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Why test TSH, Free T3 & T4, antibodies?

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Old 06-21-2004, 10:27 AM   #1
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Why test TSH, Free T3 & T4, antibodies?

Hi all-
I am scheduled to for my 6 week follow-up tomorrow. I had originally posted just my "TSH reflex to Free T4" results and was urged to get my free T3, T4 and antibodies tested. I've been following the posts and still don't understand enough to ask my doctor for the free T3, T4 and antibodies. I was diagnosed for Graves disease and took RAI 12 years ago. Do I still need to be tested for thyroid antibodies? I had called back my nurse and asked for these additional tests to be included and was told that it wasn't necessary so I demanded to see the doctor prior to taking my labs. Could someone tell me where to get more information or give a quick explaination?

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Old 06-21-2004, 10:57 AM   #2
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Re: Why test TSH, Free T3 & T4, antibodies?

Since you have had RAI ablation, my opinion would be you don't need to have antibodies tests done. It's a given that you would sooner or later become hypothyroid and need medication for it.
When in treatment for hypoT, TSH testing isn't enough to go by for the purpose of regulating the dose. Free T4 and free T3 should be done along with TSH to monitor where the actual thyroid hormone levels are [TSH is a pituitary hormone. It's not very important once a diagnosis of hypoT is made. Most MDs will run it anyway, but smart ones don't pay it much attention.]

Old 06-21-2004, 11:29 AM   #3
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Re: Why test TSH, Free T3 & T4, antibodies?

I too had RAI ( in 2002) and am working on getting my labs straight.
One thing I noticed about your labs is that your doctor is trying to keep your TSH low (which is a good thing as most people feel good when their TSH is at or around 1). A lot of doctors get their patients TSH under 5 or 3 and call it good. Also, your doctor is already testing your Free T4 right? In looking at your labs, it looks like your doctor has kept you at borderline hyper for the last couple of years. Getting your Free T3 tested would give a much broader picture of where your thyroid is at. If, for instance, your Free T3 #'s high and out of range, it would indicate a hyper status. If, however, your T3 is low, but still in range it might indicate you need T3 (in the form of Cytomel) added to your synthetic T4 (or Armour - which has both T4 & T3). Some people's labs can look ok by looking at the Free T4 & TSH, but then look terrible when you see the Free T3 (some of the synthetic T4 you take is supposed to convert automatically into T3, but this doesn't always happen with people and they end up with good TSH & T4 labs, but crappy T3 labs). Anyhow, I've kind of jumped all over the place, but I was trying to give you some real life examples of why it's good to get your Free T3 tested.

Also, if your doctor gives you a hard time, just tell you you want to make sure your T4 is being converted to T3 because that's something that ya'll have never looked at. If she still doesn't want to, just laugh and ask her to humor you. I recently started seeing a new doctor and he did request labs on my antibodies, however I'm not sure why. I mean, you could go ahead and get yours tested for giggles and again, just tell your doctor to humor you.

Old 06-21-2004, 03:36 PM   #4
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Re: Why test TSH, Free T3 & T4, antibodies?

Thanks for the info. I have never considered taking anything other than Synthroid in 12 years. I will always insist on getting my T3 also tested now. Hopefully, I will have the results by next week.

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