Hi I've not had my regular blood test, currently on 125 thyroxine, need to know what additional tests I should ask for when seeing GP?

[Thundafunda]

[skyfall]

I believe you need at least one panel - tT4, fT4, TSH, fT3, tT3, rT3 and thyroid antibodies (TG-autoantibody, TPO-autoantibody) to get a proper handle on thyroid function. Bear in mind the T4 only test and T4 + TSH test only gives you a tiny view of what's going on.

It tells you nothing about autoimmune status or T4 conversion to T3. Worse still the test results can be 'in range' and you can still feel rubbish. UK doctors often rely on these tests vs the how the patient is feeling.

In the US and Australia - this panel is standard practice.

Here standard practice is an annual test for fT4 and TSH.

I hope your GP cares about how you feel and not just ticking the 'are the test results in range?' box. Good luck.

[helvella Administrator in reply to skyfall]

skyfall,

It is perfectly possible that your experience of thyroid doctors in the USA has given you this impression. However, so far as I can see, rT3 is still regarded as somewhat non-standard. The quote below is from a reasonably well-respected USA site:

3. What is reverse T3?

Reverse T3 (RT3 or REVT3) is a biologically inactive form of T3. Normally, when T4 is converted to T3 in the body, a certain percentage of the T3 is in the form of RT3. When the body is under stress, such as during a serious illness, thyroid hormone levels may be outside of normal ranges even though there is no thyroid disease present. RT3 may be elevated in non-thyroidal conditions, particularly the stress of illness. It is generally recommended that thyroid testing be avoided in hospitalized patients or deferred until after a person has recovered from an acute illness. Use of the RT3 test remains controversial, and it is not widely requested.

labtestsonline.org/understa...

I have also seen very many USA patients saying that all they get tested is TSH or, sometimes TSH and FT4. Maybe they are the ones with bad doctors or inadequate insurance?

Rod

[nostoneunturned]

It would be remarkable if all the tests skyfall lists were to be done by your (presumably UK?)GP, even though without them a correct assessment is not possible.

But if your GP will not do them, ask him/her if you can pay for them to be done at the lab normally used by the practice when the UK standard TSH and FT4 are done. If this is possible in your area then it will be considerably cheaper than having them done completely privately.

[nostoneunturned in reply to nostoneunturned]

If you do have to go private Thyroid UK has info on private labs, 10% off if you mention Thyroid UK, check out the main site for confirmation of this and much other useful info.

thyroiduk.org.uk/tuk/testin...

[greygoose]

I wouldn't bother with the totals - tt4 and tt3 - they don't give you any useful information and are therefore a waste of money. What you want to know is how much usable hormone you have i.e. the frees - FT4 and FT3.

That's my opinion anyway, I don't claim to be an expert.

Hugs, Grey