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Thyroid Disorders Message Board
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Old 08-26-2004, 08:46 PM   #1
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please help info needed on what tests to get

Hi my sister is 42 and just had a baby 7 months ago, she lost quite a bit of weight right after having the baby, (as expected) and now in the last 3 months has gained all the weight back again and is heavier now then when she was 9 months pregnant. She is also feeling very tired and not able to cope. I told her to get her thyroid checked as every member of our family is either hypo or hyperthyroid.
When she went to her own Dr he told her that she should expect to feel this way after having a baby, but we know her better then that the baby has slept all night since 8 weeks old and my sister was always a bundle of energy.
What are the best tests for her to get? I know that your boards always say FT3 and 4 and tsh, but on the list from the diagnostic clinic for blood work it doesnt have the frees , is there any other name they go by? thanks in advance

Last edited by alana820; 08-27-2004 at 10:22 AM.

 
Old 08-27-2004, 10:25 AM   #2
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Re: what blood tests to get?

just need to know if the FT3 and 4 test are known by any other name, and what are the updated ref ranges for these and the tsh test thanks

 
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Old 08-27-2004, 10:39 AM   #3
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Re: what blood tests to get?

Sorry your question got overlooked, alana.
The free T tests don't have another name. Sometimes labs don't offer FT3 as a choice on their order forms because the cost of the test makes it prohibitive for some insurances and/or HMOs. They usually all will have FT4 as a choice, though.
Are there any groups - or "panels" - of thyroid tests on the form? It's possible that the frees are included in one of those, although it isn't too likely. The thyroid panels usually include archaic and unhelpful tests such as FTI and T3 uptake.
Some labs make the doctor write FT4 and FT3 in as a 'special' order.

Each lab has its own range for these tests. Where your results fall within that range is what indicates a thyroid problem or not. I can tell you though, that the Amer. Acad. of Clinical Endos has issued a statement that says the current TSH ranges in use in most labs today are far too broad and should be revised. An average high end of the range is 5.5. The AACE says that any TSH above 2-2.5 is too high and worthy of a trial of supplemental hormone. Progressive doctors know that a healthy woman without thyroid disease has a TSH of 1 or below.

Good luck to your sister... You're a peach for looking out for her. I really think you're on to something here.

Last edited by midwest1; 08-27-2004 at 10:43 AM.

 
Old 08-28-2004, 07:21 AM   #4
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Re: what blood tests to get?

thanks midwest, you always give great information.

 
Old 08-28-2004, 07:31 AM   #5
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T3 Test Costly, Thyroid Antibodies Also?

Yes, that's a good post, Midwest. I think I'll print it out, after waiting to see if you know about the antibodies test, to maybe take to my doctor if you don't mind. Not against the TOS here, right? Thanks in advance.

 
Old 08-28-2004, 07:39 AM   #6
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But Don't They Add Costs?

Don't most doctors add all they can to the costs, when your insurer has been paying promptly? Even the doctors you like best? Are you sure cost is the reason?

Patients probably didn't even know about T3 until fairly recently, correct? Could that be a factor?

 
Old 08-28-2004, 08:58 AM   #7
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Re: But Don't They Add Costs?

Quote:
Originally Posted by Eagle
... waiting to see if you know about the antibodies test, to maybe take to my doctor if you don't mind.
You're asking about hypOT, right? The antibodies tests for it are anti-TPO (thyroperoxidase) and anti-Tg (thyroglobulin). These are important to do while trying to arrive at a diagnosis because if they show elevated AB counts, it helps to confirm autoimmune hypoT, which deserves treatment if symptoms are present... even in the presence of otherwise "normal" thyroid tests.
Quote:
Originally Posted by Eagle
Don't most doctors add all they can to the costs, when your insurer has been paying promptly? Even the doctors you like best? Are you sure cost is the reason? Patients probably didn't even know about T3 until fairly recently, correct? Could that be a factor?
Well, cost isn't the only reason this test isn't done, but it is the most expensive of the ones that are best for diagnosis.
My own doctor, for example, doesn't profit one way or another from lab tests. (Well, possibly he gets a little referral fee from the independent lab... who can really know this without digging into his books?) If he would do his own bloodwork, then yes. He would be reimbursed by the insurance, and it would be in his best interest to run all the tests he wants, need them or not... Until the insurance catches up with the bill padding scam and they cut him off altogether. Insurance is a very complicated system.
I'm pretty sure an HMO would deny reimbursement for FT3 without thinking twice, since their mission is to save money rather than treat patients.

The other problem is that so many doctors know so extremely little about thyroid disease that they don't know the most useful tests. Most even think that TSH is enough. It's a sad state of affairs on the thyroid front.

 
Old 08-29-2004, 10:36 AM   #8
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Re: what blood tests to get?

Thanks, Midwest. I forget if you're the one who had the fine-needle thyroid biopsy for Hashi's. Whoever that was, can you tell us if that was expensive? A shortcut, so you don't need the TPO, TG, and T3? If you just want to make sure you don't have Hashi's, so you can have all the iodine (fish, kelp, etc.) you want, and want to make sure you don't need some T3?

My T4 med is a rather large dose, so I must have an absorption or conversion problem or something.

 
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