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  • Do most endo's NOT do Free T3??

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    Old 10-16-2008, 04:15 AM   #1
    LilyU
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    Do most endo's NOT do Free T3??

    I have to see my Endo today and I have realized they have only done TSH and Free T4 tests so far.

    I was upped to 100 mcg of Synthroid about 6 weeks ago and for the past 3-4 weeks I have been feeling some hyper symptoms, but still have some hypo symptoms. So I am confused and his office keeps saying my TSH is normal (2.6) but I feel like heck!!

    L.

     
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    Old 10-16-2008, 05:52 AM   #2
    lisaann1
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    Re: Do most endo's NOT do Free T3??

    My Endo will not do free t3 or t4. He only does tsh and tt3 and tt4. I cant figure out why he wont test for it. And supposidly he is supposed to be one of the best around.

    I noticed that you are from Ohio. Me too. I'm in Columbus, what about you?

     
    Old 10-16-2008, 07:39 AM   #3
    tigger67
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    Re: Do most endo's NOT do Free T3??

    Mine didn't until I asked. She kinda questioned why I wanted it, but I guess she figures as long as my insurance pays for it, she doesn't care. I'm glad she does though because if you're taking synthroid, you need to see if it's converting correctly, which mine isn't right now. I'd never know why I'm feeling so bad if she didn't test for FT3.

     
    Old 10-16-2008, 08:08 AM   #4
    mkgb
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    Re: Do most endo's NOT do Free T3??

    I had one Endo tell me that measuring and following T3 levels is moot. He feels they fluctuate to widely and that the test is not an accurate measure of thyroid hormone levels. I have adrenal issues. I have to monitor my T3 levels. My T4 levels are always hypoT, but my T3 levels drive me into hyperland. I also have a MS in Chemistry and researched the National Assoc. of Clinical Biology findings on thyroid tests and such. The Endo had to sit through a 30 minute lecture on top of receiving multiple referred journal articles on the subject. He finally broke. It was nice to see. He admitted he didn't test the FT3 because it was expensive and most didn't need it.. and he never could find the appropriate code to make the insurance companies pay for it. NEEDLESS to say this man is not going to see me again. I did however educate him on looking at the Ft4 and Ft3 levels for an imbalance as an indicator of adrenal dysfunction. At least he learned something from me. He did over look my blood work which screamed PCOS and hypoglycemia. DUH?! Anyway my IM and I are getting on just fine with out the Endum's making things worse.

    So to answer WHY don't MDs not just Endos but MDs test the proper thyroid hormones? Because they do not know better and are falling back on a myth that was perpetuated 20 years ago. This MYTH is that the TSH is the be all thyroid hormone and function measurement. WELL if they are going to cling to the pipe dream you think they would at least stay current on the NORMAL and OPTIMAL TSH range. Raise your hand if half your MDs know the current normal TSH range.. or even the 2002 normal TSH range. Anyone? I will raise my hand.. but I had to educate my MDs.

    MG
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    Last edited by mkgb; 10-16-2008 at 08:10 AM.

     
    Old 10-16-2008, 10:09 AM   #5
    namelessme
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    Re: Do most endo's NOT do Free T3??

    Doctors are surprisingly ignorant in regard to thyroid testing (and treatment too). I've gotten the same comments -- free thyroid levels aren't needed -- total is more accurate, etc.

    What I find weird is how some doctors say certain blood tests are too expensive, so they aren't necessary. Or they say insurance won't pay for such and such a blood test. Or they can't find codes for it.

    I'm not sure how other people's health insurance work, especially outside of the US, but for myself, if the doctor writes a script for labwork, it gets done -- insurance pays for all bloodwork. I have to go to an outside lab, but that's not a big deal.

    It doesn't require any doctor codes (no clue why a doc needs a code on a script), and quite often the script can even be vague (such as just saying thyroid antibody panel, and not specific ones) and the lab does it. I don't get this problem with all doctors, as I've have had obscure blood tests for other things in the past with no problems. But the endo I recently saw acted like she lost money on every blood test she wrote a script for, wouldn't consider Free values, nor even testing T3 at all. Just TSH and T4, and even then, told me to wait 6 months to get it taken.

     
    Old 10-16-2008, 10:56 AM   #6
    tigger67
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    Re: Do most endo's NOT do Free T3??

    There's a code right on the lab sheet for FT3 that my endo uses, and my insurance pays for all lab work. So unless you don't have insurance, I think most insurances will pay for bloodwork. TSH and FT4 are together as one code for my lab, so that also may be why those are the two they always test for since it's one code.

    I asked my dr.'s nurse once why the labs or my doctor weren't going by the new tsh levels that the Endo Association came out with in 2002, and she said they don't look at websites. It's not a website, I"m sure they printed a manual about it. And it's the Endo Association for crying out loud. If you're an Endo, and you're not going by what they say, then what crappy medical information are you going by???

     
    Old 10-16-2008, 11:15 AM   #7
    mkgb
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    Re: Do most endo's NOT do Free T3??

    I love a good vent session! Let it out. Yes! You have more incompetent MDs that skated through school with a 2.0 just hoping to make money in the health care INDUSTRY... than intellegent ones that felt becoming a doctor was a calling to heal people. If you really want to get an MDs back up.. ask them what their med school GPA was... I have went as far as asking to see an MDs transcript. Heck as their patient I am technically an employer no? I am employing them to solve my problem, not ask me what I THINK is wrong and WHAT medicine I think they should give me.

    I print out the A A C E announcement and give it to my MDs. Just in case they missed the memo that the various associations send out when levels change. The labs are a commercial entity and they facilities manager should be keeping up with the latest ranges approved by the NIH or NHS in England. This normally puts them behind the A A C E and corresponding specialists, BECAUSE they have to go through the motion of getting a committee to investigate the findings of Society X's recommendation. This panel of crotchety MDs then .. whoops that was catty, but I will let it ride... decides whether or not it is cost effective and statistically appropriate to change said ranges. In many cases things are turned down and considered not to be manditory because only 1% of the population is afflicated and in need of said testing.

    This burns my britches especially with regards to testing pregnant women. It should be MANDITORY to run a TSH and FT4 in my opinion. However since thyroid issues are like 1 in 100 they consider it cost ineffective! Well it is documented that 12.6% of a 17700 person study had Hashimoto's antibodies and didn't know it. Well that is more than 1%. Ugh! You are right MDs can be collective DONKEYS with blinders on. I would think that if a woman or man ASKED for a bloody test that the MD would do it. Mine do, but I do not give them a choice. It is do it or I will get some one else to. Talk about cost effectiveness. How much money has been wasted in our MD shopping? Humm? My specialists charged 150-250 for me to sit in their lobby, talk to their assistants and wave at them on my way out.

    *sighs and hops off the soap box* NEXT! That felt good.

    MG
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    Last edited by mkgb; 10-16-2008 at 11:16 AM.

     
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