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thyroid tests

Posted by katekite on November 7, 2005, at 22:56:22

In reply to Re: what is included in full thyroid panel tests?, posted by Iansf on November 4, 2005, at 19:21:42


1. All thyroid panels should include a TSH. A pituitary hormone, this is what signals the thyroid to make the thyroid hormones.

2. Then there is a choice in measuring thyroid hormone levels, the actual products of the thyroid gland:

A. Older choice, still a good one.

Total T4
or, both total T4 and total T3
T3 uptake
FTI (calculated value from T4 and T3 uptake (must have both of those values and note its T3 uptake that is needed, not just T3), this value approximates the free T4).

(doing just a T4 is not as good as doing enough to get a FTI).

B. Newer choice, the free levels are the active form of the thyroid hormones:

Free T4
or Free T3
or both

3. Some panels may include reverse T3

4. Highly recommended (by me, a non-expert veteran of the thyroid wars) to do thyroid antibodies:

A. If your symptoms are more suggestive of hypOthyroidism do a TPO (also called microsomal antibodies or thyroid peroxidase antibodies) and also thyroglobulin (TG) antibodies.

B. If your symptoms are more suggestive of hypErthyroidism do the TPO plus TG plus TBII (and there is another antibody too that I forget the name of), google "Grave's antibodies". The reason to also do TPO and TG, found more in hypO, is those can also be associated with hypER (the reverse is not true, the Grave's antibodies are not found in hypO).

Trying to decide are you hypo or hyper?

Method 1: symptoms. But this can be confusing since symptoms overlap, for example the weak fatigue of hyper can feel just like the depressed exhaustion of hypo. Weight can be gained or lost in either, despite what simplistic overviews say.

Method 2: TSH in the lower half of normal or below normal, think hyper. TSH in the upper half of normal range or above range, think hypo.

If TSH and thyroid levels are in normal range and doc says thyroid is fine but antibodies are even mildly out of whack, ask to recheck the TSH in a few months (2 or 4 maybe), see if it is headed in a direction, is there a trend going towards hypo or hyper... people say subtle problems can take years for blood tests to pick up on but you can figure it out sooner than that by looking for a trend.

Kate

PS. I found much misinformation among docs and I would check your lab-slip to see that what you need is there before having the blood drawn, it is better to take the extra time needed to get it right the first time, its half impossible trying to get a whole second blood draw when it turns out they test someone with hypO symptoms for the Graves antibodies or do reverse T3 and a T3 uptake and then wonder why they don't report a FTI, usually they will just shrug and say well it looks fine, when really it would be better to have a complete picture.


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