Hello all. I am on T3 Liothyronine medication. Therefore my blood test results look abnormal compared to someone on T4.
I have spinal stenosis and need lumbar and cervical decompression operations. I was all set to have the lumbar op. done on the 22 nd Feb.( Last week} when it was cancelled after the aneathstatist saw my blood test results from thee Pre-Op.
Even though my GP has sent information to explain why they don't look normal. He still won't do the operation. The surgeon is still willing to do it however. Has anyone had a similar experience? I have been transfered to another hospital to see if there is an aneathstatist there who will do it.
I would be grateful for any feedback please.
Thank you
Written by
Everdean
To view profiles and participate in discussions please or .
I’ve had a similar experience when I was scheduled for a Knee Replacement op.
Eventually another anaesthetist stepped in.
Did the pre - op bloods show a low/suppressed TSH or FT3 and FT4 which were over range? If Frees are over range this is overmedication and the anaesthetist’s hesitancy is justified. If it’s just a matter of TSH it’s another scandalous example of what we have to put up with.
The anaesthetist is in charge of the surgery and has the last call.
Edit
Just looked at your profile and see you have Osteoporosis! That will be power to his elbow if he’s refusing in the grounds of TSH 😬
Ahh! Infact I think there are other reasons for my osteoporosis. I had 12 months of unnecessery chemotherapy before diagnosis. Also I had very low thyroid hormones for a long time before getting diagnosed and supplimented properly.
I took a private gene test And I have the Dio2 gene problem , which forced their hand to put me in the hands of an Endo who thankfully immediately prescribed T3 for life.
I have Osteoporosis which was diagnosed long before I ever took thyroid hormones. However, that doesn’t stop an annual battle with endos who will accept no explanation for my TSH other than that I take T3.
It is a fight that goes on - defying logic, explanation or published research material which refutes any links between TSH and Osteoporosis or heart disease.
TSH is not a thyroid hormone. It’s a pituitary hormone which rises when thyroid levels are low. When we take T3, it suppresses TSH because we have sufficient thyroid hormone to function. Low or suppressed TSH does not cause broken bones or AF. Levels of FT4 and FT3 which are too high may well do
Try explaining that to an anaesthetist. Most endos have no grasp of this concept 😉
It's a well known fact in the endocrine world that long term high dose levothyroxine is a cause of osteoporosis too. T3 meds haven't been studied for long enough to warrant being a cause for osteoporosis. Another cause would be high fT4 & Ft3 due to unmedicated and unstable hyperthyroidism. Many Doctors are not knowledgeable enough to understand thyroid disease and medication effects. :/
This poor person is the victim of ignorance and poor knowledge.
First of all, I think it's easier to qualify these days, and secondly, there is a degree of hubris among young doctors. One even had the gall to tell me that he was qualified to advise me on my rare blood cancer because he had "looked it up" (the night before).
Yup. I went into hospital with stomach ache that turned out to be pancreatitis and inflamed gall bladder. Without any discussion of my diet, drinking or anything, they first diagnosed gall stones and then, with no stones visible in an MRI, they said they wanted to remove my gall bladder. The second day I was there, a young doctor approached me and said that he thought an aspirin a day was not enough (I am prescribed it for MDS/MPN - rare blood cancer), and that he proposed increasing my blood thinners. I said that nothing like that was to be done without talking to my haematologist (at another hospital) and he said that wasn't something they would do. The next morning he came and said he had looked up my condition, upheld his view, and presented me with a huge hypodermic syringe. I said No you don't, and the nurse in charge was behind me in my decision. I was quickly discharged (along with several other patients), as by then, I was well - no jaundice or stomach ache.
By a strange fluke, my partner was in the same hospital, so I had been able to visit him while I was there, which I wouldn't normally have done, it being some distance from home and I didn't know my way around.
The day after my discharge, they decided to discharge my partner who is crazy with hyperglycaemia (don't ask), and then they phoned me up and asked me to go back for an MRI the next day. I had to be at home for my partner, without even having a chance to recover from three days in bed. I did go back a couple of weeks later for the MRI; by that time my partner was back in our regular hospital. I was 79 and he was 83.
After the MRI I received a letter from the hospital saying they wanted to perform keyhole surgery to remove my gall bladder, and I went to see my GP. He was on the same page as me. Why have surgery when you've lived a long life without anything like this? Apparently, I have sludge in my bile duct (who hasn't?) but I've been fine since being on a drip with antibiotics.
Do you test as recommended early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
No I came off steroids completely several months ago. I have a kit to test my cortisol levels next week.
