Re: Not taking thyroxine dose before blood tests

[Guest guest]

Hi Sharon

This came from Professor Weetman, ex President of the

British Thyroid Association, now head of all UK Medical Schools and Dean of

Sheffield University. He gave evidence when acting as 'Medical Expert Witness'

for the General Medical Council at a doctors Fitness to Practice Hearing in

Manchester, which I attended. He states that thyroid function test results can

be flawed if thyroid hormone replacement has been taken on the morning before

the blood is drawn. You can find this by looking through the Transcript of Dr

Skinner's Hearing which you will find here on our web site http://www.tpa-uk.org.uk/skinnerday5.pdf

You should find it somewhere around Day 4, 5 or 6 I think when Professor

Weetman is giving evidence or when he was being cross examined. You will need

some time to read this and I apologise for not having kept the exact details

and now don't have to time to find these for you, but the information is there

if you want evidence to take to your GP. Such evidence can't come from a higher

person than this particular professor.

You should not take any thyroid hormone containing T3

particularly on the morning of a blood test because T3 has a very short half

life and it peaks in the blood 2 to 4 hours after taking it - and taking blood

after taking T3 would give a very high result, making the doctor believe you

were on too high a dose and s/he would then try to make you reduce your dose or

stop taking it - telling you that it is dangerous. T3 has a half life of 2 days

in humans.

Luv - Sheila

I'm relatively new to this group and still

trying to get to grips with the basics, so forgive me if I am asking obvious

questions.

I have read on the forum that you should not take your thyroxine dose within

the 24 hours before thyroid blood tests. Although I am happy to tell my GP this

and point out that most of my blood tests are invalid for this reason, I would

like to be able to cite something other than this forum as a source for this

information, but I can't find anything on the net. Can someone help me please?

Many thanks,

Sharon

[Guest guest]

This will save you some time - I checked my Saved Documents and

here it is. Unfortunately, I did not keep a note of the particular day this

evidence was given.

WHY

WE SHOULD NOT TAKE THYROID HORMONE REPLACEMENT BEFORE A THYROID FUNCTION BLOOD

TEST

Many of our members ask WHY we should not take any thyroid hormone replacement

for 24 hours before we have our blood drawn to test our thyroid function, This

is because if we take our thyroid hormone replacement the morning we have our

blood test done, the results could be skewed. Here is information from

Professor Weetman – Head of Medical Schools (UK) and an expert

witness giving evidence at a General Medical Council Hearing.

__________________________

Q What about the

laboratories that do offer the T3 and the T4? We are looking at people before

they have received any medication, before they are on thyroxine. Is T3 and T4

in those circumstances a reasonably accurate test or not?

A I do not know of a laboratory which routinely

offers free T3, so let us stick with free T4. Free T4 assays are as reliable as

TSH. Let me be clear on this, there are a number of factors which will

interfere with these assays which are well recognised by endocrinologists and

have to be taken into account. Provided one does that then the assays are

equally reliable.

Q What about

once the patient is taking thyroxine?

A

If I can just continue on the last point. One of the reasons for not relying on

the free T4 is that in the earliest stages of thyroid failure, so called

sub-clinical hypothyroidism, the TSH levels go up but the free T4 levels remain

normal. In that situation you have a partially damaged thyroid gland. If I go

back (The witness demonstrated on the chart) If there is slight

damage to the thyroid gland the TSH levels will rise in order to stimulate the

gland.

Q In order to

compensate?

A

Exactly and do so in the majority of patients. So they end up maintaining free

T4 which is normal at the expense of the high TSH which is stimulating the

gland and that is why you can sometimes have the situation of an elevated TSH

but a normal free T4.

Q I think we do

see that in some these cases. If you have an elevated TSH but a normal T4

within the reference range, is that a signal - it is not diagnostic presumably

- but is that a signal of thyroid problems?

A

It is. It would certainly need follow up.

Q I was going to

come on, if we have finished that area, to dealing with using T3 andT4 as a

test once the patient is on thyroxine?

A

The problem

with using free T4 measurements if a patient is taking thyroxine is

that the level

fluctuate after taking thyroxine treatment. Therefore, within the few hours

after

ingestion there can be a ten or fifteen per cent level difference in level

compared to twelve to twenty four hours after ingestion. The second problem which is frequently encountered by endocrinologists is that the patients may not

adhere to their treatment very strictly and may

remember to take a tablet before a blood test which will give them normal T4 levels and might have omitted their tablets over

the preceding weeks. Because of the sensitivity

of the pituitary that can be identified by raised TSH but a normal free T4. Therefore, TSH, because it is measuring a response of the

body, in this case the pituitary gland, it is by

far the best measure of the nature and degree of thyroid hormone replacement.

