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Old 07-26-2011, 06:37 AM   #1
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Free T4 Dialysis/Mass Spec

I am trying to get a diagnosis for my 13-yr-old son who is hypothyroid and he saw his 3rd endocrinologist last week. He ordered bloodwork and yesterday, when I took my son to have it done, the lab tech mentioned that the doctor hand-wrote free T4 Dialysis/Mass Spec. She said she had never seen this test before so when I went home, I looked it up. I didn't find much but it seems that it's a little more accurate than just regular free T4. Does anyone know anything about this? I have my endocrinology appt tomorrow and will request it if it's a more detailed test.

 
Old 07-26-2011, 06:51 AM   #2
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Re: Free T4 Dialysis/Mass Spec

The FreeT4 dialysis test is the most accurate FreeT4 test out there....it is much more expensive than the regular FreeT4 test.

The regular FreeT4 test is fine for most people for diagnosis/treatment but, if the doctor is having any doubts about anything, the dialysis method should ease them all.
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Old 07-26-2011, 07:36 AM   #3
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Re: Free T4 Dialysis/Mass Spec

Thanks for your quick reply Do you know of any other advantages besides accuracy? In other words, does it show more than if you just got free T4? Like could it rule out certain things as being the cause of being hypothyroid? I'm sorry for all the questions but I don't understand much about being hypothyroid. This has been the first doctor that has even said he might give my son medication and I am really ecstatic. I want to be armed with as much info as possible. At first, he started with the same old stuff. His TSH is "normal" but I kept pushing and he seemed willing to listen. He said if his antibodies are high, then we could talk about meds.

 
Old 07-26-2011, 08:21 AM   #4
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Re: Free T4 Dialysis/Mass Spec

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Originally Posted by nicolep1016 View Post
In other words, does it show more than if you just got free T4? Like could it rule out certain things as being the cause of being hypothyroid?
No, it just gives you the most accurate FT4 result. If the concentration of carrier proteins differs greatly from the normal this will give you the most accurate result as the regular FT4 may not fit into the "clinical picture". Checking Abs is a good idea at this point. One can have Hashi's and be hypoT even without Abs in the blood - a FNA would confirm Hashi's in that case.

Last edited by FinnMaid; 07-26-2011 at 08:27 AM.

 
Old 07-26-2011, 08:21 AM   #5
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Re: Free T4 Dialysis/Mass Spec

Honestly, if the doctor is going to recognize hypothyroidism, the doctor is going to recognize it.

"All" it should take is the patient having hypothyroidism with either/both FreeT4, FreeT3 levels below mid-range.

Why pay for premium when regular is just as good?
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Old 07-29-2011, 05:45 AM   #6
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Re: Free T4 Dialysis/Mass Spec

Just had to share this with you guys. I just came across a person that obviously does have "abnormal" amount of carrier proteins.

She had "all" the hypoT symptoms but her FT4 was at 15.8 (11-23) - with FT4 dialysis her level was only 9.7 (8-21).

When she was about 20 weeks pregnant her FT4 was 18 (9-19) but with FT4 dialysis it was only 9.6 (8-21) - so a humongous difference (and you can imagine what kind of a fight she has to go through with these ignorant doctors - luckily the same endo that first spotted her condition increased the dose after these labs).

Last edited by FinnMaid; 07-30-2011 at 04:27 AM.

 
Old 07-29-2011, 08:10 AM   #7
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Re: Free T4 Dialysis/Mass Spec

Thanks for sharing this FinnMaid - I wonder if the difference is due to estrogen levels being higher during pregnancy?

I remember reading that hormonal birth control can cause an elevation in the FreeT4 level....and I believe it has something to do with sex hormone binding proteins.

Since I use HBC, I asked my doctor about this (I need top-of-the range/slightly-over-range FreeT4 levels to be symtom-free).....I got a blank stare,
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Last edited by sammy64; 07-29-2011 at 08:17 AM.

