Thyroid UK
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Doctor just asked me "why do you think it's your thyroid" ?? !!! Inside my head I was screaming !

Sitting here crying writing this as thinking will I ever get the right treatment.

Doctor - All your tests don't indicate it is your thyroid !!

Your results just show a slightly over the range TSH of 4.6 we would start treatment if it was about 11 and do I suffer from stress. Your iron levels are slightly low.

I said well I do have thyroid antibodies, raised TSH, pressure feeling in my neck and having coughing fits from that feeling, tiredness, my whole body is aching and all my other symptoms.

She has given me a prescription for 20mg of Omeprazole to try for 2 weeks and said if that doesn't work she might consider starting me on a small dose of thyroxine.

26 Replies

You poor thing! It does sound like hypothyroidism to me. I'm sure someone else more knowledgeable will be able to supply you with some written evidence about how TSH at this level is treated elsewhere in the world, and how the UK is too high. In the meantime, have you taken your basal temperature (on waking)? If this is low, then it's harder for the GP to argue with this.

Is the medicine for low iron or something else? If it's an anti-depressant, I would hesitate before taking it.

Good luck.



Omeprazole is for stomach acid doctor said the tightness feeling in neck might be acid reflux !


Exactly the same approach and drug given to me.......I'm hoarse and have same cough , feel as if there's something in my throat(very dry).....didn't even bother to get it dispensed. My TSH was 3.99 and I think my thyroid is struggling. Don't give up!


Oh my good god, I'm so sorry. My gp insisted the lump in my throat was 'anxiety' even though I didn't have it when anxious and I had a list of things that *were* wrong with me when I felt anxious, that incidentally he wouldn't treat me for anyway!


Change gp and interview another


Excellent idea.


How do you interview another GP?


2 wk appointment with another gp. If no joy.

You' Dr, I feel so bad, could I be checked for Barratts instead of trying levo thyroxine?

/Can I have something for pain? Can I have a vit d test. (Any other symptoms get loads of stuff prescribed), when you are ok you wont need these things.

Think about all the answers they have given. If good or tolerable stick with them. If not move on to the next gp. Interview them and so on. What you might find is that you use them for different things at different times. Try the locums, they can be v good sometimes and used as a filler appointment. Instead of taking up the real gps time.

Try a telephone appointment before the 2 weeks to sow the seeds of discussion.

It would be really great if you didn't have hypothyroidism.

When you start levo thyroxine it could make you feel worse initially. - this isn't talked about as much on this site, and the gp you have got might not understand this and think you are depressed.

Good luck.


your doctor is an idiot my husband take.s omerazole for his stomach, she must think your throat is due to reflux acid , what a load of rubbish if you read the leaflet it will tell you all about,

it i have an underactive thyriod and like you have coughing fits and my neck is swollen, i know it's upsetting , and they wear you down when you are at your lowest, is there another doctor you can see if not, ask around your area and change doctor's, they are all a disgrace, don't give in that's what they want you to do, i go every week to see mine he won't wear me down. you will get there in the end but you have to keep on at them don't except everything they say ms polly xx


Is the dr saying that omeprazole and thyroxine has the same function? It's a very strange thing to say. You are clearly hypothyroid and in many (most ) other countries you would have that diagnosis and started treatment. Waiting until you have a TSH of 11 is professional neglect. When I had TSH of 11 I was unable to get out of bed or string a sentence together. You either need to change GP (which is probably easiest) or gather information, a lot of it you can find on the TUK website, and write him/her a letter.

Every time I hear this sort of thing it makes my blood boil.

I would think twice before starting omeprazole as a lot of hypothyroid people have low stomach acid instead of high. The symptoms can be very similar. Just make sure first.



I agree with Roslin, you need to be careful with the Omeprazole, feels like that's just been prescribed as a fob off. Taking this drug will make matters worse if you have low stomach acid, and will interfere with absorption of vitamin B12, a disaster if you are already low on this (as most of us are). It is a disgrace how they dish out these drugs with no tests to confirm diagnosis; she has blood results right in front of her indicating possible hypo and she can't be bothered to run any more tests or trial treatment. Find someone else, or politely tell her that you don't feel like experimenting with Omeprazole until you've been referred to a gastro to confirm the diagnosis.


What is your FT4 level and what is your iron level. It is awful that you have to wait and I agree that you need to see another GP and another one if need be until you get one that is sympathetic. You have the antibodies, it is not going to get better.