_____________________

Please note how skilfully Prof Weetman skirts

around the issue of the T3 ..... Although he does not say it in such

words, he is insinuating that the correct level for measuring FT4 is 12 to

24 hours after ingestion. And to be on the safe side (and not risk

our doctors to reduce our medication) - on this forum it is generally advised

to lay off the pills for at least 24 hours.

I'm relatively new to this group and still

trying to get to grips with the basics, so forgive me if I am asking obvious

questions.

I have read on the forum that you should not take your thyroxine dose within

the 24 hours before thyroid blood tests. Although I am happy to tell my GP this

and point out that most of my blood tests are invalid for this reason, I would

like to be able to cite something other than this forum as a source for this

information, but I can't find anything on the net. Can someone help me please?

Many thanks,

Sharon

[Guest guest]

Hello Sharon,

Sheila beat me to it .... - you will find Prof. Weetman's statement on day 4, page 13 of the transcript ....

Good luck,

[Guest guest]

Hi Sheila, I have just noticed that you had posted day 5 of the trial. Have you got day 4 somewhere in your files? if not, I have it, but don't know how to attach a pdf file to this forum ....

Sharon - if Sheila does not have day 4, I can send you the attachment privately - just let me know your private email addy.....

Best wishes,

xx

[Guest guest]

I have all the days - and so do you all. I uploaded these to the

web site www.tpa-uk.org.uk - click on

'Information for Patients' and on the Page that opens, click on Official

Transcripts for Dr Skinner's Hearing (or something like that) - and you have

every day of evidence and cross examination. I also have the paper official

transcript - about 6 " thick. Professor Weetman's is particularly worth

reading - I have never read such a load of twisted bunkum in my life. No wonder

we are in such a state in trying to get our doctors to give us a proper

diagnosis and choice of treatment when this arrogant so and so is heading

everything. I wish I could cross examine him - he got away with what was said

far too lightly. His arrogance is excruciating. Go on to page 5 and read

further.

Luv - Sheila

Hi Sheila, I have just noticed that you had posted day 5 of

the trial. Have you got day 4 somewhere in your files?

if not, I have it, but don't know how to attach a pdf file to this forum ....

Sharon - if Sheila does not have day 4, I can send you the attachment

privately - just let me know your private email addy.....

Best wishes,

xx

[Guest guest]

> I have all the days - and so do you all. I uploaded these to the web site> www.tpa-uk.org.uk - click on 'Information for Patients' and on the Page that> opens, click on Official Transcripts for Dr Skinner's Hearing (or something> like that) - and you have every day of evidence and cross examination.

Got it - many thanks Sheila

love, xx

[Guest guest]

>>>I have all the days - and so do you all. I uploaded these to the web site www.tpa-uk.org.uk - click on 'Information for Patients' and on the Page that opens, click on Official Transcripts for Dr Skinner's Hearing (or something like that) - <<<<

When I do this all I get is "papers for your doctor", "free prescriptions", "primary care trusts", "information pack" and 'TPA Poster'. Nothing to indicate Dr. Skinners hearing.

I have searched and searched the website and still cannot find it.

Lilian

[Guest guest]

Lilian,

Here's the link to the paper on the web site

http://www.tpa-uk.org.uk/drskinner_comments.php

I was able to look for it using a different method, but I have no idea where the

links to it are hidden on the site....

xx

>

Dr Skinner's Hearing (or something like that) - <<<<

>

> When I do this all I get is " papers for your doctor " , " free prescriptions " ,

" primary care trusts " , " information pack " and 'TPA Poster'. Nothing to

indicate Dr. Skinners hearing.

>

> I have searched and searched the website and still cannot find it.

>

> Lilian

>

[Guest guest]

Thanks .Lilian

Here's the link to the paper on the web site

http://www.tpa-uk.org.uk/drskinner_comments.php

I was able to look for it using a different method, but I have no idea where the links to it are hidden on the site....

xx

[Guest guest]

Go to www.tpa-uk.org.uk then

click in the Menu on 'Information for Patients'. At the bottom of the page that

opens, after the main four items, you will see a list of other 'Information'

and if you scroll down that list, the 10th item, you will find 'Official

Transcript from Dr Gordon Skinner's GMC Hearing) http://www.tpa-uk.org.uk/skinner_hearing_transcripts.php

Luv - Sheila

>>>I

have all the days - and so do you all. I uploaded these to the web site www.tpa-uk.org.uk - click on 'Information

for Patients' and on the Page that opens, click on Official Transcripts for Dr

Skinner's Hearing (or something like that) - <<<<

When I do this

all I get is " papers for your doctor " , " free

prescriptions " , " primary care trusts " , " information

pack " and 'TPA Poster'. Nothing to indicate Dr. Skinners

hearing.

I have searched

and searched the website and still cannot find it.

Lilian