Followup question re: tests

[KareyL]

I posted earlier.  You explained the Naturthorid having T3 that could aggravate palpations, However I did also ask what tests would your run to regulate meds for a Hashimotos patient?
Prior to taking naturthroid 16.25 mg, my TSH was w/in normal range and was mis-=diagnosed as panic attacks. Finally did antibody:

Would you test more that just the TSH to regulate the amount of naturthroid to use?   Reverse T3, Free T3, T4 ?  What panels would you recommend?

[KareyL]

The problem is... I am still having symptoms... and My TSH has ALWAYS been within the normal range.    I have had the antibody test done finally which is positive...ie... Hashimotos, and the Endochronologist that I saw 1 time said that based on looking at my thyroid ultrasound alone... with out looking at labwork or my history.. etc... He would have diagnosed me with Hashimotos.  
So if they test my TSH and it is still within normal range... What next?    I just went in to the Dr.s  again of Friday, because I have had another "attack".   Racing  heart and foggy head no focus etc..  Also, I have a very high startle reflex...  Someone startle me  by catching me off guard.. makes my heart race and pound.   Because of this happening again, I have done a 24 hr urine catch to test my Adrenal and put on a 48 hour holter monitor...  Waiting on results.

[Mark Lupo, M.D.]

reverse T3 is of no clinical utility.
A single (one-time) measure of T3 in the eval of hypothyroidism can document conversion from T4.
TSH is the best test, if abnormal then T4 and T3 can sometimes help clarify the situation