He is probably mostly wrong - but who knows, there may be some patients
for whom he is correct...
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Prof. Tim Reynolds
Consultant Chemical Pathologist / Clinical Director - Diagnostics / R&D
Lead,
Burton Hospitals NHS Foundation Trust
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-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Waise, Ahmed
Sent: 10 September 2014 11:14 AM
To: [log in to unmask]
Subject: Re: Low T3 syndrome
http://www.wilsonssyndrome.com/
So you think Dr Wilson is right!?
Ahmed Waise
Poole Hospital,
________________________________________
From: Clinical biochemistry discussion list
[[log in to unmask]] on behalf of Fiona Davidson
[[log in to unmask]]
Sent: 10 September 2014 11:01
To: [log in to unmask]
Subject: Re: Low T3 syndrome
Nobody seems to have really addressed Pete's original question of "has
anybody had enquiries from GPs about this" and what do we suggest to GPs
who have an irate patient in front of them demanding measurement of FT3.
I can't think that we have recently had any specific enquiries about FT3
that relate to this article, however, we do occassionally get specific
requests from very demanding patients who have read something similar on
the internet and are convinced that they need their FT3 measured.
Whilst we always try and reason that their normal TSH (we do not offer
FT4 as first line) means that they are more than likely completely
euthyroid we always offer them the option to pay for FT4 and/or FT3
privately. You would be surprised how many of them are completely
thrilled by this suggestion so you get the double bonus of gettting them
to stop shouting at you whilst also proving your original assertion to
be entirely correct.
I think the other important point made by others here is that the
numbers don't always tell the whole picture. It's important that our
GPs know that we are there on the end of the phone and we are always
happy to make exceptions for individual cases where the clinical picture
just doesn't fit with what the TSH (and/or FT4) is telling you. Perhaps
there are very rare cases of pure low T3 syndrome and while this
possibility doesn't justify measuring FT3 in everyone who wants it we
have to remember that (in most cases) we don't see (or have to deal
with) the patient and there may be times when measurement is fully
justified even if it is only to act as a rule out. Aren't we always
being told to treat the patient and not the numbers?
Fiona Davidson
Senior Clinical Biochemist
Kingston Hospital NHS Trust
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