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TSH Testing-Incomplete testing?
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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TSH Testing-Incomplete testing?

Dear Doc,
Why do some doctors only test TSH when that number can come back within the normal range and yet the Free T4 can be low and causing a person to suffer hypothyroid symptoms?  It seems as though the TSH test alone is an incomplete test!  Also, can men suffer hypothroid?  Thank you!
Anne
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499534_tn?1328707778
You need to find a new doctor....if the only test he is running is a TSH, then he/or she knows nothing about the thyroid and how to Properly treat it. You should have a TSH, Free T4, Free T3 and the antibody tests run to see if that is why you are hypo...or hyper.
What is your history? What was your TSH results?

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561964_tn?1283802216
Exactly what test is done to get Free T4, Free T3, and antibody? I only had TSH result from routine blood work.
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561964_tn?1283802216
I just realized I addressed the comment to Anne825 when I meant it for you.

Exactly what test is done to get Free T4, Free T3, and antibody? I only had TSH result from routine blood work.
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499534_tn?1328707778
The tests are called Free T4, Free T3 or longer version which i can look up for you....depends upon your lab sheet. And there are 3 diff types of antibody tests for the thyroid. Let me know when you need them for your doc and i will write them out in a message to you. Just message me and let me know. If you do not have these other tests done, then you do not have the whole picture or diagnosis....therefore doctor cannot treat you properly and get you better. I was undertreated and mistreated for 2 yrs by an endo!! Imagine that....I could have been well a long time ago if I had gotten a new doc back then. Stupid mistake on my part. You have to find the right doc who specializes in thyroids.
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Avatar_f_tn
So why on earth do doctors only give half a test and then tell you you're okay?  It makes me sad to think about all the people who are suffering and made to think they are lazy or some kind of hypochondriac!
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Avatar_m_tn
Exactly it is sad to read the number of people suffering still.  My doctor just told me that all I needed was to reduce my t4 and that my dibilitating exhaustion and muscle weakness at times was not my thyroid.  I know I feel better when I eat more protein and less simple carbs.  He told me I was out of shape and if I got in shape I would feel better.  I swim an hour a day and we are not talking about playing in the pool.  I am swimming back and forth.  I really dont think he understands at all.  I did talk him into T3 to go with the T4, but he is not convinced I need it.  He thinks I need to just take less T4.  I am going to try this t3 and see how I feel.  I am also going to go see a specialist, which requires my thyroid meds sent to them.  
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Avatar_m_tn
A good thyroid doctor will test and adjust Free T3 And Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  symptom relief should be all important, not just test results.  Test results are valuable mainly during diagnosis and afterward to track FT3 and FT4 as meds are revised to relieve symptoms.

If you would like to get more insight into clinical treatment, have a look at this link.  It is a letter written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

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Avatar_m_tn
Maybe I'm confused but what I got out of reading above was that someone is HYPO and wanted to "lower the T4".

That is the wrong way!  If a person is HyPO you would generally want to RAISE the T4.

But maybe it was lower the T4 med and add additional T3 med.  And that may make sense.  That is because T3 is almost immediately acting and is about 4 times more effective as T4.  Because T4 must relatively slowly go through the conversion process. Whereas T3 is IMMEDIATELY able to be used.  So to tweak a dosage it is a bit more tricky because you may very well have to adjust BOTH and not just one or the other.

Dr's are so busy that they do not have time to read the latest and best information on every condition out there.  So they simply rely on their 20 year old medical school training on things.  And back then TSH was the magic gold standard test.  We've learned a lot since then..Unfortunately due to day to day business the Dr's don't have time to become aware of it.  And further unfortunate thing is that now with the internet etc. people can learn more about their specific condition than the Dr. who has to know about 1,000's of conditions. And they don't seem by their ego or something take it very well when the patient comes in and tells them what to do and what tests to run.  So they dig in their heels.  Which is a complete shame!
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Avatar_m_tn
thank you so much!  Well after some disagreement with him yesterday, he agreed to give me some t3 and reduce the t4.  I took my first t3 this morning and already feel I have more energy and are more alert.  I have also noticed since I have changed my diet to include protein at every meal and cut the simple carbs, I am losing weight also.  Amazingly yesterday he told me yesterday that carbs are carbs are carbs, but I know that is not true.  Complex carbs  do nI am not so hungry either after moving my diet to include the protein.  I think he went to medical school and that was it. I think I surprised him with my questions about Free T3, andrelin gland and conversion issues.  Well I am convinced I need to go to a specialist and I will interview him about thyroid and glucose interaction.  I have a couple of thyroid books coming to read some more on this subject but this forum has helped more than anything understand I need to take control of this issue and quit just taking what I get from my doctor.  
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