thyroid

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Part of endocrine function analysis involves primary (actual organ) and secondary (pituitary). TSH (secondary) has historically been considered the most sensitive test for abnormalities. At my hospital usually thyroxine and free T4 are measured. T3 is measured sometimes, and seems to be increasing as an analyte. My understanding is that TSH is unreliable for sick inpatients.

TSH is unreliable for all patients in assessing thyroid function. If doctors had a clue, they would only use TSH to assess pituitary function in order to rule out secondary hypothyroidism, and assess actual thyroid function using free T4 and free T3.

Agree with fbug, TSH FREE T4 FREET3 also Reverse T 3 for a complete Thyroid Function Assessment....just got my results Friday... also included Thyroid Peroxidase Ab. and Antithyroglobulin ab. ( antibodies)......mine showed drastically high Thyroid Peroxidase Antibodies am awaiting a call from my DR on Monday.
Tests requested by most GPs are useless as they only test TSH ( thyroid stimulating Hormone) ....which is extremely limited in assassing thyroid function.

It is limited but it is sensitive and preliminary. Treatment protocol is not going to be based on TSH alone. It is the free T3 and T4 that are active; but, in the absence of total levels clinically significant shifts in binding proteins may be missed.

I think rT3 would be an unusual test to be performed at a hospital laboratory. I'm not sure if that's even done at most regional reference laboratories. I think it would be useful in chronic disease as well as athletes. It has been shown elevated in highly trained endurance athletes.

Autoimmune conditions can sometimes be spotted a mile away. Physical exam and patient history will certainly affect what tests are ordered.

Screening tests can often be either simply a qualitative or quantitative tests, with further testing based on preliminary results.

Hi NEWanderer! Yes I doubt rT3 test would be done in most hospital or pathology labs, it is necessary to find an Intergrative Pathology Lab, I don't know which country you are from but here, in OZ , it was not easy to find help in this area. I also have ME/CFS so that was what led me to research alternatives.

I'm in USA. The reference lab that my hospital is currently phasing out tests for rT3 I think only at their main lab in the Midwest. We don't test for Free T3 either on site as it's not part of a test group for insurance purposes here in this country. My for profit hospital couldn't break even on it right now.

Can you clarify ME/CFS? Chronic fatigue syndrome?

Yes NE Wanderer ME/CFS is chronic fatigue immune dysfunction syndrome ( CFIDS).
In UK known predominately as ME/CFS /CFIDS, also known as Post viral Syndrome.

Thanks. What does ME stand for? If that term is used here in the US it must be pretty esoteric. I read as far as the abstract of the recent study linking the retrovirus XMRV to CFS.

ME= Myalgic Encephalomyelitis
NEWanderer the above is what ME in ME/CFS stamds for.........