Dr visit after private test results

Hi there,just seen my GP . She did not think i had thyroid issue (she said she had no idea what ft3 or ft4 were) my bloods are as follows


FREE T4 L 11.43 12-22 pmol/l

FREE T3 6.02 3.1-6.8 pmol/l

TSH 2.19 0.27-4.20 lu/l

REVERSE T3 16.0 10-24 ug/l

T4 TOTAL 80.7 64.5-142.0 nmol/ VITAMIN D (25OH) L 44 Deficient <25 nmol/l

VITAMIN B12 L 185 Deficient <140 nmol/l

She is referring me to an endocrinologist because i pushed it.She prescribed vitamin D capsule for next 8 weeks and told me to take 2000 mg of vitamin B12 for immediate future.Is this a good outcome .i didn't find her too happy with fact i ordered my own tests and i didn't leave her surgery feeling this was a satisfactory visit.My question is this ,should she have provided injections of B12 as i am severly deplete,when i queried it she said tablet form better and why would she wait to treat my thyroid issues. I requested test Intrinsic Factor and gastric parietal cell antibodies to rule out pernicious anaemia and she said there was no need. any opinions welcome.LINDA

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20 Replies

  • GPs are effectively told not to treat until TSH is over 10. Your FT3 is rather high, FT4 low, TSH could be lower. Many of us have found that GPs will leave us at the bottom of the range or even below the range and still say everything's OK.

    Sorry, don't know anything about B12 but would advise to check out Marz's posts for info.

  • its a shame that things are so complicated when all we want is to live a normal life.lol

  • Wow! Your doctor has no idea what FT4 and FT3 are! The things we hear on here make you wonder how some of them managed to qualify! Are there no other patients in the surgery with a thyroid problem? Has no-one had more than TSH tested? I despair, I really do :( .

    Well, at least you got a referral to an endo, let's hope he/she has heard of FT4 and FT3!

    What is the Vit D she's prescribed? Did she also tell you that you also need Vit K2? Vit D increases the absorption of calcium, Vit K2 directs the calcium to bones and teeth rather than soft tissues/arteries. Oh, she didn't mention that? Mmmm, not surprised!

    Did she prescribe the B12? If you are getting it yourself then make sure you get Methylcobalamin, Solgar and Jarrow do a sublingual lozenge which are very good. Do not take cyanocobalamin. I don't know if she should have prescribed injections, I don't know what the lower level is that necessitates injections. If you take B12 you should also take a good B Complex in order to balance all the B vits, but of course she wouldn't tell you that either.

    Your FT3 is high compared with your FT4. Hopefully someone will come along who understands that and comment.

  • hi,thanks for reply,she did not mention vit k2 so i will look into it and she also said no need for vitamin b complex,i have researched myself need for this so when i privately bought B12 in health food store i mentioned this to lady who worked in shop and she laughed at ignore surrounding this issue with GPs. She said they have no interest in nutrition. i live in Ireland and we have to pay for GP vist =50 pounds,prescription for Vit D oil capsule = 35 pounds pounds and 34 pounds in health food shop.You are lucky with NHS.I am thinking of changing doctors as all she has done for me is to prescribe Tramadol for pain related to Fibromyalgia. I constantly told her issues for last 2 years were more than usual pains and got no satisfaction,glad that I went off and got myself tested privately ,shocking that i have to do this,this site is a lifeline.

  • The NHS continues to leave many of us ill and we're forced to pay for our own tests and medication.

    Are you able to buy your own vitamins and minerals?

  • Yes I can buy my own but I had to order b12 5000mg online as can't get in Ireland.

  • Your B12 is on the floor - especially as only 20% of that result will be available to reach your cells where it is needed. Anything under 500 can result in neurological symptoms and if not treated can be irreversible. You need a result of around 1000. I would take 5000mcg of B12 - of the ones suggested above. Keep under the tongue until dissolved. You will also need a GOOD B complex as B12 works with Folate in the body. Please remember that any further testing for B12 will be pointless as the results will be skewed.


    The above site will tell you all about any further testing you may need to confirm the diagnosis. It is a scandal your GP is so useless. Please click onto Films on the Menu and watch the fourth video down. You will then realise how important B12 is.

    Sometimes B12D and Hypo can overlap with its symptoms - so once you have better levels you may well feel better. It would be good to know why you have such a low reading. Are you a veggie/vegan ? Do you have any gut issues ? Are you taking any drugs that may affect the B12 absorption ? Low stomach acid ? Sorry lots of questions - just trying to solve the mystery :-)

    I notice you did no have the Thyroid anti-bodies tested.... Anti-TPO and Anti-Tg. I have noticed people with Fibro type symptoms often have been diagnosed with Hashimotos. Myself included. It might also explain why the FT3 is high in the range and the FT4 low - although that is a bit of a mystery.

    Your low VitD can also cause pains throughout the body. Do hope you soon feel stronger.

