My doctor’s surgery messaged that I was due for my annual medication review and arranged an appointment for a blood test. I went yesterday and after the blood was drawn I asked to see the test request form. I expected to see a number of tests including TSH and T4 as they don’t generally test for T3. To my surprise only the TSH test was requested.
Is testing only the TSH the new normal?
My mental image of the NHS thyroid treatment protocols - as normally applied by doctors and pharmacists apart from, and in ignorance of, some more recent research - is of a person stuck in the mud. If TSH only testing is part of a new protocol the person would now be up to their knees and slowly sinking. And turning to stone, taking us back into a thyroid treatment Stone Age.
I expect to be having an Alice in Wonderland conversation with the pharmacist soon.
Testing TSH alone is very common amongst members but some do get TSH and FT4, I imagine this depends on your local health board's policy. My local health board (in north Wales) does TSH and FT4.
We all know that testing just TSH is inadequate, that information seems to have by passed the medical profession (along with the fact that FT3 is the most important test) which is why so many of us do private tests to include TSH, FT4 and FT3.
Often when GP request TSH or TFT (thyroid function test) the lab system is set up so that FT4 is tested if TSH abnormal.
It’s totally inadequate as the TSH is not reliable and even if in range it doesn’t tell you what your thyroid levels are.
Many arrange private test to gain a full picture as NSH rarely test FT3 and nutrients.
List of companies offering different options, some packages include thyroid function, only (TSH, FT4 & FT3) other include key nutrients and thyroid Antibodies. Some also have discount codes available.
You order test online the kits arrives via post sample taken by finger prick (extra fee for private venous draw). Post back and results available online quite quickly.
I was chatting to the vet and asked how they test for thyroid problems in animals. They do TSH, T4, T3, iron and selenium! They know that the animals need selenium and the soil in the UK has low selenium.
Of course they charge for it, but the animal gets better treatment than humans!
I asked my dog's vet if he would be my doctor. He's wonderful, every time we go it's like being in vet school, you get a full explanation of every possibility for the reason you've taken your dog, and what would be the treatment, then we decide how to go forward, always the simplest thing first and this tends to be the correct treatment. Never rushed and always happy to have an in depth conversation.
She's an old dog now and has funny little ways and really doesn't like going (she's had anal gland problems and nobody would want to go after having those emptied!), but he understands her and knows exactly how to treat/handle her. I wish my GP was half as interested in their patients as he is.
TSH-only testing means that doctors can no longer diagnose Central Hypothyroidism (CH) where the pituitary can't produce sufficient TSH for the body's needs.
Depending on how effective the pituitary is in CH, and what caused it to malfunction, a sufferer could have anything from a TSH of zero up to a smidgen over the range. If that wasn't enough for the patient's needs then they will have low or very low levels or under the range levels of Free T4 and Free T3.
The person with non-existent or very low levels of TSH due to CH might find themselves being investigated for Graves' Disease / hyperthyroidism when actually they are hypothyroid and may have been for many years or even their entire life.
I sought advice from a similar thyroid charity in the uk and they are actively supporting tsh only and not to waste my money on private testing which I've been doing for a long time now!! I despair! My dentist is actually more clued on health matters than my GPs!
I believe other thyroid charities present themselves as patient led but in reality are a front for pharmaceutical companies and members of the medical profession who are fixed in their thinking. Best ignored.
yes thanks ScotPoodle you are right. 'They' seem to go backwards regarding thyroid treatment and fixed thinking is a poor attitude for any health condition.
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Blood test range change
Private blood test 
Blood test
Graves - blood test
New blood results T3, T4, TSH
