[grekson]

#1073060

Generally you want the tests done in a decent laboratory and have after your blood is drawn it analyzed for everything possible including what you mentioned.One test should tell so much.As for T3 if T4 is fine T3 will follow to normal level as well within a month or 2.

[mrstheweav]

#1019644

I have had the unfortunate luck of having seemingly inept doctors. I had one who diagnosed graves and said there is nothing that can be done and left it at that, no monitoring or anything. I think it was because I had high levels of antibodies but average levels of T4 and FTI. But I wanted a scond opinion so I went to another doctor who looked at my labs and said I absolutely do not have graves disease. I asked about the antibodies and he said that just means I have an infection. He said that if it was graves I would have other symptoms (which he didn’t even ask if I had, and my resting heart rate at the dr was 92). He also said my eyes would be bulging, but from what I understand that doesn’t happen all the time. I do have some symptoms but I don’t know if they are related to my thyroid or are just part of a somewhat stressful life. So I am totally lost and confused! I have not had a TSH test done, a free T4 (although they did do a Free Thyroxine Index (FTI)), or any T3 tests. So, I am going back to the first doctor (unfortunately because of insurance reasons my doctors are very limited and I’ve run out of good options) and I want to know what I should have him test to see if there really is anything to worry about. Does anyone have any good advice on what tests are best at determining graves? Is a Free T4 test better than a FTI? I have read things both ways but I can’t really find anything good about which test is preferred. Also do I need the T3 tests? I read somewhere that sometime T4 can be normal while T3 is elevated. And everything I read says that TSH should be one of the first tests done. I guess I just want some kind of confermation that I am getting the tests I need to see if I need to be referred to an endo. Please help, these doctors are making me go even more crazy than I am already going! Thanks.

[Ski]

#1073061

The best two levels to draw for a full picture are TSH and T4. Make sure you get a copy of the results, so you can see the normal ranges and where you fall in relationship to them. If you fall within the normal range, but just barely, that’s something to consider. Any historical test results belong to you, and you should be able to get copies if you didn’t get them for yourself the first time.

The final piece of the puzzle to diagnose Graves’ is usually an uptake/scan of your thyroid. You ingest a small amount of radioiodine (NOT the destructive type, just something that can be "read" after you’ve ingested it), and they check your thyroid after six hours and again at 24 hours to see what percentage of the substance has been taken up into your thyroid. The percentage and the uptake pattern give a pretty conclusive picture of Graves’ or not.

Unfortunately, there are many times that we end up with doctors who do not understand this disease fully. It’s a good thing you’re reaching out for information. For this one, we need to be our own best advocate.

[mrstheweav]

#1073062

Thank you both for your responses. That helps. Grekson, as far as having a decent lab do the work, do you know if there is any way to know that? Also, Ski, would I have my GP do the uptake/scan or would it be best to have him refer me to an endo to have that done? I did get my results from my first labs. My total T4 and FTI were normal but on the high normal side, but I didn’t know if that mattered at all. I am actually going to see if I can get any of my lab work from when I was younger and I was hypo in high school and when I was pregnant. I don’t know if there will be anything useful on there but it might give an endo a better picture. At this point I don’t care if it is graves or not but just being in this state of limbo is driving me crazy! I am sure it will all work out in the end, one way or the other. Thanks again.

[Ski]

#1073063

The uptake/scan is done in a radiology lab, so you’d just need a request for the test and then you’d schedule it with the lab. Your GP should be able to refer you, but you may want an endo to do it, just because they probably have established relationships with the labs.

If you’re looking for a picture of your blood test results going forward, it’s a good idea to have them done at the same lab, at the same time of day (generally, like morning, or evening), under the same conditions (i.e., haven’t eaten, or just eaten, just before your medication, or whatever). Having them done under similar circumstances will help with consistency, so it will help you figure this out.

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