First endo visit today

Hi everyone. I had my first endo visit today, I have low TSH, borderline high T4 and high T3, I don't know the exact figures. The doctor started by asking if I had any symptoms so I reeled them off, he then said "we don't go by the symptoms, we go by the blood results", he also said I couldn't be hyper because my T4 was normal. But if my T3's high then doesn't that make me hyper as that's the active form? He then said it could be my medication (atenolol and ramipril) that's affecting conversion. He said I could level out or go either hypo or hyper and he was just going to monitor me. He then sent me for blood tests and gave me a script for carbimazole but told me not to take it unless his secretary tells me to when I ring for the blood results. Has anyone else had a similar experience because I'm totally confused now? He also told me in no uncertain terms that my depression bore no relation to any thyroid problems!

9 Replies

Gosh he sounds a bit unhelpful doesn't he, you do have to wonder why he asked if you had symptoms if he had no intention of doing anything about them.

What is his plan to help you if it is your medication that is causing conversion problems?

Suppose the fact he is monitoring you and the fact he has given you a script for Carbimazole is better than nothing.

I remember having real feeling of absolute hopelessness when I was building up to being diagnosed. I might not have called it depression but I felt pretty unworthy and completely lost the ability to socialise which wasn't like me at all, I could sit in a room full of people and not want to bother talking to anyone and just felt so down and as I'm no longer like that I can only think it was to do with my thyroid problems.

See if you can get your test results, with ranges, from your own GP - just say you want them for your records.

Liz x

Thanks for the reply Liz, I don't know what I'd do without this forum.

I've done a bit of research since I got home and if anything atenolol would inhibit T4 to T3 conversion so I'm beginning to think that he doesn't have a clue what he's talking about. I see my GP in a few weeks so I'll see if I can get a bit more sense out of him. Also if I get detailed results from the endo's secretary I'll post them on here.

Isobel x

Yes, this group is great. Your endo visit must have been so disappointing for you. Was it the head man you saw or an underling? I remember someone saying to me after my first visit - the guy was ok but there was something lacking in our relationship - humour probably - anyway this person said not to worry about that, I would probably never see him again and sure enough I haven't and my next two visits, one with the head woman and another with someone probably at a similar level to my first guy, both went very well.

Keep going though because people in the group do get sorted, its just a pity that you have to battle so hard when you feel so low.

You could always say what I say, 'yes, I know I am within the range but it is very wide and I am not at the optimal place for me' see if that helps.

Liz x

It was the head man, hopefully I'll get an underling next time.


Judging by your results and your medication I'd say first that atenolol would rather increase your FT4 rather than FT3, and the other drug only very rarely affects thyroid function. At first glance it's possible you could be hovering on the brink of T3-toxicosis, where FT3 rises before FT4 out of its normal range. Do you have hyper symptoms at all, like hand tremor, inability to concentrate or sit still for long, intolerant to hot weather or heat generally? Depression is also a symptom of dysfunction, either way. The doctor's response is the unhappy situation in modern medicine today - believe the numbers rather than the patient. Diagnosis should be an intelligent mix of both, and numbers shouldn't dictate, rather guide. Reliance on numbers alone is just a substitute for thinking.

Hi, thanks for replying. I do have some symptoms on and off, shaky hands, palpitations, heat intolerance and light periods. I also have a lot more energy than I had a year or so ago. When I last had normal thyroid blood results I was constantly lethargic, so I'm thinking my levels are probably high for me.

I think the advice he gave to monitor the situation is a good idea to be honest. But you may also want to ask for a referral to an Endo specialist. I am no doctor but if he believes your current medication is blocking your conversion rate then the last thing would be to give you horrible carbimozol. That drug made my life a misery and it is a pretty hefty drug too - lowers lymphocyte levels for one! Get him to monitor your properly - tsh, ft4, tt4, ft3, tt3, iron serum, vitb12, cortisol and full blood chemistry will give him and you the broader picture of your thyroid activity, conversion and full bloody activity. Then get your referral. Only my advice of course. Remember GPS are not specialist and they don't know everything.

Hi I have to disagree about the carbimazole. I know some people have hard time with it but most like me see it as a bit of a life saver. I had no issues with it at all and it made a huge difference to my quality of life and saved me from having surgery or RAI. If this lady does become or has become hyper then there are not many other options.

I can't comment on the specifics discussed so far, except to add my support to the respondents - I would, however, urge that you ask your GP to refer you to a different endo. I stayed loyal to the 'expert' treatment I was offered for far too long, and I wish I had had the resolution to question their reliance on test results rather than symptoms presented years ago. You don't have to take the establishment on, just firmly assert your rights. Best of luck - there are good endos out there!

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