  • hi Marz

    Thanks for taking time to reply to me.i am not vegan or vegetarian(very healthy diet even eat liver ) and the only drugs i take are tramadol(zydol) 2oomg by 2 daily. i did have full range of tests done but doctor saw no area of concern,went on about lab area variations!. and how great my folate was i have fibromyalgia for last 20 years but crashed 2 years ago and since then i know something more wrong,warning bells started ringing 2 months ago as i have deveopled numbness , tingling in my hands and my feet never warm up.This is why i got tests done privatly as advised on here went to Blue Horizon.see all results below


    CRP 2.10 <3.0 mg/l FERRITIN 76.9 20 -150 ug/l


    FREE T4 L 11.43 12-22 pmol/l

    FREE T3 6.02 3.1-6.8 pmol/l

    TSH 2.19 0.27-4.20 lu/l

    REVERSE T3 16.0 10-24 ug/l

    T4 TOTAL 80.7 64.5-142.0 nmol/l


    ANTI-THYROIDPEROXIDASE abs 10.9 <34 klu/l

    ANTI-THYROGLOUBULIN ABS 20.8 <115 ku/l


    VITAMIN D (25OH) L 44 Deficient <25 nmol/l

    VITAMIN B12 L 185 Deficient <140 nmol/l

    serum folate 12.27 10.4-42.4 nmol/l

  • Did you look at the link I posted about B12 - there you can see the symptoms of B12D. That is what you have - so read the website - check out additional tests needed - look at the Guidelines that your GP should have read - and get treated. Your GP is neglecting you so you will have to take things into your own hands. Look at the videos on the website and look at the 4th one down - then you will realise how serious Low B12 is.

    I had a B12 level of around the 300's for years. Was told it was OK....long before I knew about how scandalous the ranges are. Little did I know that the VERY expensive surgery I had on my spine in 2007 was quite possibly de-myelination of the spinal cord. I now have weekly B12 injections but the damage has been done.

    B12 deficiency is not just a vitamin condition - it is a neruological one. Pop over to the PAS forum and read some of the stories there - and the horrendous amount of GP ignorance. It is astounding and criminal.

  • Thanks so much for your time.I will go on the site and look,it's pretty bad that this lack of empathy and proper medical ability exists. 

  • Western Medicine is not about the wellness of patients - it is a business and must be profitable at all costs.

  • Advice needed,i saw a different GP today and she said my b12 results were not definitive.she took bloods to retest b12 and check for diabetes. She wants to refer me to Neurologist to do a nerve conductor test due to issues in my hands. i feel i am in the twilight zone as i am doing research online saying i need help and doctors are not hearing me. can i medicate myself with b12 5000mg lozenges or are the injections better. i am swinging between fed up and irate.

  • Am afraid it is time for you to take control of your own health if your Doc thinks that B12 result is not low.  Remember ONLY 20% of that result is available to reach your cells - as detailed in the link I gave you.  Also the range STARTS at 500 in Japan where Alzheimers and Dementia is lower. The 5000mcg lozenges will certainly help - ensure you keep them under the tongue until they dissolve so they are taken up by the micro-circulation and avoid the gut.  Also add in a GOOD B Complex that contains Folate rather than folic Acid - which is synthetic. 

    Again more expensive tests for the NHS when an inexpensive treatment may well sort things out.  You could also top up with a B12 spray under the tongue.  It may take time so be patient.

    You also need to treat the the VitD.  Hope you soon feel better.

  • Many thanks for your knowledge.I am just afraid more damage is being done and they don't care. I am waiting for shipment from .uk to start treatment  and meanwhile I am taking B12 1000 by 5 daily along with B complex.looking forward to say when I am feeling well again.linda

  • Anti bodies are good so not Hashimotos which is the commonest form of hypothyroidism.

    Not knowing what T3 is the most active and needed of the thyroid hormones is ludicrous.

    Rather suggests she was making out you had wasted your money on gibberish.

  • Exactly how I felt,shame her ego more important than my health.

  • I put your figures into the sttm calculator. stopthethyroidmadness.com/r...

    And came up with a ft3/ rt3 ratio of 0.2. Showing that you have far too much rt3. This means that the free t3 cannot be used by the body...., you make rt3 from unused t4. Unused because itS not converted, or not needed....

    This could be why your tsh is raised....

    Have a look at the link and maybe consider stopping t4 and taking t3 only for a whille.....

    G x

  • Hi thanks for your post,I went onto the site and result was   373.5,is this bad,  I am new to this.I do not take any t4.Thanks for taking time out to help.

  • Hmm, are you sure she is actually a doctor? Even with just an hour or so on the thyroid at med school she should know what free t3 and free t4 are. Tablets aren't better than injections for B12 (unless you know for certain that there is no issue with absorption). I don't think those tablets will be enough to raise our B12 to a decent level. You want sublingual methylcobalamin about 5000iu (Jarrow formulas do one that you can get on Amazon using the TUK link via Easyfundraising).

  • Thanks for input.I ordered b12 5000mcg last night online. I am seriously considering leaving gp which would be weird as I have attended her for last 20 years but my health is important.

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