Grrrr Doctors: Hi there. I'm told this is a great... - Thyroid UK

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Grrrr Doctors

adam-m profile image
25 Replies

Hi there. I'm told this is a great place to go for help and advice. Ive just had my 2nd thyroid test results back and the doc says I'm fine. My T4 level is 9 (11 on first test 18 months ago) and my TSH level is 1.23 (previous was 1.38). I have so many symptoms that I won't bore you with but I need to know how I get a doctor to listen to me. I walk around like a zombie half the time and could fall asleep any given moment. I cry at the drop of a hat. Heart palps, high blood pressure. Dry and sore eyes all the time. Motivation low and a bit fed up. Hardly ever drink, eat pretty healthy and always have my 5 a day. My mum has under active thyroid (and lupus). Doc has totally made me feel like an idiot on the phone. I'm not saying it is a thyroid problem but I'd like to fully rule it out. I guess I just want someone to reassure me that I'm right to push my GP for further discussions than just admit defeat. Cheers.

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adam-m
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25 Replies
jimh111 profile image
jimh111

The idiot is not you, it's the doctor. You say T4 level is 9, I assume this is fT3 (or free T3) and is usually within an interval of something like 10.0 - 20.0. Tell them you want a second opinion, with an endocrinologist and soon (weeks not months). Be polite but firm, maybe take someone with you for support.

With a low fT4 your TSH should be higher but occasionally there can be a problem with the TSH, a week pituitary, which is the gland that produces TSH. This is called 'central' or 'secondary' hypothyroidism and should be diagnosed by an endocrinologist. I'm not saying it's this for certain but it should be checked. If you get a refusal send in a written complaint to the surgery.

adam-m profile image
adam-m

Thanks for the reply Jimh111. I asked the receptionist to clarify the tests and she just said it was Serum T4 level. Apparently in Scotland the range for T4 is 9-25 but my doctors say theirs is 7-17 which puts me in "normal" category. I asked if it was worth investigating further due to symptoms but he laughed at me. Anyway I have requested an appointment with different doctor so I just need to be clued up for my visit. I already made the mistake of getting a bit angry with the doc on the phone but he was so patronising and unhelpful. I'll probably just end up getting upset and not getting anywhere tomorrow but I don't know what else to do. They make you feel like you're wasting their time. I just want to feel like I've got some energy. So shattered. I wouldn't mind but I've worked solidly since I've left school (38 now), am hardly ever off sick but they treat you with suspicion like you're just after a sick note and a few months off work. Definitely not the case. Just want my life back.

in reply toadam-m

Hi there, even within Scotland lab ranges can vary. It depends on the particular method they use (I think). I am in Lanarkshire and the ranges they use are 9-21 for FT4. That puts you right at the bottom of our range suggesting you don't have enough FT4 and so it is likely your FT3 (the active hormone) will be low. Even if your local range is 7-17, you are still low. TSH range in our labs is 0.2 to 5.0. As you are well within range the danger is the doctor looks at that and ignores the rest. As Jimh suggests, further investigation is needed. Hope you have some success today.

adam-m profile image
adam-m in reply to

Hi there

Had a bit of a Mexican stand off with the Doctor. She thinks I'm barking up the wrong tree and have just been on google looking up symptoms. She just said there's nothing else she can do as my results are normal and I got the impression she was heavily hinting at trying to blame lifestyle. Annoying I'm like a little old man lately. Hardly drink alcohol, don't ever get to bed later than 11pm, but usually before then, always have my 5 a day and try to be active. I'm certainly not a big bloke by any means. Just under 13 stone. I feel a bit defeated at the moment. Going to give it a few weeks and see about changing my doctors. I'm also worried now that she thinks I'm a nutcase as I ended up in tears. So embarrassing :-(

in reply toadam-m

Hi Adam. I am so sorry that your GP didn't listen. Others here have given a lot of good advice about getting other blood tests. Vit B12, iron, ferritin and folate are all very important. Our GP is very good at asking for a whole range of blood tests to check for different things, and it is a relief when they come back not showing anything serious, but also when they provide some sort of explanation and a way ahead for treatment. If you are not feeling well and have loads of symptoms your doctor should be trying to find out why, not dismissing you. It does sound as though you do need to find another doctor. Best wishes.

jimh111 profile image
jimh111

Get a print out of the results, 7-17 is quite unusual.

adam-m profile image
adam-m in reply tojimh111

Unusual in what way?

jimh111 profile image
jimh111 in reply toadam-m

Usually 9 - 20 or 10 to 22, never seen 7 - 17, but could be so.