 
Old 07-29-2011, 11:19 PM   #8
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Re: Free T4 Dialysis/Mass Spec

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Originally Posted by sammy64 View Post
I wonder if the difference is due to estrogen levels being higher during pregnancy?
Yes during pregnancy the increased estrogen level causes higher TBG concentrations (that leads to lowered FT4 which leads to higher TSH, increased total thyroid levels and a new balance is found).

Last edited by FinnMaid; 07-29-2011 at 11:44 PM.

 
Old 07-30-2011, 03:57 AM   #9
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Re: Free T4 Dialysis/Mass Spec

Wow, I learned something new this week. I did read that doctors use that test for pregnant women but I didn't read why. You are right though sammy, I don't see the point of ordering it for my son unless there are other scenarios where there would be a major difference in numbers. If so, he didn't mention but it will be interested to see these results opposed to the FT4. I should be getting them in the early part of the week and I will post both results as soon as I do. Now, I just found out that my 8-yr-old's thyroid levels are almost as bad as my other sons It seems like a never-ending battle.

 
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Old 07-30-2011, 04:33 AM   #10
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Re: Free T4 Dialysis/Mass Spec

So sorry to hear that Hope your sons get the help they need.

It just occurred to me that this is maybe why women in general seem to need to have higher FT4s than men - their FT4s may look higher but with higher estrogen and TBG levels they "really" may not be as high as they seem.

Last edited by FinnMaid; 07-30-2011 at 04:41 AM.

 
Old 07-30-2011, 05:22 AM   #11
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Re: Free T4 Dialysis/Mass Spec

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Originally Posted by FinnMaid View Post
So sorry to hear that Hope your sons get the help they need.
Ditto

I am truly sorry that you found a need to come here but, it's a great place to get information and support. I believe your sons' health will be optimized as a result of the information you can get here.

We'll be with you every step of the way for as long as you'd like company.
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Old 07-30-2011, 05:25 AM   #12
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Re: Free T4 Dialysis/Mass Spec

Quote:
Originally Posted by FinnMaid View Post
It just occurred to me that this is maybe why women in general seem to need to have higher FT4s than men - their FT4s may look higher but with higher estrogen and TBG levels they "really" may not be as high as they seem.
This makes sense to me.....and what I was trying to tell my doctor. I need my FT4 level at the very top of the range to be symptom-free. I've been slightly over-range as well and still felt awesome (no hyper symptoms).

I have a friend with PCOS and she told me that many doctors don't understand the influences of the sex hormone binding globulins....lucky us
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Old 08-02-2011, 06:43 PM   #13
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Re: Free T4 Dialysis/Mass Spec

Finnmaid and sammy64,

Thank you so much for all the info and support! I have learned SO much from this forum and I feel like there is hope for me and my boys. The weirdest part about it is that we all found out that we had hypothyroidism at the same time. I'm convinced that I've had this my entire life and have suffered needlessly and I am determined to prevent my children from going through the same thing. Now the light bulb has gone on and it feels like a relief, in a sense. I called the doctor today and he is supposed to call me tomorrow with the results so I will post them as soon as I get them.

 
Old 08-06-2011, 02:04 PM   #14
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Re: Free T4 Dialysis/Mass Spec

I got a message from my son's doctor yesterday saying that his labs were normal. Without even seeing the labs at that point, I knew this wasn't the case so I called back and he never returned my call. When I took him to the lab, I requested a copy of the results to be sent to my house which I just received today. Here are the results:

Free T4 by Dialysis/Mass Spec- 0.93 0.8-1.7
T3- 128 71-180
Antibodies were in low normal range
TSH-3

I noticed that in this test, the FT4 is higher than in the regular FT4. My son's regular FT4 from the last set of labs were below normal range. Of course I know that T3 is useless and his Free T4 is still low and can only beg him at this point to put my son on a low does levoxyl because he is probably not even gonna want to do that so I'm not even gonna bother asking for Armour. I am making an appt. with another doctor who is an MD but also practices alternative medicine so I think I have a good chance of getting him to prescribe Armour for my son. We have exhausted every pediatric endo on my health plan so I don't know what else to do.

 
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