Hospital refusing to do T3 blood test

[Guest guest]

My doctor dropped a bombshell on me today when he called with my blood

results. He told me that the hospital had sent a note back to him

refusing to do a T3 test.

I have had hypothyroidism now for over four years and have tried

various treatments. I stopped taking synthetic T4 sometime ago because

I never felt as if it ever relieved my symptoms.

For a while I had been taking synthetic T3 alone and although it wasn't

been all that much better is still felt like the best option.

Then recently I tried taking armour thyroid one 60mg tablet a day with

my tertroxin (T3)20mcg. I have not told my doctor about the armour as

he does not approve of it. I had to fight tooth and nail to get my

tertroxin prescribed and now with the hospital's refusal to do the test

it looks like my condition won't be monitored at all. I really do not

know where to go from here. My symptoms have been getting worse again

but I am afraid to up my dose too much incase I make matters worse. I

really am at my wits end and feel so alone.

[Guest guest]

I don't know where you are from but in my neck of the woods I don't

have to go to just one hospital to get blood drawn for tests.. Do

you have to go to just that one hospital to get it done... It might

be a longer distance but it's worth it to go. And too , to get

another doc.....

Bev

>

> My doctor dropped a bombshell on me today when he called with my

blood

> results. He told me that the hospital had sent a note back to him

> refusing to do a T3 test.

>

> I have had hypothyroidism now for over four years and have tried

> various treatments. I stopped taking synthetic T4 sometime ago

because

> I never felt as if it ever relieved my symptoms.

>

> For a while I had been taking synthetic T3 alone and although it

wasn't

> been all that much better is still felt like the best option.

>

> Then recently I tried taking armour thyroid one 60mg tablet a day

with

> my tertroxin (T3)20mcg. I have not told my doctor about the armour

as

> he does not approve of it. I had to fight tooth and nail to get

my

> tertroxin prescribed and now with the hospital's refusal to do the

test

> it looks like my condition won't be monitored at all. I really do

not

> know where to go from here. My symptoms have been getting worse

again

> but I am afraid to up my dose too much incase I make matters

worse. I

> really am at my wits end and feel so alone.

>

[Guest guest]

WHY does the hospital refuse to do the T3?

Hospital refusing to do T3 blood test

My doctor dropped a bombshell on me today when he called with my blood

results. He told me that the hospital had sent a note back to him

refusing to do a T3 test.

SNIP SNIP SNIP

..

<http://geo./serv?s=97359714/grpId=145664/grpspId=1709251082/msgId=

26306/stime=1164317196/nc1=3848647/nc2=3848432/nc3=4025369>

[Guest guest]

Thank you to everyone who has replied to me.

I am originally from Scotland but I have lived in Donegal which is

in the north west of Ireland for the last ten years. My nearest

hospital is Sligo general and health resources are very poor in this

part of the world. My doctor has not yet explained to me why the

hospital refused to do the test only that his request was declined.

The attitude in the west of Ireland is quite simply that there is

one treatment for hypothyroidism, that is eltroxin (levothyroxine).

As I have said before two years of taking this hormone did little or

nothing for my symptoms. I became clinically depressed during that

time and had to take anti-depressants. I now refuse point blank to

take it and since stopping it I have had no more episodes of

depression. I have had to fight to get my T3 prescribed and now

they are refusing to monitor that as well.

I had a bad experience with a consultant endocrinologist in Galway

two years ago a very arrogant man who told me that he had 30 years

experience in his field and that I should not be wasting my time on

internet sites, levothyroxine was the tested and proven treatment

for my condition.

I also saw a doctor privately in Dublin at one point but his

consultations were so expensive I just could not afford to carry

on. He also wanted me to take a host of expensive supplements and

vitamins the cost of which would have left me bankrupt.

My doctor said he would refer me to a new consultant who has just

arrived in Sligo but I doubt very much if his attitude will be any

different. We shall see.

I think I mentioned that I have been taking Armour which I have had

to purchase over the internet and self medicate with. I am taking

one 60mg tablet a day along with my synthetic T3 20mcg.

>

>

> why why why don't you seek help from the english thyroid

group? found from http://www.geocities.com/thyroide I believe you

are in Scotland right? Somehow you need to get on all Armour and

high dose iodine would help a great deal.

> http://www.helpmythyroid.com

> Gracia

>

[Guest guest]

bridan90,

You wrote:

>

> The attitude in the west of Ireland is quite simply that there is

> one treatment for hypothyroidism, that is eltroxin (levothyroxine).

> As I have said before two years of taking this hormone did little or

> nothing for my symptoms. I became clinically depressed ...

Again, how much were you taking? Many on this list report bad reactions

to the drug, when they simply weren't getting enough.

