Does anyone know of a SINGLE thyroid test that includes all in the list below…

[Noelnoel]

TPOAbTgAb rT3TSHFT4FT3

Thanks

[SlowDragon Administrator]

Here

bluehorizonbloodtests.co.uk...

Requires private blood draw so that adds to the cost

[Noelnoel in reply to SlowDragon]

Thank you SD. Sorry to ask for more but are you aware of one that also includes an iron panel

[TiggerMe Ambassador]

bluehorizonbloodtests.co.uk...

[Noelnoel in reply to TiggerMe]

Thank you TM. Sorry to ask for more but are you aware of one that also includes an iron panel

[TiggerMe Ambassador in reply to Noelnoel]

I think Blue Horizon are the only company that do rT3

[Noelnoel in reply to TiggerMe]

Yes, I’ve been searching and haven’t found anything yet but helvella has provided a link which I’ll look into

[greygoose]

You don't need rT3. It's very expensive, irrelevant and doesn't give you any useful information that you can't get from testing just FT4 and FT3.

[Noelnoel in reply to greygoose]

Thank you gg but Paul Robinson has specifically requested it as a one-off and although I’ve read lots that suggests it isn’t useful, I’ve also read that it can be useful. Who does one believe🤷‍♀️

Obviously I prefer not to have the expense but if there’s a small chance that I can get to the bottom of a few questions then I’ll be happy

Thank you for your view on it

[greygoose in reply to Noelnoel]

Can you tell me in what way it can be useful? I'd be interested to know.

[Noelnoel in reply to greygoose]

jci.org/articles/view/111313

[helvella Administrator in reply to Noelnoel]

Forty years is a very long time!

Maybe some more recent research (this article is based on much more up to date information):

thyroidpatients.ca/2019/11/...

Or a search of that site for all rT3 references:

thyroidpatients.ca/?s=rt3

It isn't that rT3 testing doesn't ever tell us anything at all. But it might add nothing, or very little, and what it does add might be in a different area than the very obvious T4 and T3 pathways.

[Noelnoel in reply to helvella]

Forty years is a very long time!

It is!

Thank you for the links

[Noelnoel in reply to helvella]

Gosh, I’m none the wiser!

[Fruitandnutcase in reply to Noelnoel]

Out of curiosity - do you know the reason why Paul Robinson requests it as a one of?

[Noelnoel in reply to Fruitandnutcase]

Apparently it can block T3 and reduce certain enzymes that will have a negative effect on T4 to T3 conversion

I cannot pretend to have a deep understanding, I’m merely paraphrasing what I’ve read but while there’s a chance that the test will be relevant, I’ll get it done

[greygoose in reply to Noelnoel]

Apparently it can block T3 and reduce certain enzymes that will have a negative effect on T4 to T3 conversion

This is the old thinking about rT3. Research has moved on.

According to our late-lamented diogenes, it doesn't block T3 receptors, it has it's own receptors. It is totally inert and doesn't do anything, and only stays in the system for a couple of hours before being converted to T2.

Pretty certain it doesn't have any effect on any enzymes. And doesn't affect T4 to T3 conversion. It is the result of poor conversion, not the cause.

And to know how well you convert, you don't need to test rT3, just FT4 and FT3 and compare them. What is your FT4 level? It it's up near the top of the range then your rT3 is going to be high. That's just the way it is. But it doesn't mean anything. It's just a safety device the body has to stop you 'going hyper' - i.e. syphoning off some of the t4 and converting it to rT3 rather than FT3.

But what does he propose to do if your rT3 is high? Does he know that there are many, many causes of high rT3, and only one of them has anything to do with thyroid. So, he could be leading you up the garden path on that one.

[Noelnoel in reply to greygoose]

I’m still trying to get a feel for him really

Late Diogenes? I had no idea

As for knowing how well I convert? Impossible, I’m on Metavive

[greygoose in reply to Noelnoel]

So you don't even know how much T3 or T4 you're getting. In which case, how can Paul Robbinson help you? RT3 won't be of much help.

[Noelnoel in reply to greygoose]

Thanks

I have test results which show I’m getting plenty of T4 and T3. I’m happy with those levels. I need to work out what to do about cortisol. I think he can help with that. Whether that will be to add in a bit of T3 and drop a Metavive or two, I’m yet to find out

[waveylines in reply to greygoose]

It's interesting Greygoose. When I was put on Amiodarone post op for a month.....taken me 15months so far to sort out the mess that drug did to my ability to tolerate thyroid hormones. Nearly back to where I was. One of the features is the body converts into a lot of rt3. Amiodarone works also by blocking receptors and inhibiting conversion..I assumed the reason for the high rt3 was a way of getting rid of the t4 building up in the body? I never did a rt3 test itself but read about it in research docs about effects of Amiodarone.

So if your body can't convert aa well or absorb via the receptors is this how it reduces the levels? In which case you wouldnt be aware of this in a blood test for TSH ft4 & ft3. None of the Endos I saw during this period recommended testing for rt3. Though they knew about the drugs impact. They guesstimated about how long it eould do this for at about 6 months. Managed by lowering dose of thyroid hormones. Infact it's been 15months. The half life being 142 days. I wonder now if the rt3 might have been useful after all. Though the effects dtill would've been reduced treatment of thyroid hormones.

So if you have a problem with tolerating thyroid hormones given does an rt3 test help in knowing your body is resistant......

Like mine was albeit due to a drug inhibiting tolerance.

Sometimes I wonder how much science knows..... about this area...

[jgelliss in reply to greygoose]

👏👏👏👏👍

[helvella Administrator]

The Doctors Laboratory

tdlpathology.com/patients/

They do reverse T3 - and a massive range of other tests. But, as with many of these services, location might be important for phlebotomy. And cost.

They also say:

No appointment is required for routine tests (a doctor or clinic’s request form or referral letter is required)

[Noelnoel in reply to helvella]

Yes, thank you for that. I once took a Medichecks test there. It was fast and efficient and just a short journey from my home

[helenshubby]

I read only recently that a proper understanding of the effects of hypothyroidism only began in the ‘70’s. So a 40 year article would represent the understanding at that time. Early Days. We’ve gone to obtain T3 through a private prescription via Roseway Labs.

After 8 weeks on 2.5mcg Helen’s Ferritin, Cholesterol & bit D are are all up and her Cortisol jumped nearly 200 units, her t4 remained the same and ft3 went from 3.8 to 5.5. Also her CPR went from 2 to 1 suggesting that even a ‘normal’ high CPR may indicate you may have inflammation in your thyroid (could be something else but it went down on treatment which to me is no coincidence) and it took her TSH to a low normal. Prescriber said increasing to 5mcg not a good idea.

NHS Endo put Helen on 20 mcg day and reduced her Levi to 75 from 100 with predictable outcome. As someone previously said starting like that is like putting high octane fuel in a clapped out motor with predictable outcome results. Helen blew up - almost as if she was being set up to fail.