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Thyroid Disorders Message Board
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Old 01-01-2005, 07:58 PM   #1
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Testing Question

Hi All,

I am planning to go to endocrinologist #2 because I was not happy with #1. Basically, some nodules were found on my thyroid, I had the nuclear scan and then found out that about a quarter of my thyroid is not functioning, but he said I don't need meds because my labs are "normal". I have many symptoms of what I think is hypothyroidism, but I can't be sure. To name a few, I always have a low body temperature, hands and feet are freezing, tired, dry skin, etc...(I am underweight, though, so who knows?)

Anyway, to get to my point, I want to know what tests I should ask for. For example, I see you all mention Free T3 and Free T4. Is that different than just T3 and T4? I know I need the TSH, and they usually run the T3 uptake (which is always abnormal on me, but the doc tells me that this particular test is meaningless), but I'm just wondering what else I should request.

I'm having unrelated surgery in February so now I'm feeling a need to get this resolved quickly, as I'm not sure if there could be any potential dangers if I have a thyroid problem and it is not being addressed.

Thanks so much,
Inq

 
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Old 01-02-2005, 04:49 PM   #2
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Re: Testing Question

Quote:
Originally Posted by The Inquirer
I am planning to go to endocrinologist #2 because I was not happy with #1. Basically, some nodules were found on my thyroid, I had the nuclear scan and then found out that about a quarter of my thyroid is not functioning, but he said I don't need meds because my labs are "normal". I have many symptoms ... (I am underweight, though, so who knows?)
Good for you for having the gumption to switch MDs! "Normal" labs are the #1 reason you should find a new endo. We say here there is no such thing as a "normal" thyroid test. Just because your results fall within the "normal" range, does NOT mean they're normal for YOU. You have the symptoms... now you need the right tests, and you need them interpreted correctly.
BTW, it's a common misconception that you can't be underweight and be hypo at the same time. I have not gained weight because of mine. Not every person will have every symptom.

Quote:
For example, I see you all mention Free T3 and Free T4. Is that different than just T3 and T4? ... I know I need the TSH, and they usually run the T3 uptake (which is always abnormal on me, but the doc tells me that this particular test is meaningless), but I'm just wondering what else I should request.
Yes, the 'free' tests are different. T4 and T3 are the thyroid hormones. Most of each TH is present in a form that's bound up in a protein which must be stripped away in order for the cells to absorb it. The T4/T3 which is stripped of that protein is the "free" portion. If only the 'total' T4/T3 is measured, one can't be sure of how much is free and how much is bound.

The T3 uptake is pretty meaningless... Don't you just wonder why the heck he kept running it? That test is most often done as one step in the process to find the estimated amount of free T4... which is another rather useless test... Not nearly as revealing as direct measurement of T4.

Insist on those free T tests, and it'd probably useful to find out if you have thyroid antibodies... TPO and/or Tg. That might identify the possible cause of your malfunctioning gland.

Quote:
I'm having unrelated surgery in February so now I'm feeling a need to get this resolved quickly, as I'm not sure if there could be any potential dangers if I have a thyroid problem and it is not being addressed.
I hate to break the news, but hypoT is hardly ever... maybe never... resolved in a month's time. The good news is that nothing dire is likely to occur from it that soon, either. The cumulative effect of a shortage of thyroid hormones is rather long term; but so is the adjustment of levels using supplemental hormone.

There is one thing I should mention ... I remember reading some information that untreated hypothyroid can affect the amount of anesthesia that's required. It might be wise to at least get a diagnosis before your surgery, if for no other reason that the anesthesiologist knows your situation.

 
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Old 01-02-2005, 07:00 PM   #3
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Re: Testing Question

Midwest,

That was EXTREMELY helpful -- Thank you SO much!

Be well,
Inq

 
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