foxglove profile image
foxglove in reply tojimh111

I'm in Wrexham (N.Wales) and t4 range has been 7 - 17 for a few years now

PinkNinja profile image
PinkNinja in reply tojimh111

I know this is an old post but my ft4 range is 7.8 - 14.4. another strange one for you :)

adam-m profile image
adam-m in reply toPinkNinja

It does all seem very hit and miss. I'm in the process of changing Doctors and I'll give it another go trying to sort things :-)

PinkNinja profile image
PinkNinja in reply toadam-m

Hope it goes well with the new doctor :)

Parbrook profile image
Parbrook

It's worth remembering that the ranges are only a guide, based on people who do not have thyroid problems.

For someone with a Thyroid problem, being at the lower end of the FT4 range is not ideal.

It's worth asking your new doc for FT3 to be tested. T3 is the active thyroid hormone and is part if the TSH, FT4, FT3 jigsaw puzzle.

adam-m profile image
adam-m in reply toParbrook

Thanks for the reply. This is all really helpful. It's so complicated. I will mention this to the doctor tomorrow.

Hi adam-m. Definitely don't feel like an idiot, you are a lay person trying to make sense of feeling unwell and it's the responsibility of the GP to explain about, and treat your symptoms. Your T4 is low against either of the lab ranges, and your TSH could be better. Unfortunately GPs tend on the whole, to make sweeping statements that a result within a lab range is fine, when all it means is that it comes within the low and high end range discovered by testing a group of people (who may or may not have had a healthy thyroid when they were tested). So the stats are suspect to say the least. But having a blood test within the range i.e. "normal" , doesn't mean it is optimal for you, nor does it guarantee you are symptom-free. Explain to your GP that you need to be helped to become free of your existing symptoms i.e. well, irrespective of the lab figures. Good luck :-)

adam-m profile image
adam-m in reply to

I tried my best. All she kept saying was "what else do you want me to do? Your results are normal!".

Clutter profile image
Clutter

Adam,

In addition to the very good advice above please ask the GP if your ferritin, vitamin D, B12 and folate can be tested too as deficiencies or low in range results can present with symptoms similar to hypothyroidism. Ask for a printout of the results with lab ref ranges as GPs will tell you results within range are normal when they're scraping the bottom.

If any are deficient you should be prescribed supplements. If they are within range supplementing until they're high in range can really boost your well being and if you are hypothyroid will aid absorption of thyroxine.

Post all your results with lab ref ranges for comment on a new question.

Finally, consider writing a complaint to the practice manager. Part of the GP contract requires GPs to treat their patients with courtesy. That doesn't include laughing at them and belittling them IMO.

adam-m profile image
adam-m in reply toClutter

Thanks Clutter. Unfortunately I had this written down but she just said "talk to me, don't read off a piece of paper". So I got flustered and didn't get to say half the things I wanted to.

in reply toadam-m

I'm sorry to say this, but she seems a bit of an insensitive bully. Can you change GP within the practice, or if not, change the practice? If not, do follow Clutter's excellent advice.

Clutter profile image
Clutter in reply toadam-m

Who the hell does she think she is :x There's absolutely no point in seeing her again. You need an empathetic doctor who will listen to you because there's a lot more to managing thyroid disease than ordering bloods and signing off Levo scrips.

Do find another GP in the practice or change practice. And if you have the energy to complain about her attitude and rudeness to the practice manager you will be doing all her patients an enormous favour.

Did you get the opportunity to discuss increased meds and vitamin testing?

adam-m profile image
adam-m in reply toClutter

I understand that doctors must see lots of time-wasters or people who self-diagnose after seeing something on google. I've much better ways to spend my time than pestering doctors. I'm getting a pulse and blood pressure check in a weeks time but I could tell she was just humouring me and thinks it will be fine. I'm perfectly happy to find out it isn't a thyroid issue but I'd rather it be ruled out properly than just be dismissed. Thanks guys. You're all brilliant.

sazzyb profile image
sazzyb in reply toadam-m

<gasp> - that's unacceptable! She obviously attended the same charm school as some of the other medical dolts.

silverfox7 profile image
silverfox7

Lots if good advice above but its your doctors job to try and make you well again so you are not the problem, he is! Let us know how you get on.

adam-m profile image
adam-m in reply tosilverfox7

Thanks Silverfox7.

adam-m profile image
adam-m

I'll definitely try to keep that in mind for future encounters. Hard when you're being treated like an irritant though.

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