Help with asking gp to test Free T3

[Macey2009]

At present my gp monitors my thyroid function every 6 months.

This is due to possible development of autoimmune thyroid disease in future (raided TPO antibodies >1000)

They only test TSH and Free T4

Would it be beneficial at this point to have TSH +FT3+FT4 tested together?

And if so does anyone have any suggestions on how i could persuade my gp to test it? I know they can be reluctant to or the lab may refuse it anyway.

But if you don't ask you don't get lol.

[SeasideSusie Remembering]

Macey2009

No, it wont be beneficial. You are without a diagnosis because your TSH is still in the "2s". Knowing your FT3 level wont make any difference or persuade your GP to diagnose I'm afraid. It's all down to your TSH at this stage. Even if your GP did agree to test it it's almost certain the lab will reject the request due to your other test results being in range. They generally only test FT3 when TSH is below range.

[Macey2009 in reply to SeasideSusie]

OK. Thanks for replying. Is Free T3 only useful when diagnosed then? I get confused as i always see posts about how it's important to test all 3 for a full picture.

[SeasideSusie Remembering in reply to Macey2009]

Macey2009

Once you have a diagnosis and are on Levo, it takes a few months to reach optimal level of medication. The aim is to have optimal hormone levels where we feel well, this is usually when TSH is 1 or below and FT4 and FT3 are in the upper part of their reference ranges.

If we still have symptoms at this stage we look at how well we are converting T4 to T3, we do this by testing FT4 and FT3 at the same time and comparing the results. If FT4 is high and FT3 is low our conversion is poor, if they are reasonably well balanced then that shows our conversion is OK.

[Macey2009 in reply to SeasideSusie]

OK thanks. I was confused because i always see posts about how important it is to test all 3 together. And if its the free t3 that causes symptoms i thought it might be helpful to know what that is to get a full picture.

[SeasideSusie Remembering in reply to Macey2009]

Yes, definitely further down the line but not useful for you at the moment, the first thing you need is a diagnosis and you will only get that when your TSH goes over range at the same time your antibodies are raised.

[Macey2009 in reply to SeasideSusie]

OK thank you. Think i read too that a TSH over 2 shows signs of thyoid struggling so maybe now it's gone from 2.8 to 2.2 it's not struggling now? 🙄

[SeasideSusie Remembering in reply to Macey2009]

Here is a graph of TSH levels in healthy people:

healthunlocked.com/thyroidu...

The mode level (the level that appears most frequently) is about 1.2 but you can see that there are still people who have it higher or lower and that is their normal level in health.

None of us were tested in health to get a baseline so we don't know what our own "normal" is.

You have raised antibodies so you are at risk of hypothyroidism if your immune system attacks your thyroid enough to destroy it to the point it causes hypothyroidism. This will not be diagnosed until your TSH goes over range.

It has already been explained in previous replies about your TSH levels fluctuating slightly, and it is only slight at the moment - 2.5 to 2.8 to 2.2 are all normal fluctuations one would expect to see because, as mentioned before, nothing is static. As I said, you can test your TSH now and again in 5 minutes time and they will be slightly different.

[Macey2009 in reply to SeasideSusie]

Thanks for explaining. I guess i had convinced myself that the TSH was going to rise again slightly and felt down when it hadn't.