Frustration over why labs over rule doctors with what tests (Vitamin D) to perform?

I’ve recently had a couple of tests done for MMA and homocysteine in relation to trying to find out about my low B12 levels. At the same time the doctor had ordered Vitamin D after I mentioned to him that a year ago my VitD was 50 nmol/L and a year later it had dropped to 35, despite taking 2,000IU per day over this period.

After attending a recent GP appointment, I asked about the Vitamin D result. He informed me that the lab refused the test, as they only do it when there are clinical symptoms. Apparently I shouldn’t be worried because I am taking supplements. The lab apparently stores the sample for two weeks and will run the test if the doctor ‘insists’. I mentioned that it would of been nice to see my latest result; is it still falling, or has it gone up? Especially since I am now taking 4,000IU per day to see if this helps. Don’t think he was particularly pleased by my persistence, but as he basically escorted me out of his office, he did mention he would phone the lab, we shall see.

So since when do labs have the authority or power to over-rule what the doctor wants (and the patient has asked for)? Is this the case of the NHS (or more likely my NHS trust) penny pinching? If this was the only test I was having done (luckily it wasn’t), doesn’t this seem like a waste of my time, the blood centre and its staffs time, and the doctors time for requesting it?

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  • ...try phoning the lab yourself - it might work better....

  • I have had a lengthy correspondence with our local NHS lab and the end result is that they now check my FT4 and FT3 as well as TSH. They won't discuss any of their reasoning, but when I pointed out that if TSH is suppressed and FT4 is over range they really should do an FT3, they caved in.

    What I cannot get them to admit is that this is because of money.

    The other annoying thing is of course that the GPs quietly let them get away with it. I don't expect my GP to ask for tests that are not necessary. I expect him to use his clinical judgement and the lab to accept this and act accordingly. If they don't, and tests are omitted, I expect my GP to check and follow it up.

    In my dreams!

  • Hi,

    When I was tested for vit d3 it had to go to another lab. I'm in Cambridgeshire and it had to go to Ipswich for testing. Is it possible your lab don't test it?

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