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Total T3 test?
Is there any benefit in getting the Total T3 test done? To recap my previous doctor retired so I'm scheduled to see the doctor he recommended in his group. I had my labs drawn yesterday and noticed she ordered: TSH, FT3, FT4, and Total T3 test.
Last time I had a Total T3 done was last year when the first doctor I'd ever saw who actually listened to my symptoms Rx'd Armour (60 mg) and had my labs drawn 6 weeks later. He freaked over the TSH and told me to get off of the med saying I was hyper thyroid but failed to tell me why my Total T3 test was below range. We then moved to another state, I saw a doctor here. That doctor also flipped over the TSH but when I asked her why my total T3 was below range she said she had no clue what that meant but yet ordered that same test, why if she has no clue what it means?
Anyways, this new doctor ordered the same test. I've already called a few other doctors (in network) that I will try out if she turns out to be a TSH worshipper.
Last time I had a Total T3 done was last year when the first doctor I'd ever saw who actually listened to my symptoms Rx'd Armour (60 mg) and had my labs drawn 6 weeks later. He freaked over the TSH and told me to get off of the med saying I was hyper thyroid but failed to tell me why my Total T3 test was below range. We then moved to another state, I saw a doctor here. That doctor also flipped over the TSH but when I asked her why my total T3 was below range she said she had no clue what that meant but yet ordered that same test, why if she has no clue what it means?
Anyways, this new doctor ordered the same test. I've already called a few other doctors (in network) that I will try out if she turns out to be a TSH worshipper.
Just from general knowledge, if you had a TT 8 years ago, then neither your 75 mcg of Synthroid nor your 60 mg of Armour is unlikely to even be close to adequate for you. A lot of doctors don't know that when taking adequate doses of thyroid med, the TSH is frequently suppressed. This has been proved by scientific studies. So a suppressed TSH does not mean you are hyper, unless you have hyper symptoms, due to excessive levels of Free T3 and Free T4 which you don't even know about, since you weren't even tested. But I'd say that the odds of you being hyper are slim to none.
When you have tests done next week, you need to be tested for Free T3 and Free T4, not Total T3 and T4. If the doctor resists, then you should insist on them and don't take no for an answer. A goo dthyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results, and especially not TSH.
While you are at the doctor you should ask if he is going to be willing to treat you clinically as described. If not, then you will need to find a good thyroid doctor that will do so. I also suggest that since hypo patients are often too low in the ranges for Vitamin D, B12 and ferritin, you should ask to be tested for those also. When new test results are available, please post here, along with reference ranges shown on the lab report and we will be happy to help interpret and advise further.
In preparation for your inevitable discussion with that doctor, you might find very useful, this link written by a good thyroid doctor,
http://www.hormonerestoration.com/Thyroid.html
When you have tests done next week, you need to be tested for Free T3 and Free T4, not Total T3 and T4. If the doctor resists, then you should insist on them and don't take no for an answer. A goo dthyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results, and especially not TSH.
While you are at the doctor you should ask if he is going to be willing to treat you clinically as described. If not, then you will need to find a good thyroid doctor that will do so. I also suggest that since hypo patients are often too low in the ranges for Vitamin D, B12 and ferritin, you should ask to be tested for those also. When new test results are available, please post here, along with reference ranges shown on the lab report and we will be happy to help interpret and advise further.
In preparation for your inevitable discussion with that doctor, you might find very useful, this link written by a good thyroid doctor,
http://www.hormonerestoration.com/Thyroid.html
Had thyroidectomy 8 years ago (for nodules) was on 75 mg Synthroid which worked well for 6 years. Found a doctor who prescribed Armour and after starting very slow have been on 60 mg (1 grain) for the past year. Have felt o.k. but insomnia started and has continued. Jan 2014 Labs showed TSH .01, T3 Total 139, T4 non dialysis 1.2, doctor kept me on same dosage of Armour. Just went to a new doctor (PCP) who said I was hyper and needed to reduce my meds. Most thyroid patients I spoke to said I needed to UPP my dosage. Really confused, but am having labs done again next week. Phoeniz Az
Thank you, I'm in Colorado Springs, co.
The doctor that retired was not testing total T3. You're right it may be something she relies on or she's going by what other doctors have told her. If she does try to overrule what my previous doctor said, diagnosed, or prescribed I have refills till 7/2015 so enough time to look for another doctor.
The doctor that retired was not testing total T3. You're right it may be something she relies on or she's going by what other doctors have told her. If she does try to overrule what my previous doctor said, diagnosed, or prescribed I have refills till 7/2015 so enough time to look for another doctor.
GP Notebook - T3 (serum total)...
Measurement of total plasma T3 is a sensitive test for hyperthyroidism since levels are usually raised proportionately more than total T4. In T3 thyrotoxicosis, total T3 is elevated but total and free T4 are normal.
Difficulty in interpretation may occur in:
amiodarone treatment - this inhibits the deiodination of T4 and so causes an increase in free T4 and reduction in free T3
pregnancy or oral contraceptives - total T3 and T4 are raised as a result of raised thyroixine binding globulin
severe infection, post myocardial infarction, chronic liver disease, chronic renal failure, post surgery, drugs eg NSAIDs, salicylates, carbamazepine, phenytoin, propranolol - all may lower total T3
Measurement of free T3 may be useful when a false low or high T3 or T4 is suspected."
Measurement of total plasma T3 is a sensitive test for hyperthyroidism since levels are usually raised proportionately more than total T4. In T3 thyrotoxicosis, total T3 is elevated but total and free T4 are normal.
Difficulty in interpretation may occur in:
amiodarone treatment - this inhibits the deiodination of T4 and so causes an increase in free T4 and reduction in free T3
pregnancy or oral contraceptives - total T3 and T4 are raised as a result of raised thyroixine binding globulin
severe infection, post myocardial infarction, chronic liver disease, chronic renal failure, post surgery, drugs eg NSAIDs, salicylates, carbamazepine, phenytoin, propranolol - all may lower total T3
Measurement of free T3 may be useful when a false low or high T3 or T4 is suspected."
I can't think of any reason to test Total T3. Maybe it is related to their past experience of relying on Total T3 testing, before Free T3 testing was improved so much that it became accepted as the better test.
If you will give us your location, perhaps we can provide the names of some patient recommended doctors in your area?
If you will give us your location, perhaps we can provide the names of some patient recommended doctors in your area?
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