Despite seeing the GP about 3 times over the last year for various symptoms (unexplained weight gain, lack of energy, an infection that did not seem to go away), I was fobbed off each time. Whilst on holiday abroad, just by chance someone suggested I got my thyroid checked. TSH at 5.8, then so many other things made sense that I had never before even thought of bothering a GP with, hair loss, brittle nails, feeling constantly cold, etc.
Didn't think it worth it getting meds there, thinking I'll get treatment as soon as I got back home. How wrong was I! I never thought the NHS would be so reluctant to treat hypothyroidism. As I don't hit the magic 10 on TSH, I'm just considered "normal".
So the question is, can anyone recommend a sympathetic GP in Sheffield that would bother about my health and not what a number in a piece of paper says?
If it is a private one, can you also give me an idea of costs for consultations, meds and so on?
Thanks!
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Kitten44
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You are unlucky, the range for which they treat in my practice in north London is much lower, and you would be treated here. Postcode lottery. Did they send you to the local hospital for the blood take? It seems to be the hospital lab that sets the range here. So it may be that moving GP in Sheffield might not make much difference.
You can, as you know from reading through the posts here, privately test for nutrient levels and for a full thyroid panel to find out your antibody status. That would be worth doing if you can afford it. If you have chronic lymphocytic thyroiditis that strengthens your case. Also if you have very high cholesterol or heart problems of any kind "sub clinical" hypothyroidism should be treated.
If all else fails you can cautiously, being alert for the symptoms of overdose, self treat. Many here do.
in reply to
Here is an extract from the NICE guidelines, last updated 2011, which show that a GP can decide to treat someone under TSH 10 with symptoms if they see fit. If you find your antibodies are raised you could point this out and ask for a trial, because your TSH will go up yearly, and even the guidelines say you should be monitored due to this.
"It is recognized, however, that some people with TSH levels between 4.5 mU/L and 10 mU/L have symptoms compatible with hypothyroidism [Surks et al, 2004]. Therefore, clinicians and patients may decide on a trial of levothyroxine while monitoring for an improvement in symptoms.
There is no clear guidance available on the dose and duration of levothyroxine to use in this situation.
The dose of levothyroxine should be titrated until the TSH level is within the reference range, and given for a sufficient length of time to judge whether or not there is any clinical benefit (usually several months).
Continuation of treatment should be dependent on clear symptomatic benefit, but this may be very difficult to judge as some people may have a placebo effect."
Thanks a lot for your responses. My sister is hypo and has been treated, the difference is she lives abroad (was visiting her when I got tested), so I mentioned there is a family link (plus rife diabetes, heart conditions, etc.), yet GP was adamant he could not treat me unless TSH was over 10.
As you say, postcode lottery, so I'm really hopeful someone can recommend another GP in the area that would be a bit more supportive.
With a family history you will have a v persuasive argument if you get your antibodies tested on a private test - got to the thyroid uk website for links to labs.
in reply to
And this is a link to the European Thyroid Association guidelines. They are not rules for English doctors, but they should be persuasive in getting a doctor to prescribe... two of the doctors on the ETA as you will see are high ranking British consultants.
Here's the reply from my GP cousin but, as I suspected, really not that helpful:
Sheffield is a big place – most GPs have catchment areas, though these often overlap so there is some choice. Best bet would be to look at GPs in her geographical area and look at their websites. Generally speaking, older GPs are less likely to be bound by guidelines and more confident to do something outside recognised good practice. TSH can go up and down and I don’t think it is as closely related to the actual level of thyroxine (T4 and T3) as is assumed. She should try to get T4 and T3 tested along with thyroid antibodies to get a fuller picture of what is happening. And/or seek referral to an endocrinologist, if only to investigate the tiredness. Having more thyroxine than you need is also not good for your health.
Thanks a lot for that. I'm afraid my GP is no spring chicken, yet he is only guided by the numbers. I saw him last week and asked if at least I should get advice on diet to better manage my thyroid -looking to getting a referral with a nutritionist at the very least- and his response was that diet had no influence whatsoever on the thyroid.
I'll come back to add my lab results and see what the community thinks.
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