**************************************************************************************
Prof. Tim
Reynolds
Consultant Chemical Pathologist / Clinical Director -
Diagnostics / R&D Lead,
Burton Hospitals NHS Foundation
Trust
work tel: 01283 511511 ext 4035
work fax: 01283
593064
work email: [log in to unmask]
work URL:
www.burtonhospitals.nhs.uk
This e-mail, and any files transmitted
with it, are confidential and intended solely for the use of the individual to
whom it is addressed. If you are not the intended recipient please destroy this
message, delete any copies held on your systems, and notify the sender
immediately. You should not retain copy or use this e-mail for any purpose, nor
disclose all or any part of its content to any other person. If you have
received this e-mail in error, please notify me on 01283 511511 Ext
4035
[Picture of tree not available] Please consider the environment before printing this e-mail
--- This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within. The identified sender is [log in to unmask] --- |
During
my short time in clinical biochemistry, I have seen a number of cases of
patients desperate for their FT3 to be measured and not being given it.
Some of the comments on the article interesting…one particularly, which blames
us lab staff for being part of the problem…
“The arrogance of those running the laboratory service
astounded me”
“Whilst the article points out "So, if your blood
test doesn't show you to be low in T4, you won't be prescribed thyroid hormones
that could alleviate your symptoms", there's a good chance that your local lab
(which supposedly works for your Doctor) won't provide a T4 result. The testing
laboratory have their own protocol which frequently means that if the TSH result
is in the Normal Range (~ usually 0.3 to 5.0), then they routinely don't provide
a T4 result let alone any of the other thyroid function tests. My result was
just above the Reference Range and my own doctor asked three times for more than
the TSH but was ignored and when I wrote to the Area Health Authority, I
received a reply which said that my own doctor ought to know better than to ask.
They said they had provided GP's with guidelines as to what they would test for
and she should not have asked! The arrogance of the those running the laboratory
service astounded me. “
When lab reports go directly to patients I imagine we will receive a
significant number of calls from educated patients wanting FT4/FT3 measurements
if they haven’t been given one.
Simon
From: Clinical
biochemistry discussion list [mailto:[log in to unmask]] On
Behalf Of Peter Beresford
Sent: 09 September 2014
16:19
To: [log in to unmask]
Subject: Low T3
syndrome
Dear
Mailbase,
We have
received calls from GPs who have been approached by a number of patients
regarding the article below, which was published in the Daily Mail last
week.
The
subject of the article is ‘Low T3 syndrome”, and it suggests to patients that
they require FT3 measured routinely in addition to FT4, as well as opening up a
debate with regards to treatment with T3. The article quotes respectable
Endocrinologists quoted both for and against (although I suspect some of their
comments may have been taken out of context).
I would be
interested to know if others have also been approached in response to this
article and what guidance has been given to GPs responding to these
queries.
The
guidance documents available on the British Thyroid Association website (http://www.british-thyroid-association.org/Guidelines/
) are very helpful, but recognising that this is a complex area I wonder if
anyone is aware of any more recent evidence or guidelines about the role of T3
in the aetiology and treatment of hypothyroidism?
Best
wishes
Peter
Peter
Beresford
Consultant
Clinical Scientist
Southmead
Hospital
DISCLAIMER: The information in this
message is confidential and may be legally privileged. It is intended solely for
the addressee. Access to this message by anyone else is unauthorised. If you are
not the intended recipient, any disclosure, copying, or distribution of the
message, or any action or omission taken by you in reliance on it, is prohibited
and may be unlawful. Please immediately contact the sender if you have received
this message in error. Thank
you.
------ACB discussion List Information-------- This is an open
discussion list for the academic and clinical community working in clinical
biochemistry. Please note, archived messages are public and can be viewed via
the internet. Views expressed are those of the individual and they are
responsible for all message content. ACB Web Site http://www.acb.org.uk Green
Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List
Instructions (How to leave etc.) http://www.jiscmail.ac.uk/