Frustrating appointment with GP, test results help please.

[froopsy]

Hi

I had a very frustrating appointment this morning with a GP. I was there a few weeks ago and this new GP seemed to really be listening to my list of symptoms. She agreed to my requests to test B12, Vit D, folate and redo my thyroid and FBC. Appointmemt today was to discuss results and she just said everything is within range and because you said you have heavy periods you don't merit further investigation into why you were so anaemic. She said I'll probably need to stay on iron supplements until I stop having periods. She then suggested coming off the iron supplements to see if my symptoms worsened but other than that nothing else to be done! She wasn't interested in asking about the symptoms, whether there was any change or new symptoms, I felt like she couldn't wait to get rid of me!

I just left without really challenging her, I'm the kind of person who needs a while to digest and consider my new approach.

So I've listed my results below and any help or advice would be most appreciated. I've ordered a B12 spray (methylcobalamin) and a B complex supplement this morning, following on from info in a previous post.

TSH 2.24 (0.35-5.00)

FT4 15.1(9.0-21.0)

Vit D 26 (doc said they won't treat until it's 25!)

Serum Vit B12 354 (200-900)

Serum Ferritin 24 (15-200)

Serum Folate 6.00 (3.1-20.00)

Thanks so much!

[Marz]

Are you taking T4 ? Your Ferritin is way too low and should be around 90. Hopefully your Folate will improve with a good B complex like Thorne Research that contains methylfolate rather than folic Acid. I think you may need around 5000mcg of B12 and you need to be nearer the top of the range. No point in further testing for B12 once you are taking treatment.

If you are on T4 then you TSH needs to be around 1 or under.

VitD - cheap to treat yourself with D3 - I would suggest around 5000 IU's daily. Take with good fats as D is fat soluble. Also take K2 to ensure any increase in calcium directs it into the bones/teeth etc.

grassrootshealth.net

The chart shows you how to dose according to your results. So divide your result by 2.5 to be the same - I make it 10.4 - hence my suggestion.

Good luck and keep asking questions....your Doc is not supporting you in my humble non-medical opinion. So everything is in range - well actually it IS important where you are in the various ranges... When we are young and fit being in range is just fine - when we have health issues everything needs to be optimal....

[Clutter]

Froopsy, TSH and FT4 are in normal range for someone not on thyroxine and don't indicate a thyroid problem. Fatigue, musculoskeletal pain and low mood can be due to low ferritin and vitD. TSH is a bit high if you are on Levothyroxine.

I would continue supplementing iron until your ferritin is half way through range or >70. How much iron are you supplementing? Take each iron tablet with 500-1,000mg vitamin C to aid absorption.

VitD is optimal 75-200. 100 is usually sufficient. Supplement D3 10,000iu daily for 6-8 weeks then reduce to 5,000iu daily and retest in 6 months.

The B Complex will improve your folate.

Supplementing 1,000mcg B12 doubled my level which was similar to yours in 8 weeks.

If you are taking Levothyroxine it should be taken 4 hours away from iron and vitamin D.

[froopsy in reply to Clutter]

Hi thanks for the helpful info. I've just ordered the Thorne B complex, Vit D3 and K2 will start taking them soon as they arrive!

I am taking T4 - 150 a day Levothyroxine. The iron is 420mg a day. However since I started taking the iron I have been getting a pain under my left rib - it reminds me of being pregnant and having a wee baby foot jammed up under my rib! Another thing the doctor wasn't all that interested in this morning.

Thanks for all your helpful advice, will start supplements, see if things improve and retest in 6 months. If I'm still feeling rubbish I will push for an increase in T4 or a referral to an endocrinologist.

[Clutter in reply to froopsy]

Froopsy, an increase in T4 might help. Most people are comfortable with TSH just above or below 1.0. Read Dr. Toft's comments on dosing and levels in Treatment Options in thyroiduk.org.uk/tuk/about_...

If the full Pulse article would be useful to show your GP email [e-mail] for a copy.

[greygoose]

Froopsie, I Don't think it's so much that she was interested as that she was totally out of her depth. You were talking to her about things doctors know nothing about - hormones and nutrients.

I would say - although I have no proof, but I'm sure someone has - that your periods are bad because you're anemic, not the other way round. So, carry on with those iron suppléments! Have you tried taking a huge dose of vit C with it, to improve absorption? Might help.

BUT you need an increase in dose because that TSH is way too high for someone on thyroid hormone replacement. And an increase might help both your iron anemia and your periods.

[froopsy in reply to greygoose]

Thanks Greygoose

Yesterday I had a supplement shopping spree! I had been taking the iron with a glass of orange juice but bought some Vit C get a bigger dose. Yes the more I replay the meeting in my mind I think it was more that she was out of her depth, she is a trainee GP fresh out of uni, I kinda thought that might be a good thing because surely her knowledge might be more up to date! Think it backfired and she wasn't brave enough to step away from the blood results and try to treat my big pile of symptoms.

I'm now taking the Vit C with the iron and have also started B12, B Complex and Vit D. Have booked another GP appointment with another GP at the practice and will get an increase in T4 if I can.

Thanks to everyone for the helpful responses. This is such a helpful site, my family are great but they really just think an underactive thyroid means you feel a bit tired. When I told my mum how my appointment with the doctor went she said 'oh well they will know better than you about these things!'

[greygoose in reply to froopsy]

Ha ha! If only she knew!

No, I Don't think a new trainee doctor would be more up to date, because what they learn about the thyroid gets less and less, not more and more. All they now know how to do is look at a number on a computer screen and reach for the prescription pad accordingly. And they know more about prescribing dangerous, expensive drugs than they do about judging symptoms. In fact, they know nothing at all about symptoms, which is why, when you tell them x, y and z, they automatically say 'it's nothing to do with your thyroid'. I think they're taught that phrase by rote!

Big Pharma is in charge, these days, and doesn't want doctors to know anything about thyroid or food, because if doctors did, Big Pharma would lose billions from all those drugs that the doctor is no longer prescribing!

I think that poor Young girl must have felt dreadful that she was suddenly confronted with a situation that she hadn't been prepared for in any way. She was totally at sea! If only she could learn a lesson from that!

[humanbean in reply to froopsy]

I don't think doctors get any training about vitamins and minerals.

The assumption is :

In range = healthy.

Below range = might be healthy, might be ill. If it's a Thursday I'll give a prescription. On Tuesdays I'll tell them to supplement themselves. Any other day of the week I'll tell them the level is normal.

Above range = I'll ignore it.