Endo's blood test approach- advice please?

[Thyro12]

Hi all,I have been given a trial of T3 from a private Endo with the view of doing a blood test in 8 weeks to check progress.

His instruction was to take the last dose of both my Levo and T3 four hours before blood draw and he did not seem bothered about whether I ate or not before the test or the time of the blood test.

However, I have always followed the advice from this forum and taken the last does of Levo exactly 24hrs before the blood test which I always did before 9am and on and empty stomach. His advice is contradictory to this 🙄.

I wonder if someone could possibly advise on the best approach please?

Thank you 😉

[greygoose]

If I were you, I'd continue to follow the advice on here. This does happen that endos say weird things about blood test protocol and I wonder if it is just ignorance or if they do it deliberately with a view to reducing doses and/or stopping T3. I wouldn't put it past them! You have to learn to play them at their own game and - as my mother once said - smile sweetly and agree, then go home and do as you damned-well please!

[Thyro12 in reply to greygoose]

Thank you for this info Greygoose, and very wise words! Although he did seem knowledgeable, I did wonder at this advice! I will stay consistent with my usual approach to tests! 😉

[greygoose in reply to Thyro12]

So, if he was knowledgeable, that means he knew what he was doing and did it deliberately! That is shocking!

[Thyro12 in reply to greygoose]

Sorry, I meant he seemed knowledgeable re treating the thyroid and the importance of vitamins etc. He seemed genuine enough from what I could see. I will stick with my usual approach to blood tests!

[greygoose in reply to Thyro12]

Yes, I know what you meant.

[Brightness14 in reply to greygoose]

Your Mother sounds brilliant, good advice.

[tattybogle]

See my replies to this post :

healthunlocked.com/thyroidu...

links to a couple of papers explaining scientifically why early a.m testing 24hrs from last dose Levo is recommended.

You endo wants to see the highest peak that fT3 reaches, hence asking for 3 hr gap from T3 dose as this is when it is expected to be highest .

Whether you comply honestly with this request or not, is up to you.

Unless they stick you in an enclosed room with an observer, for 3 hrs before the test , you will be the only one who knows when you actually took the last dose.

Personally i would want to know 'for myself' how high the highest point of the peak was and what it was @12 hrs (or later if i usually took T3 as one dose) , so i'd test privately @ 3 hrs to get this info. But whether i would ever let a GP/ endo test @3 hrs would depend on what i though thier motivation was ... if they were wanting an intelligent conversation about how many hours blood fT3levels were that high for vs. what portion of the day levels were in range or below , and the balance of any risks this may entail , then i'd be willing to do a 3 hr test for them .

But if it was to be used as an isolated measure of "it's over range, you must lower the dose , or else your head will explode , i'll be responsible for that (and i'll get it in the neck from the other endo's in the department) " ..... then i would give them a 12 hr test and just keep shtum.

[Thyro12 in reply to tattybogle]

Thank you tattybogle for this very useful information. I find the less said to endo's the better 😉.

Just to see if I understand you properly, last dose of Levo 24hrs before blood draw and last dose of T3 12hrs before blood draw?

I will take my Levo plus T3 in the morning and then the next dose of T3 at lunchtime (I don't have T3 yet as waiting for prescription from Roseway).

I am having trouble getting an apt earlier than 11am as the endo's apts are few and far between! I assume this is still too late?

Thanks again 😁

[tattybogle in reply to Thyro12]

yes levo 24hrs / T3 12 hrs .

there;s a clear graph in a reply to this post : healthunlocked.com/thyroidu...

which gives an idea of what fT3 level does after each dose.

TSH will be highest middle of the night /very early am , and falls gradually to it lowest around 1-3pm . then rises slowly again. So best chance of TSH being in range is going to be 9 am rather than 11am

but .... if you have to test at 11am and TSH is lower than endo likes , you can always go with " oh well, i know it's close to it's lowest point @11, and would have been a little higher if i'd tested @9 am"

[Thyro12 in reply to tattybogle]

Thanks tattybogle, that makes sense 😁