The need for FT4, FT3 and TSH tests

[Dariab]

Hi.

Sorry I've written about this before and cannot find the responses to my question.

I have an appointment with my endocrinologist tomorrow morning. I asked if I could have Free T4 and T3 and TSH tests done. I made it clear in my request that I needed all 3. Frustratingly I had blood tests done recently and they only requested FT3. There were other tests done but not the Free T4 and TSH. Can you help me to explain to the consultant the importance of all 3 being done at the same time so I can pass this information on.

Also is there any other tests that are key that I need to mention?

Just to provide some background, I had some surgery to remove a cyst on my pituitary gland earlier this year. I was on hydrocortisone and levothyroxine just before and after the surgery as my cortisone and thyroid levels were affected. So far, I have been able to come off the medication but I need the correct follow-up tests to check.

Thank you

[Regenallotment]

hi Dariab

I use Monitor My Health which has a £26 thyroid function test of TSH, T3 and T4.

Use the code Thyroiduk10 at checkout to get the £26 price.

It’s a finger prick test you do yourself and post off to them.

Avoid biotin supplements eg B Complex for 3-7 days before testing. Test in the morning eg 8am before you eat. No Levo for 24 hours before. (I think you said you stopped taking medication - did that include you Levo hormone replacement?)

Hope that helps 🦋💚🦋

[Dariab in reply to Regenallotment]

That is helpful, thanks. I forgot this time about pausing the vitamin B complex I take prior to the test so it needs to be repeated. Thanks again.

[JannSimpson in reply to Regenallotment]

Can someone in the US use Monitor My health?

[Regenallotment in reply to JannSimpson]

Hi JannSimpson I've just read your Bio - wow, so similar. I am tempted to find out if I have Graves antibodies too... I don't quite fit the Hashi's only profile.

Medichecks are in the UK, but I remember reading in Izabella Wentz books about US labs, here is a link to her site thyroidpharmacist.com/resou...

If you scroll down she lists the Ulta thyroid panel ultalabtests.com/partners/t...

I haven't used these as I am UK based, just read about them in the book so I can't comment on how competitive the pricing is or how effective the testing is. Or if insurance will pay for it?

Amazing work on your self advocacy, inspirational!

🦋💚🦋

[JannSimpson in reply to Regenallotment]

Thank you so much! Yes I'm still a work in progress too. Hopefully one day I will pin point all of my triggers and my levels will be back to normal. Im looking at Iodine deficiency now. Good luck with your research as well and wishing much Health to you! 😊👍

[SlowDragon Administrator]

Even in normal circumstances we all need TSH, Ft4 and Ft3 tested

But as your pituitary isn’t functioning correctly, it’s even more essential

Low thyroid levels tend to result in low vitamin levels too so important to test these as well

Similarly high cholesterol linked to struggling thyroid levels, so is also a good indicator

For full Thyroid evaluation you need TSH, FT4 and FT3

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Recommended on here that all thyroid blood tests early morning, ideally just before 9am (and if on levothyroxine…last dose levothyroxine 24 hours before test )

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

[Dariab in reply to SlowDragon]

thank you for your thorough response. I have had my vitamin D and B12 checked and have started taking supplements. I also had my folate and ferritin levels checked. Its interesting what you say about cholesterol as mine is a little high. And I have a pretty good diet I think in terms of saturated and unsaturated fats. I will discuss with endocrinologist tomorrow. I think I may have to do the postal testing service but fingers crossed I can persuade them to do them all that same time. Many thanks for your advice I do appreciate it. I realise now that this time I didn't stop my vitamin B complex before the test so it won't be accurate.

[SlowDragon Administrator in reply to Dariab]

So if vitamin levels are dropping and cholesterol is rising that suggests thyroid is struggling

[Lalatoot]

As the cyst affected your pituitary gland you cannot rely on the pituitary functioning perfectly. It's job is to stimulate the thyroid by sending out thyroid stimulating hormone. If the pituitary is not working right then the level of TSH will not be right either. Therefore it is really important to know what the levels of your thyroid hormones are ft4 and ft3. It is important to monitor these levels .

[Dariab in reply to Lalatoot]

Thank you for taking the time to reply.

[shaws Administrator]

If you click on your name it will take you to your personal page where we usually put our thyroid history until we're diagnosed.

It also give members some background of the patient's journey to be diagnosed without having to make the same statement frequently.

It will also link you to your previous queries.