Chuck

[Guest guest]

I am on Synthroid .0125 mg which I take in the morning. I have been on this

same dose for 4 years--have gained 50 pounds which I cant get rid of. I have

walked etc but never lose a single pound. It is very depressing because I was

always 112 until 3 years ago when I was gaining a pound a day until I had gained

the 50# then it stopped and I stayed here. I am going to go in and make sure

that they up my dose and maybe I'll lose the weight. If anyone has lost weight

with low thyroid--please let me know how you did it

bridan90 <bridan90@...> wrote: Thank you to everyone who has

replied to me.

I am originally from Scotland but I have lived in Donegal which is

in the north west of Ireland for the last ten years. My nearest

hospital is Sligo general and health resources are very poor in this

part of the world. My doctor has not yet explained to me why the

hospital refused to do the test only that his request was declined.

The attitude in the west of Ireland is quite simply that there is

one treatment for hypothyroidism, that is eltroxin (levothyroxine).

As I have said before two years of taking this hormone did little or

nothing for my symptoms. I became clinically depressed during that

time and had to take anti-depressants. I now refuse point blank to

take it and since stopping it I have had no more episodes of

depression. I have had to fight to get my T3 prescribed and now

they are refusing to monitor that as well.

I had a bad experience with a consultant endocrinologist in Galway

two years ago a very arrogant man who told me that he had 30 years

experience in his field and that I should not be wasting my time on

internet sites, levothyroxine was the tested and proven treatment

for my condition.

I also saw a doctor privately in Dublin at one point but his

consultations were so expensive I just could not afford to carry

on. He also wanted me to take a host of expensive supplements and

vitamins the cost of which would have left me bankrupt.

My doctor said he would refer me to a new consultant who has just

arrived in Sligo but I doubt very much if his attitude will be any

different. We shall see.

I think I mentioned that I have been taking Armour which I have had

to purchase over the internet and self medicate with. I am taking

one 60mg tablet a day along with my synthetic T3 20mcg.

>

>

> why why why don't you seek help from the english thyroid

group? found from http://www.geocities.com/thyroide I believe you

are in Scotland right? Somehow you need to get on all Armour and

high dose iodine would help a great deal.

> http://www.helpmythyroid.com

> Gracia

>

---------------------------------

Everyone is raving about the all-new beta.

---------------------------------

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[Guest guest]

I am on Synthroid .0125 mg which I take in the morning. I have been on this

same dose for 4 years--have gained 50 pounds which I cant get rid of. I have

walked etc but never lose a single pound. It is very depressing because I was

always 112 until 3 years ago when I was gaining a pound a day until I had gained

the 50# then it stopped and I stayed here. I am going to go in and make sure

that they up my dose and maybe I'll lose the weight. If anyone has lost weight

with low thyroid--please let me know how you did it

bridan90 <bridan90@...> wrote: Thank you to everyone who has

replied to me.

I am originally from Scotland but I have lived in Donegal which is

in the north west of Ireland for the last ten years. My nearest

hospital is Sligo general and health resources are very poor in this

part of the world. My doctor has not yet explained to me why the

hospital refused to do the test only that his request was declined.

The attitude in the west of Ireland is quite simply that there is

one treatment for hypothyroidism, that is eltroxin (levothyroxine).

As I have said before two years of taking this hormone did little or

nothing for my symptoms. I became clinically depressed during that

time and had to take anti-depressants. I now refuse point blank to

take it and since stopping it I have had no more episodes of

depression. I have had to fight to get my T3 prescribed and now

they are refusing to monitor that as well.

I had a bad experience with a consultant endocrinologist in Galway

two years ago a very arrogant man who told me that he had 30 years

experience in his field and that I should not be wasting my time on

internet sites, levothyroxine was the tested and proven treatment

for my condition.

I also saw a doctor privately in Dublin at one point but his

consultations were so expensive I just could not afford to carry

on. He also wanted me to take a host of expensive supplements and

vitamins the cost of which would have left me bankrupt.

My doctor said he would refer me to a new consultant who has just

arrived in Sligo but I doubt very much if his attitude will be any

different. We shall see.

I think I mentioned that I have been taking Armour which I have had

to purchase over the internet and self medicate with. I am taking

one 60mg tablet a day along with my synthetic T3 20mcg.

>

>

> why why why don't you seek help from the english thyroid

group? found from http://www.geocities.com/thyroide I believe you

are in Scotland right? Somehow you need to get on all Armour and

high dose iodine would help a great deal.

> http://www.helpmythyroid.com

> Gracia

>

---------------------------------

Everyone is raving about the all-new beta.

---------------------------------

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[Guest guest]

> >

> > The attitude in the west of Ireland is quite simply that there is

> > one treatment for hypothyroidism, that is eltroxin (levothyroxine).

> > As I have said before two years of taking this hormone did little

or

> > nothing for my symptoms. I became clinically depressed ...

>

> Again, how much were you taking? Many on this list report bad

reactions

> to the drug, when they simply weren't getting enough.

