While making a fuss about not testing T3 in my blood sample, I was sent the following:-
The British Thyroid Association Guidelines suggest that measurement of TSH should be used to monitor liothyronine treatment. FT3 results are extremely variable in patients taking T3 therapy and monitoring TSH is the recommendation. The reference range of FT3 is based on patients without thyroid disorders and is not necessarily appropriate for hypothyroid patients on treatment. Associated extract from British Thyroid Association Guidelines: 3.1.3 Guiding treatment with tri-iodothyronine: If tri-iodothyronine is used as a replacement hormone increasing doses should be used until serum TSH is within the reference range. The measurement of FT4 is of no value in patients on tri-iodothyronine replacement and the measurement of FT3 is of limited value because of the variability after taking the replacement dose.).
The relevant section 1.3.3. for primary hypothyroidism states – Offer levothyroxine as first-line treatment for adults, children and young people with primary hypothyroidism.
1.3.4 Do not routinely offer liothyronine for primary hypothyroidism, either alone or in combination with levothyroxine, because there is not enough evidence that it offers benefits over levothyroxine monotherapy, and its long-term adverse effects are uncertain.
1.3.5 Do not offer natural thyroid extract for primary hypothyroidism because there is not enough evidence that it offers benefits over levothyroxine, and its long-term adverse effects are uncertain.
So there you have it. They are moving to just test TSH as that tells them all they need to know. It is funny how so many people survived in the past on taking natural thyroid extract without long term adverse effects, but lets ignore that fact!
So to get a good idea of what is going on, you will have to pay for private testing, because oddly enough, they understand you need TSH, T4 and T3 levels. Odd that. Spitting feathers here!
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serenfach
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This test is used to test your blood for levels of thyroid-stimulating hormone (TSH), and, where needed, thyroxine and triiodothyronine (thyroid hormones)."
It's that phrase "where needed" that seems to be used to mean that it's not needed.
My new surgery (after moving house) apparently does an annual test of TSH (only) for all thyroid patients. I was told to make sure they know that I have an underactive thyroid so that they can put me on the list for that. Odd that they haven't picked that up already from my record.
Has nobody realised in the NHS that the TSH test was devised to monitor Levothyroxine therapy only and is not suitable if Liothyronine is also taken? I have to explain this every year to my very compliant GP but if she ever leaves I am sunk, as my TSH is always in its boots. Every year she tries to persuade me that it is dangerous for me and every year I persuade her that it does not matter. Yesterday was the annual review and she tried to persuade me to have a Dexa scan, which I refused. I do not want to know if my bones are crumbling because the alternative will be a life of misery without T3. I walk several miles a day and hope this is making a difference.
I would advise never refusing a DEXA scan because they can pinpoint causes for concern, which can be monitored and treated. Plus, if you then have them annually thereafter and they do not show a declining trend, that is ammunition for you to support your treatment preference. Ignoring possible skeletal issues, if they do exist, is not helpful for future mobility.
It is all a load of rubbish, my last test from the GP was for TSH
Came back no issues " no indication of any thyroid disorder"
yet I am on meds for hyperthyroidism, so apparently according to GP tests I've gone from overactive Nov 2020 to cured March 2021. Luckily the nurse from endo said we can reduce the dose as I was concerned about going too far the other way (As only TSH done shows no indication of any movement on the other ones so how can we be monitored if only TSH done)
I know off topic as hyper but GPs do just test TSH
Nobody will have central hypothyroidism in the future if they just test TSH. "yes, yes, I can see you look terrible, but your TSH is normal, therefore it is not your thyroid. Lets try some antidepressants!
My TSH on starting Levothyroxine replacement was 2.9 on 50mcg , and 2.5 on 100mcg , and 2.7 on 150mcg .
Please could you tell me what dose i should have been on according to my TSH result ?
Also , my current TSH is 1.947, while my fT4 is according to my GP 'dangerously' over range at 16.6 [7.9-14] ie 142 %.
Can i now tell my GP to get off my case because my TSH is normal and these guidelines say he should ignore my 'dangerous' fT4, because he shouldn't have been testing it anyway . so he's a naughty boy ?
I was thinking when would other hormones be tested, and found that if a man went in with erectile disfunction, four different hormones were tested (including thyroid). So you see erectile disfunction is such a serious condition that could be life threatening, whereas your thyroid is a piffling thing.
You’re kidding me. Further fuel to the fire that poor thyroid management by the health service is as a result of sex discrimination. Same happens with PCOS, endometriosis and many others I’m sure.
Ah, maybe we should all claim erectile dis-function; GPs wouldn’t be able to discriminate if one is female as we are able to claim any sexual orientation we like and not doing the hormone tests would be discriminatory. (Tongue in cheek.)😁
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Why measure TSH when you have no thyroid.
Do all labs give the same comment on TSH?
ThyroidChange - Tell the ATA and AACE how YOU feel about their treatment guidelines
Will lowering T3 dose raise TSH?
