Do we need to go private?

Hello everyone.

My girlfriend has suffered from all the symptoms of hypothyroidism for the last 20 years and yet her GP says she is within 'normal ranges'. Her blood results are:

T4 - 11 in a range of 10-22

TSH - 1.6 in a range of 0.3-5.5

To us this shows that her T4 is very low and yet the pituitary is not encouraging the production of more T4 and she would benefit from thyroxine to help increase her T4 levels to 22+.

We are going to ask for either a trial of thyroxine to increase T4 or a referral to an endocrinologist but feel this may fall on deaf ears. I think that we may need to go private to get any kind of results so would you let me know:

Can we see a private doctor and get a prescription directly from him?

Do we have to get referred to the private doctor from her GP?

How much would a private GP cost?

Does anyone have any recommendations for Dorset/Hampshire doctors?

Thank you.

13 Replies

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  • Welcome to the forum, Dorset92.

    I recommend you ask your GP to consider secondary hypothyroidism (pituitary dysfunction) rather than primary hypothyroidism. One would expect to see higher TSH with such low FT4 in primary hypothyroidism. Treatment of secondary hypothyroidism is Levothyroxine to replace low thyroid hormone but pituitary should be investigated, usually in endocrinology, in case growth and sex hormones are also low.

    Email louise.warvill@thyroiduk.org.uk for list of member recommended private GPs and NHS and private endocrinologists. You should be able to choose the NHS endo you are referred to.

    _______________________________________________________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thank you so much for your reply - we will act on your advice.

  • This is a link which I think you will find very helpful:-

    thyroiduk.org.uk/tuk/testin...

    If you also (on the above link) look at the topics on the left-hand side, there is also a list of symptoms which can be ticked plus other information you will find helpful.

    If you ask for a copy from the surgery of the blood test results with the ranges you can compare.

    Was the latest blood test taken as early as possible? If not request another and also fast as the TSH varies throughout the day and they rarely take notice of clinical symptoms but only the TSH and the symptom will probably be given 'another' name. If on thyroid hormones they should be taken after the blood test.

    thyroiduk.org.uk/tuk/diagno...

  • Hi You need FT3 for a proper analysis. Best treatment for thyroid is a private Endo as not so bound b y hospital rules.

    Jackie

  • Hi, just wanted to add that if you go private it is probably worth trying to see an endocrinologist rather than a GP, as they will have more specific knowledge. If you see a doctor privately, you will most likely have to pay for a private prescription, which is the actual cost of the medicines rather than a fixed price. It could be that whoever you see is able to transfer you to their NHS list afterwards, or that he/she can write to your GP and ask them to prescribe subsequently. You can call their secretary to ask the cost of the appointment, but it would normally be around £150-200 for a half hour appointment, plus the cost of any blood tests.

  • Unfortunately you can't just go to a Consultant - you do in England anyway need to be referred by your GP. You will have a problem if he/she is unwilling to give you a referral.

    So far I have never solved this problem when faced by a GP's refusal to issue a referral - some are so anti private medicine.

  • If you are seeing a consultant and paying out of your own pocket, rather than using private health insurance, then some consultants will see patients without a referral. It may be quite rare though. I managed it once, and although I got almost nothing out of the appointment directly, he did write to my GP and suggest who I should be referred to on the NHS. And his choice turned out to be a good one ( eventually - the wheels turned extremely slowly) and I got the problem I had fixed.

  • A private GP consultation might be around £50 plus, while I have had Consultants charge anything between £100 and £200 for a half-hour consultation.

    Any test they might require will cost extra - and beware some things can be awfully expensive - e.g. £1200 for a private CT scan.

  • Before you do that go back to the GP

    insist on tests for. Central /pituarity hypothyroid which is the likely reason for bottom of the range t4 and low TSH. (Congrats on figuring out the problem yourself )

    Dont be fobbed off by "its rare " cos thats crap 5 out of 6 hypos in my family have central hypo

    theres no point going to see any endo privately unless they are really good and theres only very few who are

    insist that

    tsh

    free T4

    Free T3

    ferritin

    folate

    b12

    vit d3

    are all tested as they are all interelated and must be optimal not simply in range

    then with the results we can help you find the right way fwd

    the gp will need to put. . .? CENTRAL HYPOTHYROID on the form otherwise the lab will refuse to test t3

  • Thanks for your reply. We are going back to the GP first and hopefully they will be sympathetic - we will certainly ask to put Central Hypothyroid on the form too - although we have TS3 result. We also have ferritin result which is 22 in a 20-400 range!

    We will certainly ask for forte / b12 / via D3.

    Fingers crossed we are narrowing things down and building a case for a referral.

  • If you have a free t3 result post it on here

    If ferritin is only 20 then thats a major reason why she is also hypothyroid

    And why levothyroxine will not work

    Ferritin

    Folate

    B12

    Vit d3

    MUST ALL BE HALFWAY IN THEIR RANGES OTHERWISE THE BODY CANNoT CONVERT T4 INTO T3

    Post every single blood test result you have and where in the country you live and someone will know a good gp or a good endo with luck

    Plus we will know how to help

  • We have results of two tests which are:

    TS4 - Test 1 was 11 Test 2 was 12(Range 10-22)

    TSH - Test 1 was 1.6 Test 2 was 2.4(Range 0.3 - 5.5)

    T3 - Test 2 was 4.6 (Range 3.1-6.8)

    Ferritin Test 2 was 22 (Range 20-400)

    Test 2 was 8 days after giving blood so the results may be skewed by a low blood volume. She had half her thyroid removed 20 years ago.

    T4 is low but without elevated TSH doctors see no issue but this points to possible secondary hypothyroidism.

    We are in Dorset.

    Thank you

  • Firstly unless she has "iron overload" she should not give blood

    Ferritin is stored iron and MUST BE OVER HALFWAYin its range or she cannot convert t4 in levo into t3

    Her t4 is at bottom of range when both t4 and t3 should be in UPPER QUADRANT of their ranges

    Her t3 is near bottom so i suspect the low ferritin is implicated

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