>

> Chuck

The largest dose I ever had of levothyroxine was 100mcg

>

[Guest guest]

Sandy,

You wrote:

>

> I am on Synthroid .0125 mg which I take in the morning. I have been on

> this same dose for 4 years--have gained 50 pounds which I cant get rid

> of. ...

I assume you mean 0.125 mg or 125 mcg. Unless you still have half your

thyroid working or are male, this is not nearly enough. The

manufacturers' recommended replacement dosage for average weight adult

women is 200 mcg. If you are male, then this could be about right.

Chuck

[Guest guest]

bridan90,

You wrote:

> The largest dose I ever had of levothyroxine was 100mcg

Again, that is probably less than half of what you need, and there is

very little symptom relief until you get very close to the right dose.

Rather than fight over Armour and T3 tests, you might simply show your

doctor the recommended dosing schedule and ask him why he is so far off.

Chuck

[Guest guest]

Chuck, I told my endo that 200 mcg was the full replacement dose for females for

synthroid. He told me that it was 125 mcg and that females needed less than

males. I'm currently taking 125mcg (no thyroid function left at all and am

female) and I definitely feel like it's not enough. All I could find on the

synthroid website was that most people didn't need over 200 mcg and that the

usual amound was around 125 (I believe). Could you direct me to where I could

find info on 200 being the right amount. I'd like to have something to bring

him so he hopefully stops trying to lower my dose! Thanks a lot,

Chuck B <gumboyaya@...> wrote: Sandy,

You wrote:

>

> I am on Synthroid .0125 mg which I take in the morning. I have been on

> this same dose for 4 years--have gained 50 pounds which I cant get rid

> of. ...

I assume you mean 0.125 mg or 125 mcg. Unless you still have half your

thyroid working or are male, this is not nearly enough. The

manufacturers' recommended replacement dosage for average weight adult

women is 200 mcg. If you are male, then this could be about right.

Chuck

[Guest guest]

,

You wrote:

>

>

> Chuck, I told my endo that 200 mcg was the full replacement dose for

> females for synthroid. He told me that it was 125 mcg and that females

> needed less than males. ...

Sorry, I did not keep the old guidelines, but I seem to remember they

were from Knoll Labs. I have no clue why they changed. The Abbott Labs

version on file with the FDA is at:

http://www.fda.gov/cder/foi/label/2002/21402lbl.pdf

The relevant excerpt says:

[... Therapy may begin at full replacement doses in otherwise healthy

individuals less than 50 years old and in those older than 50 years who

have been recently treated for hyperthyroidism or who have been

hypothyroid for only a short time (such as a few months). The average

full replacement dose of levothyroxine sodium is approximately

1.7 mcg/kg/day (e.g., 100-125 mcg/day for a 70 kg adult). Older patients

may require less than 1 mcg/kg/day. Levothyroxine sodium doses greater

than 200 mcg/day are seldom required. An inadequate response to daily

doses > 300 mcg/day is rare and may indicate poor compliance,

malabsorption, and/or drug interactions. ...]

So, the 200 mcg/day is now considered a sort of maximum replacement

dose, not a " full " replacement dose. Women generally need a higher full

replacement dose because estrogen increases thyroid binding globulin

(TBG). This removes a higher fraction of the total T4/T3 and leaves less

in the Free categories.

Also, 70 kg is 154 lbs. Perhaps your endo is referring to the difference

in average weights, in which case the 1.7 mcg/kg times the average

weight gives a lower total for women. However, I distinctly remember the

table that had females getting double the dose _rate_ of males at all

ages. For a male and female with similar weights, that means the total

dose would be about double, perhaps due to TBG.

[... Changes in TBG concentration must be considered when interpreting

T4 and T3 values, which necessitates measurement and evaluation of

unbound (free) hormone and/or determination of the free T4 index (FT4I).

Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral

contraceptives, and acute intermittent porphyria increase TBG

concentrations. ...]

So, the new guidelines call for titrating to a combination of Free T4

and TSH. I suppose that is the best we can argue to the doctors for now.

Sorry if I caused any embarrassment.

Chuck

[Guest guest]

,

You wrote:

>

>

> Chuck, you didn't cause any embarrassment ...

Good.

FWIW, I remember discussing the guidelines some time ago with my own

physician, and he confirmed that most women end up much higher than the

average, roughly double the range for men. Guidelines are conservative

but also based on statistics, which can be skewed by relatively small

effects.

For example, they must figure the average 1.6 mcg/kg for post-menopausal

women only, since they specify that the presence of estrogen RAISES the

replacement significantly. As I recall, the number of men is less than

10%, so the average is really for these older women ONLY. It also must

be based on the old reference range with a max of 5.0. In other words,

the 1.6 average is for the group that gets below 5.0 at that dose. The

new reference range tells us that the average is not based on a

population that is properly treated.

According to the guidelines, the 200 mcg amount should be considered a

" maximum replacement dose. " However, that seems to be the most common

dose I encounter, especially for younger women.

Chuck