GP says I'm in "the normal range" - only yearly tests now

[luthien]

Hey, so after lots of blood tests, and Thriva ones, combined with my Endometriosis the GP finally admitted I have Autoimmune Hypothyroidism, so I'm on medication for that. Since there's a link between Endometriosis, Hypothyroidism, and Diabetes I want to keep an eye on my HbA1c levels.

Results:

01/12/2020 Annual HbA1c 54 mmol/mol (NHS GP) - family history of prediabetes. Nearing the maximum pain and symptoms for Endometriosis - requires invasive surgery. GP considering possible links to Hypothyroid symptoms.

13/01/2020 HbA1c 49 mmol/mol (Thriva subscription with other tests)

20/01/2021 surgery to excise endometriosis

16/02/2021 GP finally admitted I need Levothyroxine - starter dose of 50ug

19/02/2021 Routine 3 monthly HbA1c 46 mmol/mol (NHS GP) - kept up with the dietary changes to help with endometriosis symptoms

I have rang my GP to pre book in an appointment to have my repeat HbA1c as usual which would be early May, best to get them in soon and all that. They have said as my last reading was 46, I now only need yearly tests.

I'm not happy with that as my thyroid medication will need monitoring and could change, this will have an impact on the risk of developing diabetes, and I still have endometriosis which could flare up. It's clear that my levels are changing so quickly, and could go up as well as down. So should I be pushing for the 3 monthly check at least until I'm out of the "prediabetic range"? When I'm back into the normal range then I'd understand the need for only yearly checks.

I'm happy to do just the Thriva test if this is something which is okay to self monitor and skip trying to push the GP.

[Koalajane]

I am surprised as some of your Hba1c results are in the diabetic range, so I would push for a 6 month blood test.

[luthien in reply to Koalajane]

I shall see if I can ask for 6 months.

I think they're going on the last result being pre-diabetic, so no action required. They completely ignored my Thriva one, saying it's not a true test.

[Koalajane in reply to luthien]

My hba1c is 39 now and my diabetic nurse is happy to review every 6 months

[luthien in reply to Koalajane]

The GP is going by the NICE Diabetes guidelines (and Diabetes UK sites) which say I need two consecutive HbA1c readings in the diabetic range to be diagnosed with Diabetes and assigned a Diabetic Nurse. This makes sense as statistically a diagnosis should not be made on one reading alone. So I have not been assigned a Diabetic Nurse, and I am now in the prediabetes range - i.e. normal, so yearly tests. Hence why I'm wondering if I should push for them more frequently.

[Pigivi]

How often your GP will test you for Hashimoto's? When I was diagnosed I was tested every 3 month until it stabilized - my first diagnosis of Type 2 came at 57 HbA1C - 3 months later I was 37 - stayed in normal range now for 2 years, and still my GP wants me to be tested every 6 month

PS I'm in Ireland

[luthien in reply to Pigivi]

For the Hashimoto's the NICE Thyroid Disease Guidelines say it should be tested at 6 to 8 weeks until stabilised. Then once a year, any change in brand of medication or change of dose should force a retest at 6 to 8 weeks again. I will be due a test in a few weeks so I'm expecting a dose adjustment as I'm on the starter dose.

Every six months makes sense for your HbA1c test, that's what I was expecting mine to do, but they've said as I've not been diagnosed as Diabetic I don't need regular tests. NICE Diabetes guidelines (and Diabetes UK sites) say I need two consecutive HbA1c readings in the diabetic range to be diagnosed with Diabetes. This makes sense as statistically a diagnosis should not be made on one reading alone.

[LottieMW]

What bad luck they didn’t book you in sooner for a repeat HbA1c at the beginning. I saw my GP as a raised BP was picked up in work (Jan 2020). They did a full blood screen (quote…we’d better give you a full MOT!), including A1c due to family history. Mine was 52. Saw GP who booked me in the following week (so about 2.5 weeks apart!) for repeat test. This was also 52, so diagnosis of type 2. Then COVID hit…

I basically went on a low carb/high fat (LCHF) diet, and only ate within a 14-16 hour window. (No late night snacks!)

Oh did I mention I also was diagnosed with hypothyroidism 🤦🏻‍♀️

I went on the thyroid uk forum for info, and made sure I still got my blood tests…mainly by being lucky enough to work in a NHS setting, so got my colleagues to take my bloods to send to the surgery! I was therefore in control of which tests I had.

3 months later HbA1c was 42, then end of August 39. I’m due my annual review Wednesday. I’m hoping it’s still down as I have been more relaxed with my carbs, but I am still maintaining my weight loss (13-7 Jan 2020 to currently 10-4).

I’m going to badger her to check my thyroid levels…

So…if you’re going in for thyroid levels, I would ask the nurse to do an extra bottle for your diabetic bloods.

Sorry I waffled on, but I know exactly where you are coming from.