On the subject of ?poor patient compliance it may be necessary to exclude
poor absorption of the
oral thyroxine dose. In some cases where compliance is an issue our
clinicians may go to the trouble of doing an oral thyroxine loading test
using a relatively large dose (?300 ug) and with blood being collected for
total thyroxine (AxSYM) at 0, 1, 2, 3 hours. I am a bit vague on the
interpretation of the results but a rise in values would tend to confirm
normal absorption and that the failure of therapy would be likely due to
non-compliance.
Michael Freemantle
Sullivan Nicolaides Pathology
PO Box 344
Indooroopilly Q4068
Australia
Ph +61 (0)7 33778638
Fax +61 (0)7 38705989
----- Original Message -----
Sent: Wednesday, January 19, 2000 7:52 AM
Subject: Half-life of T4 and patient compliance
> In these patients we do sometimes see a relatively high FT4 compared to
> the TSH, e.g. a raised TSH with FT4 at the upper limit of normal or
> there abouts. Our assays have been in control at the time. I know there
> are other possible explanations, but am I right that this could be due
> to poor patient compliance (raising the TSH), with the conscience
> stricken patient taking too many T4 tablets to compensate (pushing up
> the FT4) just before a clinic appointment?
> Dr S J Frost
> Clinical Biochemistry Department
> The Princess Royal Hospital
> Haywards Heath
> West Sussex
> England
> [log in to unmask]
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