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THE Q & A

Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.

Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.


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ForumForumDiscussionsDiscussionsQuestion and An...Question and An...Getting my GP serious about T3/T4Getting my GP serious about T3/T4
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 6/21/2010 9:50 AM
 
Elaine:

Last week, my cardioilogist set me up for an EP test, believing my tachycardia and fatigue symptoms may be related to a heart disfunction. She also suggested that the mild nausea I have had for the past three months (dry heaves one morning back in April) could be related to a gall bladder problem. I am not eager to do the invasive EP test until I know more about my thyroid, and my GP refuses to look at my T3/T4.

If there is a T3/T4 imbalance, is it permanent, or does it fluctuate so that sometimes the readings are properly balanced? Would a T3/T4 reading anytime during presence or absence of symptoms reveal the same thing? If so, can you suggest how I get my GP to agree to a T3/T4 test before any invasive procedure like the EP test?

Thank you for your continuing consideration.

Michael E. Lindenmeyer
100621.0850

Michael E. Lindenmeyer, MS,MS, PE
New Post
 6/21/2010 2:24 PM
 

Hi Michael,

In all states except NY, NJ and RI, you can get direct access to lab testing. That is, you can order certain tests on your own without a doctor's order if you go to a lab that does direct access testing. At this link you can order and pay for your labs and they'll send you to the closest lab. Your lab results are available to you and you can submit them to your doctor. In some cases you can submit the testing fees to your insurance company although not all companies reimburse for direct access testing. It would be better to have tests for FT4 and FT3 since these levels measure your available thyroid hormone.

As long as both levels are within range, there isn't a specific balance between the levels that's needed. In fact, most people feel best with FT4 between mid- and high-range, and an FT3 around mid-range. Your thyroid hormone levels (in the absence of a thyroid disorder) are usually fairly stable and they're kept stable by the pituitary hormone TSH. So you'll see more fluctuations in TSH.

If you have a thyroid condition then your levels can differ depending on whether you're having a flare. In early disease, periods of flares and symptoms can alternate with periods of normalcy.

As for convincing your doctor, you could mention that the thyroid influences cardiac function, but he probably knows that. If he's tested you for TSH and it's normal, he probably figures that this is adequate, and in most people it is since normally TSH reflects thyroid function. As a screening test, TSH is usually adequate but when one has a thyroid disorder they're being treated for, TSH can be misleading. Best, Elaine

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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.

 

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