RE: Help with understanding T3 results

[Guest guest]

Hi Deb

A brief background is that I have recently

started on levothyroxine and it is being increased monthly. My doctor has been

very helpful in agreeing to keep increasing the dose until my TSH is

suppressed.

First off Deb, a doctor should NOT be treating you until your

TSH is suppressed, your Doctor should be treating you UNTIL YOUR SYMPTOMS HAVE

BEEN MITIGATED OR DISAPPEARED.

When I first when to see him and asked for the

full panel thyroid tests, the lab did not do the T3 as requested. The doctor

said this was because my antibodies had come back negative and they wouldn't do

a T3 test when that was the case.

This is a ridiculous excuse, they don't test free T3 because by

not doing so, they are saving their laboratory money. How does your doctor or

anybody else for that matter know whether you are converting the mainly

inactive thyroid hormone thyroxine, into the active thyroid hormone T3. It is

T3 your body and brain need to make them function NOT T4.

I asked for a T3 test again when my thyroxine

dose had increased to 50 mcg and I still didn't feel at all well. The doctor

again said the lab wouldn't do it because I was hypothyroid. He said they

assumed hypothyroids would be low in T3 and so there was no need to test for it

because they expected it to be low. So I asked how would I be able to tell if I

were converting the T4 to the T3 if I could never get the T3 tested?

No laboratory or doctor has a right " to assume "

anything and this is why these serum thyroid function tests ARE available. If

they " assume T3 to be low " then it would make sense that if the

doctors know this, they should then give you a prescription for T3,

either in combination with T4 or T3 alone to bring the level of T3 to a place

where you feel better and your symptoms start to disappear. It is up to your GP

to telephone the laboratory and demand that your free T3 is tested. The

laboratory have not seen you to check out your symptoms and signs or family/medical

history, and the laboratory is not your doctor, they are there to perform the

tests your doctor requests.

He repeated the same argument but did agree to

request the T3, adding it was unlikely they would do it.

If the laboratory refuses again to test free T3 when requested

by your doctor, your doctor should demand that they give him a written reason

why they refuse to comply to his requests. You should at the same time, as your

GP to test your levels of ferritin, vitamin B12, vitamin D3, magnesium, folate,

copper and zinc. This is because if any of these specific minerals and vitamins

are low in the reference range, no amount of thyroid hormone will be able to be

fully utilised at the cellular level until what ever is low has been

supplemented. Check out the attached, in case the doctor tries to tell you that

there is no connection between these low levels and symptoms of hypothyroidism.

When you get the results, post them on the forum together with the reference

range for each test done and we will help with their interpretation. Doctors

don't know how to interpret such blood results and if the laboratory writes

" normal " against them because they appear within the reference range,

then the doctor just tells you that the results are normal and that there is no

problem. We need to know whether they are at the top, the middle or the bottom

of the range.

The lab,

miraculously, did the test and it came back at the bottom end of the normal

range (where I seem to come in all types of medical tests!).

The result for T3 was 3.3 where the normal range is 3.1-6.8.

This is VERY low and no wonder you are feeling like pooh! Test

results for those not taking any form of thyroid hormone replacement should be

just above the middle of the reference range, and for those who are taking

thyroid hormone replacement should be in the upper third of the reference

range.

I said to the doctor that this seemed rather

low considering I had been on 25 mcg for one month and 50 mcg for the second

month. He again said – we expect hypothyroids to be low in T3. I didn't

really understand his explanation. It seemed that the T3 was seen as a relevant

test for hyperthyroids not hypothyroids with normal antibodies results. I do

not understand this. Can someone please explain why the doctors would expect T3

to be low in hypothyroids taking corrective medication? They must have some

reason for thinking this is normal .

Neither do I, and you need to write a letter to this GP asking

him to give you in writing, an explanation as to why he considers that free T3

should be low in the reference interval. Doesn't he know that Triiodothyronine

(T3) is the ACTIVE thyroid hormone that every cell in the body and brain needs

to make them function. How can these function with a low level of T3? Ask him

to cite references to show the scientific evidence to back up his statement.

