So I saw a private endocrinologist today... - Thyroid UK

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So I saw a private endocrinologist today...

MrsFitz profile image
10 Replies

My last two blood tests have shown my TSH level to be below the NHS accepted level of 5.5. After 'discussing' my ongoing symptoms (joint and muscle pain, moving at the speed of a slug etc) with my GP and requesting additional levothroxine (currently at 75mcg), he said no further action is required. So today I have seen a Private Endo and he will be writing to my GP to request that that he treat me with an increase in my meds until my TSH is between 1 and 2. Why is this so hard for a NHS GP to accept without the additional stress and cost?

Rant over.

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MrsFitz
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humanbean profile image
humanbean

What is your TSH?

MrsFitz profile image
MrsFitz in reply to humanbean

3.9 - (NHS range 1 - 5.5)

humanbean profile image
humanbean in reply to MrsFitz

I'm shocked the bottom of the range is as high as 1. I thought it was usually around 0.3.

You could ask your GP why sick people are forced to have a higher TSH than healthy people.

See this graph showing the distribution of TSH in a healthy population and note how skewed it is and where the bulk of the results are :

web.archive.org/web/2004060...

The graph was drawn using data from this research paper :

eje-online.org/content/143/...

In particular look at the right hand half of Table 3. It shows you the TSH of each gender given separately, in different age groups, in healthy people with no known evidence of thyroid disease.

To give a couple of examples :

The median TSH for women aged under 40 is 1.30.

97.5% of women in this age group have a TSH of 3.3 or less.

The median TSH for women aged 80 or over is 1.70.

97.5% of women in this age group have a TSH of 3.8 or less.

The problem with TSH is, as the graph shows in my first link, the distribution of TSH is highly skewed with most healthy people having levels in the lower half of the range.

Doctors take it for granted that the median level of TSH is bang in the middle of the reference range (which is wrong!) and keep patients levels far too high.

Treepie profile image
Treepie in reply to humanbean

Very interesting graph.Good find Bean ,thanks.

Rapunzel profile image
Rapunzel in reply to humanbean

Thanks hb. Another post to add to my offline 'wise ones' folder :) x

humanbean profile image
humanbean in reply to Rapunzel

Thank you for the compliment! :)

helvella profile image
helvellaAdministratorThyroid UK in reply to MrsFitz

Just for clarity - there is no NHS range as such.

Although sometimes labs might have the same ranges, you have to assume that each and every lab uses its own ranges.

MrsFitz profile image
MrsFitz in reply to helvella

Thanks Humanbean for the graph, I think I will print that out for my next GP appointment. And sorry, you are right about the path lab showing the ranges Helvella. But either way my GP wouldn't even consider increasing my medication for a single moment, as far as he was concerned my thyroid was fixed and no way would be refer me to an endocrinologist.

I had to see another GP to ask for a referral, and pay for the privilege. He actually listened and said the first course of action was to work on lowering the TSH level. We even discussed whether other courses of treatment can be considered as levothyroxine doesn't work for everyone, obviously for me it is still early days. But I am very happy to at least have the option to increase my meds now.

loueldhen profile image
loueldhen

How long have you been on levo? It doesn't work for everyone. Read the side effects on the drug leaflet - I suffered crippling joint and muscle weakness pain. Took 10 years before I realised these symptoms were caused by levo.

MrsFitz profile image
MrsFitz in reply to loueldhen

I was only diagnosed in December 2015, and I certainly became very unwell after starting the Levo. But my real problem has been my GP, he was very quick to decide that according to his NHS guidelines I was now Okay, and any other symptoms were now chronic fatigue not thyroid. It's expensive to visit a private endo but at least he has given me some sensible advice now. He has advised my new GP to increase my Levo meds to 75 mcg and 100 mcg on alternate days and also low level amatriptoline (bad spelling!) For pain relief. He was happy to discuss Amour, and accepts that for some people it is the right course of action but only with careful monitoring.

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