I am only on T3 . I don't feel well on any T4
Yes I am dairy free as I feel ill when I have dairy except some sheeps milk yoghurt sometimes.
I am on Moorningside T3. I know this has some lactose in but thought I was tollerating it. Maybe not. As I am on 50mcg per day now.
Should I request another blood test? Only the head of the laboratory who does the testing for our practice said not to bother testing as their tests arent suitable for those on T3. So the GP doesnt bother testing. They just go on my symptoms.
Not sure where to go from here as even if I did a private blood test the Anethstatist my may not accept it
thank you Slow dragon ,but I wonder if the hospital will accept a private test anyway, especially if they do their own pre op test at any time of day or evening.
Just shows how much of an ignoramus he is as it’s an NHS Lab!! He has a God complex me thinks and that bubble really does need bursting because it will be hurting his patients !! It’s for a similar reason I went to a private Endo!
Do you normally split your T3 or do you normally take as single dose
If test was done 2-3 hours after a single dose of 50mcg T3 your Ft3 result would most likely be dramatically over range and anaesthetist would be unlikely to agree to operate
I take a single dose in the morning. But I didn't didn't know about the blood rest results of that. So thank you Slow Dragon. However there would have been 10 hours between taking the full dose and the blood test. How would that affect the results please?
Yes I always request them. But apart from telling me on the phonecwhatcthecresulrs we're to prompt them refusal. I have found this whole Spinal thing along with the pain extremely stressful and exhausting, traveling back and forth to the GP and to a hospital in another town and finding lifts.
Very very frustrating for you. I have had similar experiences when an anaesthetist perceives the anaesthetic risk outweighs the potential urgency or benefit of the op especially when the op is not deemed ‘life saving’. The anaesthetists are now the primary gatekeepers for nhs operations and you may find yourself going round in circles.
options- Get your surgeon to reinforce urgency, get an endocrinologist /clinician to confirm no issue with TSH,ft4, ft3, challenge them with scientific evidence to refute their (poor) understanding of TSH, and/or the impact of cauda equina. If there was an emergency they would have to do it irrespective of risk.
Thank you bikebabe. I'm relying on my surgeon to be on my side and find a new anaesthatist in the other hospital. I have written to his secretary for some feedback on the issue , but no reply as yet. My Gp sent all the relevant info including the Endo's letter about it, but that didn't help. maybe the new hospital will accept, but no guarantees. I will post again when I know more as it seems this issue could be a problem for many on T3.
If there was an emergency they would have to do it irrespective of risk.
That’s absolutely right - but, as you say, they’d look at balance of benefit v risk
The anaesthetist is the gatekeeper because the patient’s life is literally in his / her hands. Even senior surgeons defer to them.
I’ve had 12 surgeries and on each occasion just before being taken for surgery have had a visit to my hospital bed from the anaesthetist to check whether I was fit enough for surgery.
Sorry to hear this. I may need a neck op and am also on T3 only but self-treat. Ive read about this problem on thyroid sites too, its very annoying. They certainly woñt like my results.😩 It will be very difficult to get a test before 9 unless the pre-op is done at that time. Hope you get it sorted.Janexxx😊❤️
My results came into a place where all in range so they couldn’t argue on that score. But then there was something else that put me on another ‘cycle’ of delays. Might I be cheeky and ask what gene test you had?
It’s also worth noting that low nutrient levels and cortisol issues can stop or slow down conversion. Some medications and supplements too - for example Propranalol (Beta Blocker) and Alpha Lipoic Acid (supplement for nerve pain).
It’s worth checking every new med or supplement we take. We can’t just assume conversion is going to be ‘ok’ because we haven’t got a faulty gene.
Some anaesthetists do take fright, some justified.
You can usually find another anaesthetist who is willing to cover your surgeon. Ask your surgeon. Sometimes the same surgeon works at another hospital.
It is also possible to find another anaesthetist who would do it privately- but that is costly.
I also take only T3 for many yrs. you may be able to show you normally have consistently high T3 but you are well on those levels
My Tsh is at the bottom, so is my T4 because I have no thyroid at all, either my body destroyed it or a virus did. There wasn’t enough left to biopsy 30yrs ago.
I have found it helpful to make an appmt to speak to the anaesthetist. But if this one has pulled up the draw bridge,, try your surgeon
Yet, on the other hand, I recently had an NHS hip replacement at a private hospital and my thyroud status was not even discussed. I just continued taking my T3 as normal, and my TSH is undetectable. Mad, innit?!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
thyroid blood test results
Thyroid blood test results 
Abnormal Blood Results
Thyroid blood test results
Blood test results