NEVER TAKE NO FOR AN ANSWER. TPA is here to help further 'educate' such

doctors, and 'educate' them we will.

(In case it's relevant, my TSH was initially

4.75 and is now 2.38 and my serum-free T4 was initially 12.4 and is now 13.7.)

TSH in the majority of normal healthy citizens should be around

1.0 and when thyroid hormone replacement therapy is being undertaken, the aim

is to get it around 1.0. a TSH result of 2.38 is too high. The top of the TSH

reference range in the US is 3.0. The top of the TSH reference range in

Germany, Belgium and Sweden and some other countries is 2.5 with a

recommendation by Belgium, this be lowered to 1.5. Your GP needs to be

encouraged to go on a refresher course and to do some research into the

functioning of the greater thyroid system. All I can say is that I'm glad he

isn't my GP.

You need to ask for a referral to an endocrinologist of your

choice, one who has a specialty in thyroid disease to see if you can get a

combination therapy using T4/T3, either synthetic or natural. Sadly, if you

stay under the care of this GP only, you are likely to be left to suffer

through his ignorance of this disease.

Luv - Sheila

[Guest guest]

I think the problem is due to the 'reference range'. If the numbers fall within the range despite where exactly, then they consider that to be normal DESPITE how you feel.The result for T3 was 3.3 where the normal range is 3.1-6.8.I said to the doctor that this seemed rather low considering I had been on 25 mcg for one month and 50 mcg for the second month. He again said – we expect hypothyroids to be low in T3. I didn't really understand his explanation. It seemed that the T3 was seen as a relevant test for hyperthyroids not hypothyroids with normal antibodies results. Of course T3 is not irrelevant for hypos; THAT IS WHY WE ARE HYPO! Your doc doesnt seem to have a very good understanding of how the thyroid hormones affects the body. You must educate yourself on this subject, so that you can blow your doc silly remarks out. Even if you

have to go with written information and read it to your doc, then do so. This will alert your doc that you are not willing to be duped. It may also teach your doc about thyroid and its hormones.

http://thyroid-rt3.com/

look through this site it is very helpful in understanding T3 and rT3 etc.I do not understand this. Can someone please explain why the doctors would expect T3 to be low in hypothyroids taking corrective medication? They must have some reason for thinking this is normal . It stands to reason that if your fuel tank on your car is low that is because there is little fuel in the car. If your T3 or any of the thyroid hormones levels are low that is because their level is low. There is exception to this analagy whereby if your fuel gauage (blood levels) for your thyroid hormone is high and you still have symptoms of hypothyroid then its likely there is a blockage and the fuel isnt getting through to the engine and so the car wont start. So in the case of thyroidhormones if you have high blood levels circulating (that is your thyroid is making good

amounts or you are taking supplementation) BUT your body is unable to convert or further that you have some resistance at the cellular level. (In case it's relevant, my TSH was initially 4.75 and is now 2.38 and my serum-free T4 was initially 12.4 and is now 13.7.) So this is going in the right direction. But you need more thyroid hormones supplement. When taking blood levels for T3 it is a good idea to look at the rT3 levels also; particularly when you are taking T4 supplement. T4 can be converted to rT3 and this is unavailable to your body it is neutral not active like T3.

Conversely if you take T3 supplement then this cannot convert to rT3 it can only convert to T2...if it converts at all; usually your body has a T4 to T3 conversion problem and this is why you continue to feel hypothyroid.

However, I would say you just need to keep increasing your T4 supplement and see how you feel along the way. Your SH should BE SUPPRESSED THAT

Thanks in advance for any light anyone can shed on this. Also, what do you make of this T3 result? Tricky without knowing what it was before, I know, but would you expect it to be higher than this in view of the medication I'm taking and my other results?Thanks and best wishesDebbie PS Am now on 75 mcg, taking iron and vit d and starting to see an improvement.Are you specifically iron defiicient Debbie?