What to do next?

[Ducks_Ex_Machina]

Hi, I was hoping someone would be able to advise me on the next steps I should take regarding my treatment. I'm due to have another blood test soon, and I want to make sure I actually get the right things checked. I'll include bellow the results of my previous blood test, but first I wanted to ask how I should go about getting referred to an endocrinologist. I asked my doctor, and she said they would not normally do that because "Treatment is the same either way." She also said the same thing about checking me for Hashimotos though, so frankly I don't feel like trusting her opinion. If I had the money I would go to one myself, but that isn't something I can afford. Either way, being diagnosed with severe myxoedema at 22, I would have thought someone would be at least slightly curious.

I don't think either of my doctors in the last year has checked my fT3 or thyroid antibody levels, so I'm going to go straight to the phlebotomist with that request when she takes the blood. The last nurse I had would OK extra tests if they sounded reasonable. What else should I get tested while there? And what else should I ask?

Here are my results from the last blood test, not sure what the monocyte count means. The TSH seems worryingly out of reference levels though.

! Thyroid function test - (fw) - To see doctor

-Subclinical hypothyroidism.

-Treatment with T4 is recommended when TSH > 10 mu/L

Serum free T4 Level 14.3 pmol/L

! Serum TSH Level 13.7 mu/L

! Full blood count - FBC - (aw) - Just out of normal range ok

Total white cell count 6.8 10*9/L

Haemoglobin count 137 g/L

Red blood cell (RBC) count 4.60 10*12/L

Haematocrit 0.393 Ratio

Mean corpuscular volume (MCV) 85 fL

Mean corpusc. haemoglobin (MCH) 29.8 pg

Mean corpusc. Hb. conc. (MCHC) 349 g/L

Platelet count 234 10*9/L

Neutrophil count 4.47 10*9/L

Lymphocyte count 2.02 10*9/L

! Monocyte count 0.16 10*9/L

Eosinophil count 0.10 10*9/L

Basophil count 0.02 10*9/L

Urea and electrolytes - (aw) - Normal - no action

Serum Sodium 140 mmol/L

Serum Posassium 4.2 mmol/L

Serum urea level 4.9 mmol/L

Serum creatinine 80 umol/L

GFR calculated abbreviated MDRD 77 ml/min/1.73m^2

ACCUTE KIDNEY INJURY 0

No current indication of AKI

So, those are my results. After receiving these I was increased from 50micrograms levothyroxine to 75. Any advice you can give would be greatly appreciated. Thanks!

[Jose651]

Hi Ducks-Ex-Machina,

Can you edit your post and include ranges in brackets. Look at other posts re bloods for an example. Ranges are very important as they vary in different regions. Someone more experienced will get back to you.

J x

[Anthea55]

I'm sure you are entitled to a second opinion, so try insisting that you get a referral to an endocrinologist. You may get someone helpful.