GP/Endo advice

I've just come back from my first GP appointment. I had private bloods done and got advice on here, (TSH=2.48, FT3=3.85, FT4=13.46, Anti-Thyroglobulin 420.6, Anti-Thyroidperoxidase=209). GP has said, predictably, the TSH (which is the only thing he tested) is "normal" (no surprise there). When I was insistent about low FT3/FT4 and antibodies, he said it wasn't his area of expertise and will refer me to Endocrinology at GWH in Swindon. I've already ordered NDT as I'm tired (excuse the pun) of feeling unwell and not up to par and they should arrive by the end of this week. My dilemma now is do I start the NDT before seeing the endo as I'm not at all confident of getting anywhere with him/her or should I have faith that there may be *someone* within the NHS that I won't have to do battle with to get better?

4 Replies

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  • Hunny, Autoimmune thyroid disease (Hashimoto's) isn't treated and NHS usually only treats the resulting hypothyroidism when bloods are outside of normal range. It can take months to get an endo appointment with no guarantee of a diagnosis and treatment.

    If you try NDT and symptoms improve it's still no guarantee of getting a diagnosis but you will know that symptoms are due to low thyroid and improved by replacement.

    It can help to manage Hashimoto's by adopting a 100% gluten-free diet which may also help to reduce antibodies.

  • As always Clutter, many thanks for your prompt reply. Having seen that the average wait time for an appointment is 72 days, there's no way I'm prepared to wait that long to try to fix my long list of symptoms so I guess I'll press on once the NDT arrives and see where I am before the appointment. I had a feeling when all this kicked off that I was going to be doing it without the assistance of the NHS. Thanks goodness for you guys!

  • Hunny, Start with half a grain (30mg). Give it 2 weeks minimum. If you need to increase you can raise to one grain after two weeks. I suggest you hold at one grain for 6 weeks and have a thyroid test before increasing further. It takes up to 6 weeks for a dose to be absorbed and metabolise so increases should be gradual.

    thyrophoenix.com/adjusting_...

    Sites like STTM will tell you to increase dose every 2 weeks until symptoms resolve but the advice isn't appropriate for someone starting replacement with mildly elevated TSH as you are likely to become overmedicated before the replacement has started working.

  • I'm definitely a fan of taking things at a reasonable pace. I've been over nearly every page on the thyrophoenix website already :) I've ordered some adrenal support supplements as well as the B12 (which I've now started). I'll be monitoring temperature and symptoms regularly - I don't want to end up with palpitations or any other symptoms of overmedication.

    Thanks Clutter :)

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