Doc's Receptionist says "everything's normal"!!

Just to give some background info, 4 months ago levothyroxine was increased 25mg to 150mg and told to take iron tablets because TSH was 4.61 (0.4-4.0) and free t4 was 19.2 (12-22) and ferritin was 16 ug/L (25-300). Called the doc surgery today for latest blood results and receptionist informs me everything's normal. Well, I've never been normal (joke). So, I request my printout and wonder if this is why I can't sleep, have had heart palpitations and get anxious at the flick of a switch!! Free t4 is 24.8 pmo1/L (12-22) TSH 0.05 mu/L (0.4-4.0). Please help. Where do I go from here?

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  • Pollydolly, your bloods indicate you are over medicated and your symptoms certainly sound hyper. I'd skip your dose of Levothyroxine for a couple of days and then reduce your Levo to 125mcg.

    Taking iron with 500mg/1000mg vitamin C each dose helps absorption and will mitigate the constipatory effects of iron. Make sure to take iron 4 hours away from Levothyroxine.

  • The symptoms you describe (most important) combined with your results make it look like you are slightly over medicated - your T4 is above range. I'm surprised they said that is 'normal' because they are normally very obsessive about things not going over range.

  • It's also very important to remember receptionists are not medically trained! If worried speak to your gp x

  • If I had to phone the surgery for results and the receptionist gave them I would ask where they got their medical degree!! They are not supposed to give results out, they are not qualified!!

  • I think it's perfectly acceptable that receptionists give out results, they are simply reading from a screen, but what they shouldn't be doing is commenting on them. ;-)

  • Glynis,

    Receptionists don't interpret results. If they say results are normal they will have been told so by the GP.

  • Receptionists giving 'normal' results is like a slap to a patient. One's immediate reaction is ' if everything's fine, why did you do the blood tests, then?'. One wants a medically qualified person to interpret the results. One may very well have questions. The receptionist just keeps on parroting 'normal'. It is poor patient care. It is one reason why I no longer bother agitating for a blood test once a year. What is the bally point?

  • Humphrey, I'd rather the receptionist passed on the message the GP interpretated as normal results than tie up the GP's time unnecessarily. My objection is when results are deemed normal but clearly are not when one sees the printout.

  • I'm sorry to drag this on, but you've hit a bit of a nerve with me on this :o)

    A lot of people do not question 'normal' results. A lot of people don't know what it should say on the printout. Hopefully the numbers of those people are reducing thanks to this site. But they are completely at the mercy of the Receptionist-parrot repeating 'normal'. It does harm. I do not believe that the courtesy of giving a patient his/her results by a qualified doctor is an unnecessary use of the doctor's time.

    I guess we shall have to agree to differ, huh?

  • I can see it irks you :) I'm trying to get across that receptionists aren't interpreting results, they are passing on the doctor's instruction to tell the patient the results are normal.

    The patient will also be told that the result is normal by the doctor.

    It's only when the patient sees the results with ranges that the patient realises the results are not actually normal.

    One GP wrote to me to make an appt to discuss some abnormal results. When I saw a different GP he told me he wasn't concerned about the results. That was when I decided that if it was to be a matter of opinion I'd like to see my results and follow up any abnormalities myself if the GP/s appeared to be conflicted.

  • It is possible your free t4 is too high but its also possible that your ferritin is low and thus your T4 toxic

    Doctors fail to recognise that long before hashis is diagnosed ferritin and often folate plummet and until ferritin is a minimum of 70 you cannot correctly convert the t4 in levothyroxine into the t3 your cells need

    try dropping back a dose of levo and get ferritin , folate and b12 tested

  • Are you taking your iron at least four hours apart from your levothyroxine? Have you had your b12 tested?

    Sue

    thyroiduk.org

  • I think you should report her to your GP. Can she not read FT4 is too high and not in range. You could have taken her word and carried on suffering putting your health at risk. Good luck lowering your dose.

  • Fixit, it's likely the GP told the receptionist the results were normal. It would be very unusual and wrong for a receptionist to interpret results.

  • Hi I have the same problem up and down every blood test never the same my dr said he treats the patient and not the disease is he right because now I have AF and have told me to take 75mg asprin until next ecg, can any one advise

  • Thanks to everyone who's commented. I already make sure the iron is kept at least 4hrs away from the thyroxine. Other results were folate 7.9 (3-20), Ferritin 33 (25-300) B12 438 (180-800). I shall go back and see the doc next week but I know they wont prescribe vitamins or minerals so will probably need to self medicate re B12. I think I would also benefit from knowing what my serum T3 is but I dont think the lab test for it?!?

  • You need to get your free t 3 tested. Your free t 4 is too high and could mean you are not converting well, thus the hyper symptoms, but not enough t3 to rid you of hypo symptoms.

  • Not particularly bothered who tells them to, they are still not qualified to give results, nor should they be given over the phone!!

  • Don't ever ask the receptionist. They aren't doctors. If I were you see your doctor and see another doctor for 2nd opinion. Don't ever change your dosage without doctors approval. I did that couple months ago and realized that I was "losing it". Good luck

  • Your symptoms suggest you're overmedicated, as do your TSH and T4 values. There is a brand of T4 that's available in 12.5 microgram increments up to 150 or 200. If it's not an option, then taking a 125 mcg tablet and half a 25 mcg tab daily would be the equivalent. Insist on speaking to the doctor next time you call!

  • Am I right in thinking that you have been taking the extra thyroxine and the iron for about 4 months now? Because if so your iron level may be staring to recover, which would make your body able to better utilise the T4, plus you are taking more T4. It looks as though you are now over medicated. Reducing your T4 dose but keeping on taking the iron would probably help you.

  • dear pollydolly, i can relate to every word you say, for 10 years I have never been stable, and now to make me feel doubly anxious they say I now have Arial fibrillation and have told to go on to warfarin to stop blood clotting which I feel reluctant to take.

    Please help a lady

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