These are the results the doctor was looking at this morning

Bloods taken 29th May at 9.30am (fasting test)

! Serum TSH level 4.46 (0.40-4.00) was 3.41 in January

Serum free T4 15.5 (12.00-22.00) was 14.7 in January

(Please note, these results have been released without consultant biochemist evaluation. Please phone laboratory if further interpretation is required)

Serum Vitamin B12 333 (180.00-800.00)

! Serum ferritin 20 (25.00-300.00)

Serum folate 3.5 (3.00-20.00)

Serum sodium 139 (133.00-146.00)

Serum potassium 4.3 ( 3.50-5.30)

Serum creatinine 73 (44.00-80.00)

GFR calculated MDRD 79 mL/min/1.73m2

8 Jan 2013 - ! Thyroid Peroxidase antibodies 317 (<49.00)[>75 = positive] TPO antibodies are associated with autoimmune thyroid disease


- Your TSH is rising and is now out of range + strongly positive TPOab is indicative of Hashi's. Hopefully someone else will comment on what your doc should be doing, as I have Graves so not sure.

- Your ferritin and folate are way too low and need action. She should have prescribed iron there and then given you are out of range. But you can't really take folate until you're sure of your B12 status. 333 is in the grey area so further testing is warranted, i.e. active B12, MMA/homocysteine. Link for these tests here:

See someone else at the practice, this doctor is not for you. How / why can you look at these results, and listen to the symptoms, and send someone away with Opramezole? What does she think is going to happen in the next 2 weeks? Don't waste time thinking any more about her, see someone else if you can.

H x


Your B12, Ferritin and folate are all low. Have you had a Vit D3 test? It wouldn't surprise me if that was low too. If I had these results I too would be feeling very tired. Is your Dr going to prescribe iron? Are you going to supplement to get the B12 and Folate up? Also your FT4 is not too low so I wonder if getting up these other things will help you to feel better in the short term. Obviously with that antibody result and your TSH being high and over their range you are hypothyroid and your GP is an idiot to not start treating it.

Insist on a Vit D test and some iron tablets and get your supplements going and get back to your GP within the 2 weeks and hold him to it, or get another GP. You could ask at the practice reception if any of the other GP's specialise in thyroid.


Hi there,

Your thyroid tests are indicative of autoimmune thyroiditis. Your current TSH and fT4 levels reveal 'subclinical' hypothyroidism. Many doctors do not prescribe levothyroxine at this stage, but given your symptoms and strongly positive autoantibodies (which indicate that your thyroid function is likely to deteriorate), other doctors would indeed prescribe levothyroxine. Frankly, I agree that you should make an appointment with a different doctor.

Your ferritin is out of range. Although a ferritin of 20 is rarely sufficiently low to cause anaemia, you still deficient. I suggest buying a pot of ferrous sulphate 200mg tablets from a pharmacy, if your GP has not prescribed a supplement. Take one tablet per day. These tablets do sometimes upset your stomach but are much more likely to be effective than the very low dose supplements you find in a supermarket.

Your folate is also rather low. Would you say you eat a balanced diet? High dose folate supplements are prescription only but you can buy 400mcg tablets from a pharmacy or supermarket (one brand is PreConceive). The risk of taking folic acid in the presence of B12 deficiency has been brought up. This applies when high doses of folic acid are given in the presence of pronounced B12 deficiency, when the B12 deficiency itself is left untreated. Although the optimal level of serum B12 is a matter of some dispute, you do not appear to be deficient. Low dose OTC folic acid supplements are safe.

If I were you I would take:

Ferrous sulphate 200mg tablets, one per day.

Folic acid 400mcg tablets, one per day.

And a good multivitamin.

Most of all see a different doctor.

Take care,



Make sure you hold your doctor to what she said... book that two-week follow up appointment now because I very much doubt that omeprazole will help you.

It may even make things worse... low mineral levels can cause a person to feel very cold, and omprazole reduces stomach acid, which is necessary to absorb minerals...

Comments below deleted by responder and Admin


>pressure feeling in my neck and having coughing fits from that feeling

If small amounts of stomach acid reflux from your stomach and pass from your throat into your lungs, a coughing fit can occur. Acid in the throat normally causes a burning feeling, not a pressure feeling. The prescription for omeprazole sounds a little odd.


At least some people believe that reflux in hypothyroidism has a genesis not based on excess production of stomach acid.

Indeed, it appears possible that the lower oesophageal sphincter closes better when stomach acid levels are at least adequate rather than low. Hence it could be diametrically the wrong medicine. (And could be why apple cider vinegar seems to help some people.)

