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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Medical
Satisfied Customers: 3123
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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Why won't my endocrynologist order a Free T3, Free t4 and a

Customer Question

why won't my endocrynologist order a Free T3, Free t4 and a T4 along with the tsh? She says they aren't necessary!
JA: The Doctor's require payment for their services. It's way less expensive on JustAnswer than face-to-face would cost. When was the last time you had your levels checked? Have you noticed any weight loss or weight gain?
Customer: Any reason?
JA: Anything else in your medical history you think the doctor should know?
Customer: Not really, I have Lymphedemia and am toher wise in good health. Lately, I find I can't write well and am tired, can't lose wait and losing a lot of hair!
Submitted: 2 months ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 2 months ago.

Hi,

Can i ask are you on any treatment already for your thyroid? have you been diagnosed yet? This information will allow me to answer your question in a better manner.

Customer: replied 2 months ago.
Synthroid 125mcg
Expert:  Dr. Muneeb Ali replied 2 months ago.

Ok thanks for the additional information, ill just compose my answer and get back to you in a couple of minutes!

Customer: replied 2 months ago.
no
Expert:  Dr. Muneeb Ali replied 2 months ago.

Well usually doctors dont order free T3 and T4 levels when monitoring your treatment protocols as a TSH alone will be able to determine if your drug dosage needs to be adjusted, this is because if you are on a low dose of the drug which seems to be the case here then the TSH will be high. This is the likely scenario in your case because of the symptoms that you have mentioned. A free t3 and t4 is ONLY recommended to be done in those cases where your TSH is normal and within the therapeutic range and you still have symptoms of hypothyroidism. In such a case free T3 levels would be more important and you MAY need to be shifted to armour thyroid for T3 replacement. This occurs in those patients who are unable to convert synthroid to the active form of the hormone which is T3.

But in all other cases, TSH alone will give all the information that is needed.

Do you have any more questions?

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Customer: replied 2 months ago.
If I want these extra tests done, why wont the Dr accommodate me?
Expert:  Dr. Muneeb Ali replied 2 months ago.

If you want them done on your own, then your doctor SHOULD accommodate you however he may be bound by insurance rules which dont allow him to order tests which in his medical judgement are not necessary at this time. Otherwise he should be able to order the extra tests for you, if you request for them.

Do you have any more questions?

Customer: replied 2 months ago.
No thank you! I contacted my insurance and the costs are accepted!
Expert:  Dr. Muneeb Ali replied 2 months ago.

Then there is absolutely no reason for him not to order the tests, if the insurance accepts these extra tests then he can order them on your request. There is absolutely no HARM in getting them done. They may yield more information in a small group of patients as i mentioned in my initial response.

Customer: replied 2 months ago.
Okay! I'm done!! Thank you and goodbye!
Expert:  Dr. Muneeb Ali replied 2 months ago.

You're welcome, i hope i was able to answer your questions to your satisfaction?

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