Hi currently on levothyroxine 74mg but still struggle with tiredness, weight gain etc. My GP does not test my T3 levels but say my TSH and T4 levels are fine and there is nothing more they can do - totally fed up- any advice? Thank you in advance.
Can I insist on a T3 test?: Hi currently on... - Thyroid UK
Can I insist on a T3 test?
GP can refuse to test as TSH alone is deemed sufficient & FT4 tested if TSH not in range.
Even if GPs do order on blood test on form the lab likely automatically remove test for it.
It’s why many feel forced to pay privately for full thyroid function tests.
What were your actual results? Do you review yourself? Obtain printout via reception (don’t ask doctor) or arrange online access. Don’t accept verbal or hand scribbled notes you need a printed copy with ranges (ranges vary between labs so essential). They shouldn’t ask why but if they do try to be obstructive just say for your records. You are legally entitled to your records.
Most feel well when TSH around 1 and FT4 in top 3rd of range. “In range” might be TSH of 4 and FT4 just in range.
How do you test? Recommended you have draw taken first thing in morning after fasting (except water) delay dose until after draw.
Stop taking any supplements containing biotin week before test (can skew results)
Manzany
Not a good idea to insist on anything, it sort of gets up GP's noses when patients demand things. Better to ask but even if GP agrees to request it it's up to the lab to decide, they generally only test FT3 when TSH is suppressed. This is why hundreds of us here use private labs when we need tests that the GP can't or wont agree to.
For basic TSH, FT4 and FT3 then MonitorMyHealth is cheapest at £26.10 when using the code here:
thyroiduk.org/help-and-supp...
If you want to include antibodies and vitamins then check out Blue Horizon and Medichecks (scroll up the page linked to above).
What are the current results for TSH and FT4 that your GP says are fine? Can you post them, along with their reference ranges (ranges vary from lab to lab). If you don't have them you may have online access to them (although not all surgeries offer this) or just ask the receptionist for a print out.
75mcg is only one step up from starter dose
Unless very petite, likely under medicated
Essential to test vitamin D, folate ferritin and B12 too at least annually
Being under medicated leads to low vitamin levels
Low vitamin levels leads to poor conversion of FT4 to Ft3
Poor conversion tends to result in low TSH, high FT4 and even lower Ft3
All thyroid tests should be done as early as possible in morning before eating or drinking anything apart from water and last dose levothyroxine 24 hours before test
Come back with new post once you get results
Hi Tiredness I take iron...liquid iron (floradix) from Holland & Barrett. Plus hi strength vit B supplement. Keep your vitamin D within range too. You can send off for fingerprick blood test to check yr vit D level. Lab in Birmingham cant remember name got it off this forum. Stop eating bread, try to cut out gluten much as possible. And pester your GP till he/she increases your dose of levo. I'm 58 and always thought, think I read it somewhere that dangerous for your heart if you take too high dose as get older. I'm currently on 125 mcg daily keeps my TSH under 1 however last blood test was just over 1. Weight loss?? Good luck with that! I find only way is intermittent fasting which I've been told hampers conversion (T4 to T3) but only way I can keep my weight down.
Not sure if this is of any help but when I felt dreadful on Levothyroxine it was eventually found that I needed T3 not Levo. Knowing more now I realise this is because I live in a damp house - not something I'll do again from choice - and I wonder if by any chance you are subject to damp? Or perhaps have the gene that means you don't convert T4 (eg Levo) into T3?