Dr Shirine Boardman

[ann_g_k]

I understand that Dr Boardman is happy for her name to appear in postings.

Has anyone been referred to her via their NHS GP rather than privately?

I'm seeing my GP next week and am hoping the opportunity will arise for me to ask for a referral. I'll be discussing:

1) results of MRI head scan to determine the cause of pulsatile tinnitus. Blood tests have ruled out a thyroid connection, though the TSH value is definitely climbing:

1/12/15: 3.84 (0.27-4.20)

27/2/15: 2.53 (0.35-6) (the range changed in April 2015 to the above)

Folate is in range but low:

11/12/15: 5.4 (4.6-18.7)

27/02/15: 5.8 (4.6-18.7)

I've never been diagnosed with hypothyroidism (but have a diagnosis of ME). BTW my B12 levels are off the scale and getting higher, so I don't have poor B12 levels (neither serum nor active):

11/12/15: 914 (191-663) (serum)

27/2/15: 887 (191-663) (serum)

20/4/15: 154 (25.1-165) (active)

Not quite sure what to make of this.

Other test results:

Ferritin: 120 ug/L (15-350)

Total cholesterol 5.0

HDL cholesterol 1.5

LDL cholesterol 3.2

total:HDL ratio 3.3

2) my ongoing problems with low core body temperature. I've been carrying out an exercise - using a geratherm basal thermometer I've recorded my temperatures three times a day (where possible) for the past three weeks. The readings are all over the place, with no consistency whatsoever. The lowest reading is 95 F | 35 C and the highest (when I was ill with throbbing headaches following the MRI scan) is 97.2 F | 36.2 C. Average temperature on waking is 96.6 F | 35.8 C. Exercise doesn't seem to have any effect.

I keep getting fobbed off by being told that I must be "one of those women who just happen to feel the cold most acutely". Surely it's not right for a 55-year-old woman to have such a low core temperature that it is regularly on the cusp of hypothermia. AND if it is so low at this age, what's it going to be like in twenty years' time?

Sorry for the long posting.

[Clutter]

Ann_g_k, some members have complained that Dr.B has become insistent that TSH remains within range but that will only be a problem for those who need lower or suppressed TSH. I don't know whether she accepts NHS referrals or not. Email [e-mail] for a list of member recommended endos which includes some NHS doctors.

NHS won't usually diagnose hypothyroidism until TSH is over range or FT4 below range. TSH 3.8 is close to the top of range and indicates your thyroid is struggling to produce hormone which is why you are symptomatic. Tinnitus is a very common symptom in undiagnosed and undermedicated hypothyroid patients.

Folate and B12 are synergistic and low folate may be why B12 is high. PA Society recommend B12 is optimal at around 1,000 so 993 isn't a concern. Supplementing 400mcg folic acid will improve folate and enable better use of B12.

_______________________________________________________________________________

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.

[ann_g_k in reply to Clutter]

Thank you Clutter, this is very helpful. I forgot to add FT4, FT3 and antibody results (both done privately in July 2014):

FT3: 3.14 (2.63-5.7)

FT4: 13.6 (9-22)

Anti-TPO <33 (0-59) negative

I'll get some folic acid and see how that improves the situation.

[Clutter in reply to ann_g_k]

Ann-g-k, antibodies are negative for autoimmune thyroid disease (Hashimoto's). FT4 and FT3 are low in range consistent with high in range TSH.

__________________________________________________________________

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.

[ann_g_k in reply to Clutter]

The FT3 and FT4 were tested in 2014 when my TSH levels were 3.36 (0.35-6.00) and near enough mid-range, so given that the latest result is more towards the top of the range it is likely that the FT3 and FT4 are lower. Or maybe it doesn't work that way!?

[Clutter in reply to ann_g_k]

Ann_g_k, TSH usually rises because FT4 and FT3 have dropped.

[Anthea55]

Your temperatures being all over the place reminded me of something I read - probably a link from here. Anyway look at this website.

drrind.com/therapies/metabo...

Dr Rind suggests that unstable temperatures can indicate adrenal fatigue.

I have read that if you have adrenal problems you need to sort them out before you can make progress with any thyroid problems.

All the best.

[ann_g_k in reply to Anthea55]

Thank you Anthea55,

I have long thought that the adrenals were implicated and have been thinking of getting the stress profile test carried out. However, I've been reluctant as the results are of no use if GPs/endos don't recognise the value of saliva testing. DHEA tests always come back as 'normal'.

It could be that the brain scan shows something awry with the pituitary (despite all blood tests to do with the pituitary being 'normal') which would have an effect on the adrenals.

I was wanting to be armed with the name of a good endo (hence my enquiry about Dr Boardman) in time for my GP consultation next week, though it is looking increasingly as though this isn't a good route to take, given people's experiences.

Thanks again

[HarryE]

You cannot be referred on the NHS as she is private only. But my NHS GP referred me. Unfortunately they then proceeded to ignore everything she asked them to do, including prescribe any medication. Waste of time & money. I have no option but to stick to self medication it seems

[ann_g_k in reply to HarryE]

That must be very frustrating and it shows how hard it is when the GPs who are supposed to be working for our good choose to ignore specialist knowledge and experience. Thank you for your advice.

[Margo]

I would be very interested to know how you get on with your MRI results ann_gk. I am waiting for an MRI appointment for Tinnitus. I also have very similar temperature to readings as yourself and am constantly very cold.

[AmandaK in reply to Margo]

Hello Margo, my appointment is next Tues so will let you know the outcome. In fact, depending on the results I may send out a post to the community as they might help others with the same problem. The subject pops up from time to time.

[Margo]

Great AmandaK, good luck and look forward to reading about it.