T3

[kewlweather]

Hi, I just got diagnosed with hyperthyroidism. My test results:
THYROXINE/T4 FREE 3.34
TSH ULTRASENSITIVE 0.04

My first question, is T3 test necessary. My doctor doesn't think so. My sister and mother (both hypo thyroid for years) says yes.

Reason I wonder is, I've felt my symmptoms for years, but the TSH and T4 have always been normal.
Thanks so much for your help. I have learned so much from this site.

[kewlweather]

Thank you everyone for your answers. I can hardly wait til my appt.

[yankeeRN]

My guess comes from what I have seen  mds order at the medical center where I work, comments I hear from mds when I question why they aren't ordering free t3 especially with symptomatic patients , etc.  If I hear one more md say but the tsh is in the normal range, I think I will blow a gasket especially when they are close to either end of the scale .  I recently had a hospitalist say that a patient's TSH is just barely in the top of the scale so it's not her thyroid but the patient had multiple complaints which pointed to thyroid--when I asked her if she was going to do a free t3 and she said it didn't need to be done that she would just start the patient on an antidepressant for her depression and send her to a nutritionist for her diet and cholesterol problem--this was a young patient--about 30 years old.  I thought --here we go again treating the symptoms but not the cause. I told her how depressed I had felt when my thyroid was in the hypo mode( not a good feeling and not having a reason to be sad as I have a wonderful life)from too much antithyroid med ---the md ended up ordering  the free t3 for that patient--I never saw the result because I was off the next few days and the patient had gone home but I hope at least it might have ruled out the thyroid or that the thyroid would be treated if it needed to be.   kewlweather--you're welcome  lots--lol :)

[kewlweather]

Thank you! I thought you were just wishing me lots of luck! :)

[goolarra]

You do have the right to request tests.  However, your doctor also has the right to refuse your request.  Just be prepared to stand your ground and not be intimidated.  If your new endo is any kind of thyroid doctor, he should order FT3 and TSI without your having to ask.

Best of luck with your appointment...

[gimel]

I found your 90% estimate very interesting.  I have used that same number as my own estimate, based on just what I see and hear from friends who generally have had great difficulty finding good thyroid doctors.  I blame a lot of this on the professional thyroid organizations like the AACE and the ATA, who promote all the wrong things, in conjunction with the large pharmaceutical companies that promote T4 as the only med needed for all hypothyroid patients.

[yankeeRN]

Sorry about the slurr of the "luck"--I must have been holding down the "c" key--Iol

[yankeeRN]

Definitely get the free t3.  It does correlate with symptoms much better.  I had been complaining to my md that I was starting to feel hyper (thyroid) again and he had been checking the total t4 ---mine was 9.8 (reference range 5.3-12.3)--now your average md might think that I am "fine" because I am "within the range."  I listened to my md till things got worse over the course of 2 months --the restlessness I was feeling got worse, I was getting moodier, my hands started to get those tremors again--he retested the total t4 which was now 11.7--he reassured me that I was still in the normal range. I came on this site once again for help and because I wanted to talk with someone who knew what they were talking about and they recommended the free t3 be done.  I called my doctor back and told him that he needed to get the free t3 because even though my total t4 looked good to him I DID NOT FEEL MYSELF and it was getting WORSE!!Believe me I was quite assertive.  He agreed to do the free t3 and that was 5.5 (reference range 2.0-3.5).  Not sure how he got my lab results so quick because I had them drawn at 6pm at night and he called me that next morning at work at 730am all concerned and told me to increase my antithyroid medication because I was too high--something I was trying to tell him all along. I will admit I myself am still learning and I have now become much more of an advocate for patients with thyroid problems --- I understand them better---I dare say that 90%  of  family MDs are not up on thyroids and I dare say that nurses are right there in that category.  I know that my own thyroid problem--Grave's (hyperthyroid) has made me do  much more research--I still don't have all the answers.  The public needs much more education.  Ok enough said from me--get the free t3:)  Good luccccck and I hope you feel better :)  

[hempem]

Kewlweather of COURSE you have every right to request the Free T3 test - and a test for antibodies.  It's just not a complete picture as things stand.  What if you have lots of free T4 but your body is not good at making it into T3, which is really important?  I can't believe doctors don't order free T3, but I had to ask my Doctor to do it also.  He said, "Ah, I see you are well-informed on this issue," and since then he has been very cooperative.  ;)

[kewlweather]

He's sending me to a endocrinologist on Aug 1. I will ask for the tests. But, what if he or she says no. Do you know if I have the right to request them?
THank you so much for your reply.

[goolarra]

I'm with your mother and your sister.  FT3 is the test that correlates best with symptoms.  It could be that it';s been off for some time.

In addition, your doctor should test TSI (thyroid stimulating immunoglobulin), which is the marker for Graves' Disease.  By far, most hyper is caused by Graves', but you want to make sure of that.

Is your doctor suggesting treatment?