Endocrine/Thyroid Testing: TSH, Free T3, Free T4

[Guest guest]

Hi Sue,

Sorry for the delay in responding. I have had a terrible cold which is

something to celebrate as I haven't had a cold in years! But it resolved itself

within 3 days (the last time, it was two months). Perhaps my immune system is

normalizing!

Your question is the one that everyone asks and there is no good answer.

The best way to be treated for hypothyroidism is by clinical presentation.

Unfortunately, that technique hasn't been taught in medical schools in the U.S.

in over 50 years. I have had the best luck in doctors trained in other

countries as they know what to look for and don't rely solely on lab tests.

Having said that, you are your own best advocate. So, get the testing done, then

get a paper copy of your results, read up on the endocrine system and determine

for yourself where you stand based on your lab results.

I have a great endo - took me a while to find her. Since I have Medicare, I am

limited in my doctors. So, I see her, pay out of pocket since she is not in my

plan, get the list of tests she wants run (on her letterhead), then I go to my

in-network primary care doctor, give her the list and she runs the tests so that

they are covered by insurance. Hassle but there were no endos in network (that

don't go solely on labwork) so I pay for an office visit from my out of network

endo once or twice a year.

You may have to do the same since you use VA doctors. There are various good

doctors lists that can help you locate a good endo but as someone else has

mentioned, you may have better luck with a functional medicine doctor. I have a

functional medicine doctor but she was a little light on the endocrine system so

I kept looking. Other functional med. doctors may be stronger in that area.

Remember that you may still be hypo and have normal TSH based on the updated

range - I am a case in point - called subclinical hypothryoidism).

Mainstream docs usually determine you to be hypo if your TSH is over 4.5 or 5.0.

The upper limit of the reference range has changed recently and some labs use

slightly different ranges. All of them are around 5.0 which would leave so many

as raging hypo.

Alternative/Integrative/Functional Medicine/Enlightened Endocrinologists use a

much lower limit to diagnose hypo thyroidism, either 2.0 or 2.5.

My endo and my functional medicine doc and an ME/CFIDS specialist that I saw use

initial TSH of 2.0 so that is what I use. Once you start thyroid treatment, TSH

is meaningless and you should go by Free T3 and Free T4 ranges but most

importantly, SYMPTOMS!

Here is link to the controversy:

http://thyroid.about.com/od/gettestedanddiagnosed/a/tshtestwars.htm

Here is a link to a description of the tests (showing TSH but search Free T3,

Free T4 and the antibody test)

http://www.labtestsonline.org/understanding/analytes/tsh/test.html

Here is a link to the endocrine system. Very medical but a great place to learn

as you can.

http://www.thyroidmanager.org/Chapter2/2-frame.htm

Here is a link to T3 and Fibromyalgia which has really helped me tremendously.

I feel that I don't have FMS anymore just by taking T3.

http://www.jacemedical.com/articles/thyroid_is.pdf

Like ME/CFIDS, the endocrine system is tricky and can be difficult to address.

Each patient will have to have a working knowledge so that they can be their own

advocate.

If you cannot get help, there are websites that allow you to order the testing

on your own and there are place to purchase Armour, Armour equivalent, T3 from

overseas, without a prescription. Let me know if you get to this point.

Hang in there, don't get discouraged. It may be a battle at first but there are

great rewards to getting the endocrine system under control. Here are some of

the benefits I have had - less fatigue, better sleep, better food utilization

(less weight gain), less dry skin, less constipation, disappearance of a macular

pucker in my eye. Hopefully, long term, less chance of osteoporosis which runs

in my family. The endocrine system is very important to having a healthy body.

Marti

> >

> > Hi Sue,

> > I will share what I know. Others here have differing opinions so hopefully

they will jump in here.

> >

> > At a minimum, testing should include Free T3, Free T4 and TSH. The standard

testing is fine, you just use a different range. You should always get the test

results on paper so you can determine if they are normal yourself (as opposed to

getting a phone call from the doc or the nurse saying you are normal).

> >

> > I had alot of this info on a PC that crashed and I haven't yet copied over

my data. There are several great places to go for help.

> >

> > Here are some good books to read (I have included adrenal info as that

system is interlinked with thyroid system)

> >

> > Safe uses of Cortisol by Dr. Jefferies

> > Hypothroidism Type 2 by Dr. Mark Starr

> > Your Thyroid and how to keep it healhty by Dr. Peatfield

> > The Metabolic Treatment of Fibromyalgia by Dr. Lowe

> >

> > These books have been recommended to me and I am in the process of

reading/digesting. I cannot say 100% that these books are correct. Please use

this list as a starting point, join an adrenal/thyroid forum for general support

questions and find a doctor willing to help you (not easy - try alternative,

integrative, doctor of Osteophathy, naturopath or functional medicine - you can

try mainstream medicine but it may be hard to find someone who understands. If

they prescribe Armour and/or Hydrocortisone, then they may be more enlightened.

You can call a compounding pharmacy and ask which doctors prescribe Armour to

their patients. Some pharmacies will tell you, others won't.

> >

> > Here are some good forums:

> >

> > Forum Name: NaturalThyroidHormonesAdrenals

> > Moderator:

> >

> >

NaturalThyroidHormonesADRENALS/?yguid=27521\

4264

> >

> > Forum Name: Real Thyroid Help

> > Moderator:

> > http://www.realthyroidhelp.com/

> >

> > An informative website is " stop the thyroid maddness " website. I have linked

to their recommended labwork page as their website has been revamped. After

reading this page, go to the home page and review the material as your energy

allows.

> >

> > http://www.stopthethyroidmadness.com/recommended-labwork/

> >

> > Ferritin and cortisol levels should be checked as well since both of these

being low can keep you in a hypothyroid state.

> >

> > Lastly, about Synthroid and other synthetic T4 products. These normally do

not work. Armour thyroid changed it's formulation (due to new Federal

guidelines to remove dextrose from tablets (all tablets not just Armour thyroid

tablets). In doing so, the substituted filler has a more binding effect than

dextrose (which allowed the pill to be dissolved sublingually, a better method

of delivery.) So, if you get the new Armour thyroid formulation, you will find

that it does not work as well due to the binders. You may have to take slightly

higher doses.

> >

> > Personally, my mom, son, niece purchase their Armour thyroid equivalent from

overseas. The Canadian product is called " Thyroid " (I think) and the Asian

version is called " Thyroid-S " . I have not used the Canadian version but the

Asian version does dissolve under the tongue and can be split with a pill

splitter very easily (without crumbling into a million pieces).

> >

> > It can also be compounded by a compounding pharmacy.

> >

> > HTH,

> > Marti

>