!st step is finally complete

[rock4god]

Well I did it. Actually my mom did. We got the right tests. She had to throw a fit but we got them. FT4, FT3, and TSH. Those are all the thyroid tests they could do. They're also redoing Vitamin D. Somehow they still manage to make me feel guilty for even daring to challenge them with this. Bad news is, it's not covered by my insurance. So it'll probably be costly unless we can take care of that. But now I'll know for sure if something--or nothing--is wrong with me. Now I wait. Friday is my doctor's appointment. So what should I be looking for in the results of my labs?

[annamae26]

great letter gimel please let us know if you ever receive a response     thanks

[Barb135]

Yay for you for getting the tests done.  Make sure you get a copy of the lab report and let us know the results, along with the reference ranges as soon as you can.

[gimel]

That's great.  Happy for you.  Now you should be on the road to better things.

I expect that you are going to find that your FT3 and FT4 are in the lower part of their so-called "normal" ranges.  Since the ranges are far too broad, and have never been corrected, as was done for TSH 8 years ago, many of our members report that symptom relief required their FT3 to be adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.  Symptom relief is all important, not TSH level.

If your FT3 and FT4 levels are as I expect, but your TSH is within the currently recommended range of .3 - 3.0, then that may point to the need to also check out your pituitary function.   Also, if your FT3 and FT4 are in the lower part of their range, then expect that you are going to have to pressure your doctor to treat your symptoms, by medication to get your Frees into the upper part of their ranges.  Based on your experience to date, I expect this will be  somewhat difficult, so here is an article written by a doctor that explains the need for this to be done.  Maybe it might influence your doctor, if you give him a copy to read.
http://www.hormonerestoration.com/Thyroid.html

Also, if the doctor needs further convincing, then you might give him a copy of this excerpt from an email that I have submitted to the Amer. Assn.of Clinical Endocrinologists.
_______________________________________
My most important concern is patients who get past the TSH diagnostic and are finally tested for FT3 and FT4.  The FT3 and FT4 ranges have not been revised (like TSH)  and are so broad that symptomatic patients frequently fall into the lower end of the current ranges.    As a result, they are labeled "normal" and receive no treatment to increase their active thyroid hormone levels and alleviate symptoms.  

This could be corrected if the data bases and reference ranges for FT3 and FT4 were rigorously screened and revised, for the same reasons as your change for the TSH range. My extensive background and experience in statistical analysis lead me to conclude that if this were done, the typical range for FT3 would change from 2.3 - 4.2 pg/ml up to approx. 3.2-4.3.  The range for FT4 would probably go from .6 - 1.5 ng/dl up to 1.0 - 1.55.  I firmly believe this is why millions of people with FT3 and FT4 results in the low end of current  ranges, continue to have lingering hypo symptoms.  I was one of them for years.

In summary, it boils down to these questions, in order of priority.
     1. Will the AACE consider the need to rigorously screen the data bases for FT3 and FT4 and revise the reference ranges as was done for TSH?   One of your members suggested this was being worked on.  Please assure me.  
     2. Now that highly-sensitive tests for FT3 and FT4 are available, will the AACE recommend that these tests which correlate best with hypo symptoms become the primary emphasis, rather than TSH?
     3. Will the AACE consider further revision to lower the TSH reference range in order to make it more effective as an indicator of thyroid problems?
      4. Will the AACE consider clarifying for the medical community that instead of being ironclad limits, thyroid reference ranges should be considered guidelines within which to adjust hormone levels as required to alleviate symptoms?    
       5.  If these changes do not fall within the purview of the AACE, then please recommend who I should contact.
  
Thank you very much for your time and patience.  Anything you and the AACE can do to help implement needed changes will be a godsend to the millions of long suffering thyroid patients.  I will be forever grateful if you will respond and can tell me if there is some hope for future changes in these areas.  
__________________________________________


Please be sure to get a copy of your lab results.  They are required to provide a copy upon your request.  Then post results and reference ranges here and let members comment.  Best of luck Friday.  We're all pulling for you and are here to help in any way possible.