My doctor will not refer me to endo is this right ?have i got right to ask to see one

[olivia01octopus01]

[Aurealis]

Criteria for referral is on gpnotebook

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If you are in England, this describes what choice we have:

gov.uk/government/uploads/s...

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nhs.uk/chq/pages/1094.aspx?...

I'm afraid you can't insist but you can certainly ask.

[shaws Administrator]

In theory, it is easy to treat thyroid gland problems, particularly hypothyroid. You are prescribed levothyroxine, GP's take a blood test now and then and as long as your TSH is 'within range' whatever else ails you, has nothing to do with the thyroid gland. So the British Thyroid Association guidelines more or less state.

How wrong can they be for so many of us, who take levo and do not get better and seem to have more clinical symptoms appearing that we had before.

I think some private doctors may not need a referral letter but, of course, it's the cost, especially if you have to buy medication.

[shaws Administrator]

This is an extract from the BTA:-

PATIENTS WITH NORMAL THYROID FUNCTION TESTS

(a) We recommend that those patients whose thyroid blood tests are within the reference

ranges but who have continuing symptoms, whether on thyroxine or not, should be further

investigated for the non-thyroid cause of the symptoms.

british-thyroid-association...

An extract from Dr Lowe, who was scientist, logistician, director of Fibromyalgia Research Foundation, Dr Lowe.com and Thyroidscience.com.

This is an extract from Dr Lowe.

Abstract

.

"Replacement" is the most widely used approach to thyroid hormone therapy. Clinical practice

guidelines define replacement therapy as: adjustment of a patient’s thyroid hormone dosage so that his or her TSH and thyroid hormone levels remain within current laboratory reference ranges. Overall, the endocrinology specialty endorses T4 -replacement as the preferable approach to thyroid hormone therapy.

Four studies published in late 2003 compared the effectiveness of two types of replacement therapy, T4 alone and combined T4 and T3 (T4 /T3 ). In three of the studies, patients who took part had been suffering (1][2][3] from hypothyroid symptoms despite their T4 replacement therapy. The studies showed that neither form of replacement therapy improved the patients’ symptoms. In the fourth study, researchers gave psychometric tests to hypothyroid infants after they had been on either T4 - or T4/T3 -replacement therapy for six and then twelve months. Compared to healthy infants, hypothyroid infants on both types of replacement therapy had impaired psychomotor function. In reporting this specific result of the studies—that neither type of replacement therapy effectively relieved patients’ symptoms or abnormal neuropsychological test results—three groups of people have misrepresented, perhaps inadvertently, the outcome: the endocrinology researchers who conducted the studies, the endocrinologists who commented on them, and the journalists who reported them. Rather than reporting the specific study result, these groups reported a false general conclusion: that no approach to T4 /T3 therapy (replacement is the only one they tested) was more effective than T4 alone. This false general conclusion violates a rule of

quality scientific reporting—that we precisely formulate our statements to accurately convey conclusions that we can validly deduce from the studies we report.

also

Alternate thyroid hormone therapies are already in demand and in widespread use by hypothyroid patients for whom T4 -replacement is ineffective. These patients, many clinicians, and some researchers report that the alternate therapies are far more effective for the patients than replacement therapies. The endocrinology specialty’s objections to these other therapies have been either speculative or based on invalid conclusions from studies

This imposes an urgent scientific obligation on the endocrinology specialty: that it now open-mindedly reevaluate its objections to alternate thyroid hormone therapies. This is essential on both humanitarian and ethical grounds.

web.archive.org/web/2010073...

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Write a letter of complaint stating that he's not helping you regain your health. Send a copy to the Practice Manager.

I've done this and got some action, GPs don't like complaints. Complaints get bought up at their revalidation and they're questioned.

[teacherspet]

I asked several times for a referral and they wouldn't me give one. However I eventually got referred because I complained of recurring symptoms while my TSH was 'normal' and one GP (1 out of 4 I'd seen) in the practice agreed to refer me.

Still not much use though as I wasn't given any choice about the hospital and I got stuck with an endo who didn't inspire me one little bit - within 5 mins he'd trotted out the 'it sounds like depression because your TSH is normal' speech and then wondered why I looked less than happy.

I hope you can get a referral but you need to try another (if there is one in your practice) GP or just keep asking and hope they change their mind.

[Glynisrose]

I did it the other way round, I found an endo who prescribed NDT as an alternative and went to my doctors and asked for a referral, I got one and he has prescribed me NDT ever since, unfortunately he is not allowed to prescribe to new patients.

[Zephyrbear]

Given the usual 'Your GP knows what treatment suits you best...' nonsense, I suggest you find yourself a different GP who will refer you without becoming 'precious' about having his (dis)abilities questioned. But be aware, as some others have pointed out here, you may not be any better off because the thyroid is just one of those organs whose precise workings escape the knowledge of many...

[GeorgieB]

Hi not sure if this will be useful at all, but I was referred to an endo who told me and my GP that my problem was depression. I wrote a letter of complaint to the endo who then refused to see me again and all GP's in my practice wil not treat my symptoms which are getting worse. This has been going on for 8 months now and have lost my job. GP won't sign me off as he feels that I am capable of working! In the past ten years I have never had a day sick!

[HarryE]

Can you afford to see someone privately who doesn't need a referral? Sorry, but it might be your only option, it's so unfair!