I have Hypertyroidism / Graves disease - diagnosed April 2023. Treated with Carbimazole. Thankfully , I have been in remission since May 2024 and have had steady in range blood test results now since then until for sure December 2024 (while not taking Carbimazole ) - having throughout had regular / monthly TSH,FT3 and FT4 blood tests .
I am seeing the consultant on 17 February and have just had the blood test which will decide if I am still in remission and if he can put me on a cycle of checking up on me annually ( or not and instead a different plan if tests suggest otherwise ).
However, on this blood test the consultant only asked for the TSH and FT3 blood tests - not included FT4.
I checked back with him via the admin team and they came back with the message that he doesn't need the FT4 and can make his decisions re on going care on the TSH and FT3 alone.
I am keen to know the community views on this please?
My own are that it makes sense to do FT4 as well -if nothing else for consistency ; but also that the two T3/ T4 together help in analysing the progression of Graves. TSH only gives an indication that all is well with the thyroid gland .... but only an indication / likelihood. I quite like but certainties rather than just likelihoods! What do you think please? Should I insist on the FT4 as well?
Many thanks
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Littlefoot1thyroiduk
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Thank you ! All makes sense . I'll see what my GP can do - she's very receptive .. should be able to get done in time . Whatever, I will interrogate consultant on ongoing care and monitoring - see if I can wangle extra tests ... especially as:
... not only do I have asthma treated since age 12 and long term use of steroids ( if only I knew what they did but was a breathing or not choice so .... ) ; .. but also osteoporosis ( now being treated with extra daily VIT D and annual Zolendronate infusions ; silent acid reflux ( LPR) - treated with -Lansoprazole 15mg daily; and I recently went down with a bad chest infection - again - so antibiotics will have striped me of anything good!
And have a stressful job / self employed and sole wage earner and stressful home life with 3 chaps in the family all suffering debilitating mental illnesses. No wonder I have hyPERthyroidism - had to to cope with that lot ( said jokingly) .. think of the energiser batter advert! 😀
A TSH and T3 is better than a TSH and T4 - as T4 converts to T3 in the body -
so if your T3 is at a high enough level for you not to have any symptoms of hypothyroidism I guess the thinking is you must have enough T4 circulating in order to support this level of T3 and don't have problems in your body, converting T4 into T3 -
The body runs on T3 and not T4 -
though the NHS don't generally measure or prescribe T3 in primary care - which makes a mockery of the whole monitoring and dosing of the thyroid blood tests run in primary care - however - moving on -
you can live without T4 but you can't live without a good solid level of T3 circulating in your blood stream with the majority taken up to keep your heart functioning and your brain alive.
The TSH when with Graves is very much controlled by the immune system with antibodies sitting on TSH receptor sites and pushing them down - so if your TSH has recovered and now not suppressed and back in the range - it likely means this phase of Graves is over and any antibodies circulating in your blood stream of no significance.
For the sake of around £2 which is a rough guess at how much it costs to process a biomarker ( it was just under £1 - some 7/8 years ago ) peace of your mind isn't a consideration.
I now arrange my own private blood tests yearly so I can see my TSH, T3 and T4 and just as importantly I get my core strength vitamins and minerals run -
as ferritin, folate, B12 and vitamin D are the corner stones of your health and well being and these need to be maintained at optimal levels, whether with or without a thyroid health issue as when the thyroid malfunctions and metabolism runs faster and slower than ones ' normal ' and or is slowed with the AT drugs and the body will struggle to extract key nutrients through food no matter how well and clean you eat, and levels can nose dive through ranges.
So, if you wish Thyroid Uk - the charity who supports this patient to patient open forum have a page dedicated to Private blood test companies - I arrange an Advanced Thyroid Function test which is around 10/11 biomarkers and pay to have a nurse to come to my house to draw my blood.
I doubt there is time to get this arranged and back before your appointment if that was the idea but there are also faster turn around finger prick blood test kits for just the TSH, T3 and T4 with one company Monitor My Health being a NHS laboratory so the results should in theory be accepted by your doctor/consultant.
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Blood Test ft3 ft4 TSH - Round 2
Cam someone explain in simple terms please?
Hmmmm..... results in - should I be pleased or not ??
High TSH despite high FT4
