# A reason to only check FT4?



## Hayatiggs (Aug 19, 2014)

So my previous doctor never took anything I said seriously. I once told him I was having trouble sleeping, and his response was, "You might have ADD."
Anyway, I voiced concerns about symptoms that I thought may be thyroid-related. He felt of my throat, and told me it felt fine. When I pressed and told him I wouldn't be satisfied until bloodwork was done, he finally gave in and ordered it. I went back in for checkup, he simply said my results were normal. I finally got a copy of my test results today, and it only lists TSH and Free T4 (which was only .1 away from being low). Does this mean my T3 levels weren't checked at all? Is having my T3 checked even necessary, or was the TSH and T4 sufficient?


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## joplin1975 (Jul 21, 2011)

A lot of doctors won't check free t3. It IS important, but if your free t4 is so low that its 0.1 from being out of range, you can pretty safely assume that you are pretty darn hypo. Have you had any additional testing?


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## Hayatiggs (Aug 19, 2014)

The only other testing done was my Vitamin D and B12, both low, and then my Cortisol which was normal. He said he felt additional testing wasn't necessary and prescribed me sleeping pills.


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## joplin1975 (Jul 21, 2011)

I think it would be really good -- if its feasible -- to get checked out by another doctor. I would ask for thyroid antibodies to be tested and also for a thyroid ultrasound. It sounds like you don't have a good doc!


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## Lovlkn (Dec 20, 2009)

Can you please list the tests run, result and range please.

Most doctors will run a TSH only for a thyroid screen. Your doctor actually did good by running the FT-4 in addition to the TSH.

Cortisol is best tested with 24 hour saliva which you can order yourself from ZRT Labs. I'm not sure if you can order cortisol only - I got my test in a package that also included hormones.

If you want more thyroid testing you can order tests you want run at Healthcheckusa.com.

After you get all your results you can go back to "this doctor" or find another who is wiling to work with you. Having a few labs will help get your point across. Ranges are just that - a range and low range is not necessarily a good place to fall.


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## Hayatiggs (Aug 19, 2014)

I forgot that folate was tested. This was all bloodwork, no saliva test. Range in parenthesis

TSH 2.69 (0.40-4.50)
T4, FREE 0.9 (0.8-1.8)
Vitamin B12 169 (200-1100)
Folate 17.1 (normal >5.4)
Cortisol 10.1 (4.0-22.0)
Vitamin D 27 (30-100)


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## Lovlkn (Dec 20, 2009)

Hayatiggs said:


> I forgot that folate was tested. This was all bloodwork, no saliva test. Range in parenthesis
> 
> TSH 2.69 (0.40-4.50)
> T4, FREE 0.9 (0.8-1.8)
> ...


TSH is on what most would consider higher than we would like.

T-4 Free is LOW. We know doc's thoughts on that - WRONG!

B-12 LOW. Did he suggest sublingual supplementation?

Folate - HIGH

Cortisol - not a very a very accurate test as only one time of day is tested. Saliva cortisol is a much better indicator of cortisol production.

Vitamin D LOW - what did they prescribe? I have to take 5K IU daily to maintain 3/4 of range.

High Folate, Low Vitamin B12, Anemia from Bacterial Overgrowth?

This was from my Google of High Folate and Low B-12.

Care to share any additional information on your history? It's odd that a doctor would test Folate.


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## Hayatiggs (Aug 19, 2014)

About 8yrs ago (around age 24/25) I went to my doctor with extreme fatigue (sleeping all the time, lack of motivation, headaches) and a heart murmur and discovered that I had low B12 (lower 100). He did an ultrasound of my heart and started me on monthly B12 injections. They brought my levels up to the mid 600s. When I went in for my yearly bloodwork last year, he saw this number and decided I no longer needed the injections because my level was normal. So my low B12 this time was after a year of no injections. He said since it was "close" this time I could just take high IU sublingual supplements. He said my heart murmur would most likely never become a problem.

He never mentioned that low Vitamin D. I only found out when looking at my test results.

That's all the medication I take except birth control. I very rarely go to the dr because he always made me feel like nothing was wrong. Blamed my tiredness on being a working mom. Blamed my headaches on lack of good sleep. I got to the point where I believed him (he's a doctor after all) and chalked my symptoms up to life, stress and laziness.


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## Andros (Aug 26, 2009)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser) 
Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

There is an exception. If your FREE T4 is really low, that "could" mean that you are converting FT4 to FT3 at a rapid rate and you "could" have antibodies keeping your TSH in range.

Hyperthyroid must be ruled out. And I think your doc should be ruled out to.

I am furnishing some info for you.

You also need an ultra-sound to rule out cancer or any other abnormalities.


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## Hayatiggs (Aug 19, 2014)

Thank you for the info Andros!


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## Andros (Aug 26, 2009)

You are very welcome and I hope you gain some insight by reading the material which is credible.

Let us know how you are doing....................

Hugs,


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## Hayatiggs (Aug 19, 2014)

I've been reading the info and I will be printing some of it out to take to the doctor with me. I am setting up an appointment with a younger doctor, but apparently she is VERY thorough and very good at listening to her patients and addressing their concerns. According to two friends, she has no problem ordering tests for them. I'm hoping!


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## Andros (Aug 26, 2009)

And we are hoping w/you!


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## Lovlkn (Dec 20, 2009)

It took me several doctors and several years to have my thyroid issues diagnosed - then another few doctors and few years to find another who knew how to properly replace me after my thyroid was removed.

Keep on looking - you will find one.

It's sad that most doctors do not know how to properly diagnose and treat thyroid patients - but it is fact based on all the posters here.


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