I too was given some because of long-term nausea - and I did (maybe do) have a very slight reflux issue which only disclosed on a barium swallow. One tablet made me wretchedly sick and I took no more. (I think vitamin D resolved my nausea, but that is simply my best guess.)

And yet we see a considerable number of people here having been given omeprazole and often left on it long term. Quite often not the lowest dose. It often feels as if it is prescribed as a reflex action. Stomach = omeprazole.

[Hiatus hernia and gastroesophageal reflux disease as a manifestation of a newly revealed hypothyroidism].

[Article in Russian]

Savina LV, Semenikhina TM, Korochanskaia NV, Klitinskaia IS, Iakovenko MS.


The aim of the study was to reveal hypothyroidism (HT) in patients with hiatus hernia (HH), treated at Russian Centre of Functional Surgical Gastroenterology. The subjects were 64 women: 18--with HH and diffuse or diffuse nodular goiter, 36--with HH, and 10--without endocrine or somatic disease background. The examination included the evaluation of the thyroid and metabolic status, endoscopy, and 24-hour ph-metry. The results show that one of the early signs of HT is HH and gastroesophageal reflux disease. The latter in HT patients is associated with gastrointestinal motor-evacuatory disturbances rather than with acid exposition in the distal esophagus.



>At least some people believe that reflux in hypothyroidism has a genesis not based on excess production of stomach acid.

As far as I know, excess production of stomach acid is not believed to be a common cause of reflux. Hiatus hernia and LE sphincter dysfunction are common causes, and GORD is associated with pregnancy and abdominal obesity. Omeprazole does not prevent reflux, but it does make it a lot more tolerable and often unnoticeable. Attempts to prevent reflux (eg. with metoclopramide) are often ineffective. Thanks for pointing out the possible relationship between reflux and hypothyroidism.

>And yet we see a considerable number of people here having been given omeprazole and often left on it long term. Quite often not the lowest dose. It often feels as if it is prescribed as a reflex action. Stomach = omeprazole.

Yep, that's common. PPIs are very useful when used appropriately but they have been overprescribed for years.


>said if that doesn't work she might consider starting me on a small dose of thyroxine. she must agree that it could be your thyroid :) I don't think I read that bit before.


When I went to see my endo 2 years ago armed with test results going back several years, all of which showed that my TSH was regularly over 4.5, I stated that in my opinion that was way to high and he agreed with me. As a result I now have a T3/T4 combo treatment that has reduced my TSH reading to 0.05 and has put my T3 reading to the top of the scale and I feel fine. So for your doctor to turn around and say that she will not do anything until your TSH gets to 11 is downright negligent and if I were you, I would change doctors! And Omeprazole (unless you have a stomach ulcer where acid is actually detrimental to your health) will do absolutely nothing but make you feel worse and slow the already sluggish metabolism down even more...


Dear Loulabel,

I am in a similar boat to you and cried all the way home yesterday after seeing an endocrinologist who will not treat my thyroid. Says.....wait and see......GRRRRR! I have decided to look for another doctor and I also think that arming yourself with written material and medical facts to show them, sometimes (not always) makes them sit up. I had written a letter, but that did me no good as I don't think my doctor even read it. I hope you get sorted. Best of luck.


I feel your pain, as do the rest of us here. I live in the US, but was hoping to ask a question of someone. I have many of the hypothyroid symptoms, including GERD/HH symptoms, and have gotten basically eye-rolling from my Physician Assistant (would probably be better if he even was a Nurse Practitioner, since he's not even an actual doctor).

My TSH swings between 1.5, then 4.7, then 1.8, then 3.5.... Free T4 and Free T3 were reasonably mid range, and TPO Ab was 9 on a scale of 0-32. Is that considered "negative"? I have seen references to this say that anything over 2 is positive or some that say anything out of range is positive because of the possible presence of other autoimmune diseases.

I am just really tired of being brushed off, and just plain tired... Thanks All


Hi smichaels,

You can still have autoimmune thyroid with a negative antibodies result some people only find out after a scan of their thyroid that they have an autoimmune thyroid. Read the link below for a little more info that might help.


Thank you loulabel... I had a thyroid US, which showed three "hypoechoic" nodules in various parts of the thyroid. For five years I have had sensation of pressure/something in the throat, and feeling something when I swallow. According to the report, these nodules are far too small for that. What causes these symptoms (and initially the panic that came with them)? That has improved, but only because I have become accustomed to the sensations. I assume that nodules do not automatically give a thyroiditis diagnosis?... since my doctor did not even comment on it. I plan to see a DO (GYN) later in the month and hopefully she will have some answers for me as well. Thanks so much for your input.


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