refused to give me the proper care due to the fact that she assumed that, anything not approved in typical NHS fashion, must therefore be bad. I have tried to converse with these people, GP's, Endocrinologists and etc but all to no avail. It is time to go, and, once th present situation calms down, off I will go.
The fact seems to be that doctors do not like to think that we, the patient, know more than they do. They also have no knowledge at all about how the thyroid gland functions and what is its purpose.
The fact is that because we are taking thyroid hormone replacements and not improving that we begin to search the internet. If people were doing well on levothyroxine and went about as they did when they didn't have a problem with their thyroid gland, they certainly wont be on the internet searching for help/assistance.
Another fact too, is that the majority of assistance on this forum enables us to recover our health. A huge difference between feeling very unwell or going about our daily life as other 'normal' people do - and that is how we should feel when taking the correct replacement hormones and/or the replacement dose.
Another fact is that before the internet we had to follow what the doctors told us. In fact I had the honour of being able to consult two of the 'old school' doctors who were trained upon clinical symptoms alone - before bood tests were introduced - they diagnosed us upon our clinical symptoms alone and they prescribed what suited us, be it NDT (natural dessicated thyroid hormone replacements - and the very original) which saved lives from 1892 onwards or levothyroxine or T3/T4 combination. Unfortunately the NHS withdrew this essential NDT replacement without notice, as they also did with T3 (due to cost which could be sourced elsewhere more cheaply). They had set minds that we, the patients, should swallow what we were prescribed and ignore the fact that many of us did not feel well at all. Some lost their jobs as their thinking wasn't as it should be. Relationships might well have suffered too as I doubt any person who does not have a dysfunctional thyroid gland can imagine what it is like for their body not to produce all of the hormones necessary for life.
Endocrinologists cannot prescribe what they want as they have to stick to the guidelines. ie. T3 has shot up in cost - removed. NDT - made False Statements about it, despite its safety being wel established from 1892 and still does today.
I've never been able to work out why the NHS (NW England) sometimes tests my ft3 and sometimes doesn't . (i had not asked for it , and wasn't told it had been done)
My suspicion is that sometimes the GP doing the annual review of thyroid
medication had ordered it, and recently , this has been one of the senoir gp's at the practice , but not always. On a couple of these occasions fT3 looks to have been ordered and reported back separately from TSH/fT4.
There also seems no consistency about which TSH /fT4 levels have led to testing if it was a 'reflex ' test which are automatically generated by the lab if TSH/fT4 are under /over range,
which is what makes me think the GP ordered it specially.
Below are the TFT's , all from same lab , and on some occasions on which you would think an fT3 would be generated, it was not done, and on one occasion * which didn't seem to require it , it was done ;
date ------------TSH---------------------fT4---------------------fT3
The only conclusion i can make from these examples is that for a period of time, my GP's were asking for it to see if i was thyrotoxic, and then got bored of looking because according to my fT3 results it seemed i wasn't.
And possibly since 2018, they have been under more pressure not to order the fT3 test ?
Tell them you take NDT - then explain what NDT is for the 100th time - and if they write NDT on the lab envelope, they usually do test T3. I think this is partly to prove to you that you do not need it!
Even if my GP writes T3 and Vit D they dont always do it. The Vit D costs more. They came back to the GP with "he had not made a good enough case for the test". I hit the roof and the tests were done, showing my Vit D was dangerously low. I wrote to the lab and showed them the proof, and demanded that they apologise.
A good trick with a GP is to ask "what hormone does the body produce naturally that it does not need?" They of course will say none. So why do they think the natural T1,T2,T3 are not needed? I have stumped a few GPs and Endo s like this.
Another trick I have done a couple of times is the "Oh you havent read the latest research, McVittie and Merlo et al?" (make up your own names!) "showing T3 is the best test of thyroid health?" It makes them think.
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