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
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Everdean
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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.
"Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins" - what is with that? It's becoming the same in Poland. My endo always used to put that on my test order and now declares it is unnecessary. Global algorithm?
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.
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.
Sounds like a young and foolish doctor looking to have a bit of experience and fun by doing unnecessary operation. Good for you for sticking to your guns!
Well, the consultant wasn't all that young, but I did suspect what you say. However, my haematologist said she probably would have said the same thing, which I find a bit worrying. I've got enough going on in my life to start having operations.
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.
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?
B12 injections I haven't had a vitamin test for about 6-8 months.
The latest in my saga is that the Anethstatist wants me to have a consultation with an Endo. Iv'e asked to see the one who prescribed the T3. Hoping that will happen.
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
PS. I even had a heart operation in 2017 with those results.
I have a difficult intubation history so I obtained an appmt with the chief anaesthetist- chosen by my surgeon. We spoke 2 hrs. He went away and used models to work out how to intubate me successfully. There were no problems in the ooo operation.
A yr later I had a bad ankle fracture, Weber B and was admitted to another hospital. I refused to let them operate until they had spoken to Simon to understand the issues. They couldn’t see there would be major issues but 3 days after they had spoken to Simon they said ‘no operation’
I was eventually transferred to my main hosp abs saw a lovely orthopaedic surgeon who got me an exogen machine. Even with that it took 90 wks!!!🙀 for all the bones to heal.
I was so pleased I had stood my ground a d The wonderful anaesthetist who took the time and effort to make sure I was kept safe.
So discuss with your surgeon what your anaesthetic options could be.
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?!
I thought it was ignorant and dismissive of our rare syndromes that the few doctors who do know anything about them admit that they are a challenge to understand and treat, never mind so rare that the funding just doesn't cover vital research, and yes, it belittles the hours we spend looking things up into the early hours. I wonder where he looked "it" up and how long he spent doing his research. He didn't ask me any questions about it, hiding the fact that he knew nothing, and fair enough; no-one expects doctors to know everything, but saying that he had looked it up shines a spotlight on his crass ignorance. I doubt he understood (any more than I do) what it means to have a crossover diagnosis and why I only take a little aspirin per day - because we can get both blood clots and haemoraging. Does looking something up about a complex subject confer expertise on the person doing the reading? I very much doubt that he would have considered the information might help him further his career.
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