Call to GP tomorrow

[Skyla8]

Hi, well I went to the GP practice hoping to collect my medical certificate since I have been feeling terrible. The receptionist told me no medical certificate had been done for me to be covered for a month starting from the 23rd August because they are not done in advance. I have been told to post it off by 22nd August by the latest so I will be in trouble over that. Secondly I have been advised to phone the GP practice tomorrow to discuss the issue with my iron tablets as I have been having trouble taking them. The GP said she will "rethink" about what other iron supplements I can take if I have trouble with them but I am only hoping that my reasons I have trouble with taking the ones prescribed are valid. The problems I have with taking them is that I need to take the iron away from milk, which is hard if iron interacts with milk, I need to take the iron supplements 2 hours away from the Levothyroxine but I have seen it stated that it's 4 hours? So, not looking forward to the GP appointment at all and I am thinking that it might be a good idea to ask for a second opinion during the call. Hopefully that is not too harsh.

[hose1975]

I take my thyroxine first thing in the morning and my iron supplement last thing at night. I don't drink or eat anything dairy after about 8pm so this is fine.

[Skyla8 in reply to hose1975]

Usually when I get up in the morning the first thing I feel like having is a cup of tea. But that would mean I would need to take the Levothyroxine even later than first thing in the morning. The only thing I have in dairy late at night is tea with milk but that is it.

[shaws Administrator]

Iron has to be taken 4 hours apart from levothyroxine. I always take supplements at lunch time, altogether so there is not problem. Iron is usually taken on an empty stomach (ie 2 hours since you've last eaten) but if it causes problems you can take it with food.

If it's more convenient for you you can take levothyroxine at bedtime as long as you've last eaten 2 hours previously.

Excerpt:-

There are foods and other substances that can interfere with absorption of thyroxine. Examples include calcium and iron supplements taken within 4 hours of levothyroxine,

en.wikipedia.org/wiki/Levot...

[Skyla8 in reply to shaws]

Thanks for this information. The GP is adamant that 2 hours is a long enough time for the Levothyroxine and the iron to be taken away from each other. I don't think I'll be able to change her opinion on this so I will go with your advice. I don't know if taking Levothyroxine at night would benefit me, maybe it would. I won't know unless I try so perhaps starting from tonight I could try that.

The GP has said a racing heart that has doubled is "normal", apparently. I think she's seeing that from a medication point of view, as in I'm still experiencing the aftereffects of staying on the split dose when I should have skipped it. So I will continue to stay off the Levothyroxine for a few more days.

[shaws Administrator in reply to Skyla8]

Some things I have read also say 2 hours. The thing is we don't want the possibility of interfering in anyway with the levo.

I had palps all the while on levo and a doubled pulse is not normal. The just ignore what you say or put it down to anxiety or anything other than maybe your body's reaction to levo.

Do you take note of the make of levo you get from the chemist and get the same one each time. After a while if no progress ask if they have another one and try that for a while too. Sometimes the fillers/binders make a difference.

[Skyla8 in reply to shaws]

I think that the doctor thinks what is happening is in my head . I don't take take of the make of Levo I get. I usually get the ones with Lloyds Pharmacy packaging on them.

[shaws Administrator in reply to Skyla8]

As long as you are consistent that's fine. In a few months if not improving you can ask if there is a different one, mind you it could be processed by the same company. I think it says in the inside leaflet who manufactures them.

[Skyla8 in reply to shaws]

I've just had a look at the inside leaflet. The manufacturing companies are Actavis and Wockhardt. But yes, I'll see in a few months if I'm not improving and then let the GP know. I still have a blood test booked in for next week for the GP to see if my TSH is low as my thyroid hormones were suggestive of overmedication, would I need to cancel that if I change the way I am taking the medication (I was advised to skip the dose for a few days or at least a day and then re-take the Levothyroxine)?

[Skyla8]

I usually wake up around 8:30ish or so. I don't have breakfast as whatever I eat "goes straight through me" or gives me a funny stomach. If there's no time limit on when I can take iron tablets as in taking it away from milk then that's ok. I was a bit concerned about there being a time frame for it. Thanks

[sandrad]

Hi, re: the medical note - if your work are pressuring you tell/make appt with GP and explain this is causing you extreme stress and if they can't do note then could they write a few lines on surgery paper explaining this to employer. I'm sure medical notes are done in advance - it would cause chaos if you received them retrospectively.

xx

[Skyla8 in reply to sandrad]

I see the GP tomorrow. I've already been told off twice about leaving it too late to send in sick notes and it's stressed me out a lot. The receptionist says they don't write sick notes out in advance. I am hoping I can get signed off again, I feel so crappy, but when I last spoke to the GP about this she says that the practice doesn't treat someone based on how they feel. Isn't that why they go to the doctor in the first place?

[sandrad in reply to Skyla8]

Sadly it sounds as if they don't fully understand thyroid conditions. Wishing you all the best, stay calm and focussed and explain how you feel and the symptoms that you have.

Sandra xx

[Skyla8 in reply to sandrad]

Thanks, I will.

[Hidden in reply to Skyla8]

When you are sick the GP will ask, how are you feeling, where is the pain etc.

So when you see the GP tomorrow, say to her.

When I saw you last week, you said to me, that this practice doesn't treat patients, based on how they feel.

Then how can any GP judge a person's well being, without asking, how the person feels.

We go the Doctors because we are not FEELING well.

I would point this out to her assertively, you may get the upper hand by confronting her, in this way.

What a stupid thing for her to say!!

A forum member who was having trouble with her iron tablets, suggested Carbonyl Iron.

She had no tummy upsets or constipation, and very happy with it.

I have not bought any as yet, but will do so, the product is in liquid form.

Good luck with your appointment tomorrow.

[Skyla8 in reply to Hidden]

Thanks very much for your advice. This is the worst I have ever felt. I have been feeling nauseous all afternoon and whilst I can't say with any certainty that it's the over medication or an undiagnosed nutritional deficiency (that'd be jumping to conclusions!) it has only been today that I've had it. As long as the Carbonyl Iron is in liquid form I will take it, as I can't swallow very well.

[Skyla8]

Thanks, my Free T3 and Free T4 are already high and they were done privately (because NHS labs I discovered when I had my TSH done only test FT3 and FT4 when the TSH is out of range at both ends). My TSH is very low but in range and at the same time my Anti-TPO antibodies were 110 and when they were retested (why I don't know) they were 141 with the range at 34 or lower.