Should T3 or T4 be checked?

[Newbee2000]

Hi, I have hashimoto's and hypothyroid. Two and half weeks ago my labs indicated my TSH was down to 1, yet I still have symptoms: some constipation, sometimes numbness in hands (I was dx w/ carpal tunnel after hypo dx),  still have heart palps when I'm in laying down in bed, and still have slight tingling in feet.  My symptoms aren't as severe as earlier in year when TSH was high, but I'm still having them w/ TSH at 1. My endocrinologist told me he doesn't check T3 or T4, he only checks TSH number.  Should I ask to have T3 or T4 checked?? Could my T3 be a problem. Shouldn't I be feeling completely well w/ TSH of 1?  I take 75mcg of Synthroid. -- thanks

[Tiffany08]

I don't know much about T3 or T4 levels, but I have Graves Disease and hypothyroidism after a sub-total about 15 years ago because of a goiter. I have also been trying to get pregnant, so I have been paying attention to the TSH levels, as that could cause problems. I think that the whole thing is like a see-saw...when your TSH is too low, you are hyPER, and when they are high you are hyPO. I have been dealing with this since I was 14, I'm now 28 and still don't completely understand it all. I had my levels down to 0.01 and my doctor lowered my synthroid. He said the levels can fluctuate, and some docs aren't as picky, but they should be between 1 and 3, closer to 1 if you're trying to get pregnant. I didn't feel good at all when my levels were that low and I feel much better when they are between 1 and 2. You can always change doctors if you don't think they are treating you properly. My levels are regulated by my ob/gyn only because we are trying to get pregnant. I would change doctors if they want your levels to stay at 0.01 personally.

[patient-x]

My lips turn blue & I shiver.
I dont smoke either
I have no goiter though

Thought I understood the results
but then my results this time came back
TSH    0.01
T3     2.7
T4    13.0

I was convinced by symptoms was hyper again.
But, doc said results normal! so no change in meds.

I feel really unwell at the mo, back to how ill I was when first
diagnosed.

Am I hyper/hypo......?
I dont know anymore!

[Mark Lupo, M.D.]

The symptoms are suggestive, but not specific for, persistent hypothyroidism.  When the TSH is around 1 and there are still these types of symptoms then I sometimes try T4/T3 combination therapy (ie add some cytomel to synthroid -- but working with a doctor who uses cytomel routinely as many do not understand that it should be dosed am and early afternoon and is 4x as potent as synthroid).

Testing T4 and T3 may shed some light on things as well and I have found this useful in many cases....

[Shanine]

Hi, I had a Dr's visit today, but what I went for was to find out what caused my lips to turn black.  I do not smoke and I could not figure out what was going on with them.  He told me I had the nodular goiter thing.  They drew some blood to run tests to find out what was going on with my thyroids and what was making me so tired and what ever else was going on if anything.  I just feel like I am falling apart.I had not been to the Dr. since June that is when I had the ultrasound down to find out about my thyroids.  They just told me some of what is going on.  My T3 and T4 will be checked.  I have not a clue.  I am not medically knowlegeable in some things.

[borninquisitive]

I am no authority on this and hearing what the doc has to say, will be interesting.
Just in my reading 'ventures', I have seen some with good TSH values but would not have good FT3/4 values. As have I seen good numbers with a thyroid panel...but elevated antibodies.

Beings you have a known condition, treated for it and still having symptoms...it certainly would be reasonable to look into your frees. Even if only for your peace of mind.
Your request isn't for some expensive, un-related tests...for crying out loud.

If your doctor is being bull-headed about it and your curiosity must be satisfied, you can get legitimate testing done, without doctor's orders: http://www.healthcheckusa.com/lab_tests/Thyroid_Screenings/Thyroid_Panel_II

I went this route. The lab that this site sent me to, was a "Lab One"...one of the labs (a chain) our doctor's office uses.

I do believe code 12345 is long-standing and will take 10% off your order.

Best!