Doctors appointment went ok

[Justliloldme]

I feel slightly better after my appointment. I felt like she'd fobbed me off last time but I feel she took me more seriously today .

I took my BH blood test results with me & she had a really good look at them. She looked at B12 & I told her I'd been supplementing since getting the results. She said that fine but it was 'in range'. She drew a diagram of how the thyroid works & said that whilst TSH is showing slightly high T3 & T4 are pretty much ok. So looking at the bloods I'm not hypo, so I said but what about these & pointed to a list of symptoms I've been experiencing. She said a lot of these are symptoms of menopause.

The up shot is she didn't want to prescribe meds just yet as she didn't want me 'to go the other way' but she would do bloods again and check, she's also checking for menopause (last time she said she couldn't do that because I have an implant!) and B12 & Vit D. Once I have the results I'm to go back in & see her - so no call from the secretary to tell me 'they're OK' like last time.

So I'm feeling relived that she's taking me seriously now & much more hopeful that something will be done.

[shaws]

The problem is that they are told only to take notice of the TSH alone.

Before the blood tests and levo were introduced in the late 50's/60's we were given a trial of Natural Dessicated Thyroid Hormones due to our symptoms alone .They came to no harm and they didn't have all this to-ing and fro-ing and from the doctors.

The doctors knew their business and some doctors who fought against the new 'Guidelines' stated often that they see patients (who had to go private) who were clearly hypothyroid. This is a doctor who ended up being embroiled with the British Thyroid Association as he was getting the left-overs who couldn't get diagnosed and for that he died of a stroke and his patients believed it was caused by his repeated appearance before the GMC (his patients certainly didn't complain as the 2,500 testimonials they sent to the GMC stating their lives were saved). Excerpt.

This book was written to draw attention of the medical profession to a major faux pas in the care of patients with hypothyroidism. This arises from the inexplicable refusal of the medical profession to recognise that patients can suffer from hypothyroidism when the thyroid chemistry is deemed to be ‘normal’ if the free thyroxine or the thyroid stimulating hormone lie between 95% reference intervals. There is a further problem that when a patient is diagnosed as hypothyroid many patients receive too low level of thyroid replacement through servile reliance on thyroid chemistry with (often) cavalier disregard of how the patient feels accompanied by an implicit and bizarre belief that a level of thyroid hormone is a better index of wellbeing than the patient’s own view of his/her wellbeing.

This situation has arisen from the mindless deification of ‘evidence-based medicine’ which usually means laboratory-based-medicine where one chooses the evidence which suits and ignores evidence which doesn’t suit. There is no evidence that the efficacy of thyroid replacement is better correlated with levels of thyroid chemistry than with the initial clinical picture nor clinical outcome and in a small pilot study the author has provided preliminary evidence of this assertion. (my own bold highlight)

worldthyroidregister.com/Go...

[bluebug]

A few points -

Firstly your GP isn't trained in nutrition so it is not surprising she would say as your levels are within range they are fine. If you went to see someone e.g. a doctor trained in nutrition, a trichologist they would state your vitamin B12 level is not high enough. (You can test your doctors knowledge of nutrition by asking them do they recommend the NHS diet. This recommends a low fat high carb diet without evidence that it works and current nutritional science is against this diet. )

Secondly if you have started supplementing with vitamin B12 then retesting your B12 level is a waste of time as your serum level will be increased. You have to stop taking the tablets now to confirm there is a problem and be tested in about 5 months time. In fact if your GP wants to see if you have an issue absorbing B12 she needs to do a intrinsic factor antibody and/or anti-parietal cell antibody tests. (She cannot do these tests on you on the NHS because your B12 level while low isn't below the range.) If those tests are negative then one of the differential diagnoses for low B12 is hypothyroidism.

Thirdly she said "a lot of these are symptoms of menopause" however they are NOT ALL the symptoms of the menopause plus the tests for menopause aren't conclusive. The only conclusive way of establishing you were menopausal is when your periods have stopped completely. There isn't tonnes of research out there about the menopause even though half the population goes through it simply because drug companies cannot medicate it due to the age of onset varying a lot and ethical considerations including the fact the drug companies don't see women in general as a prime audience for it's drugs as even the first pill research was done with private money. So telling you, you are menopausal is basically telling you to shut up and go away.

[Justliloldme in reply to bluebug]

Thanks for this but she hasn't told me to shut up and go away. She did last time (see previous posts) however, this time she is doing full bloods including to check for signs of menopause.

Once these are done I have a base for my case to get the medication I need. This is a step forward. Whether my TSH & T's show an issue & whether she'll medicate remains to be seen but I'll cross that bridge when the results come through.

[GM50]

At least she's listening and has done a re-test. However, beware of doctor's keen to blame your symptoms on something else though. Symptoms of thyroid creep up on you in a horrible way and you experience them long before your bloods show there's anything wrong. When I eventually saw a sympathetic endocrinologist, he said it is just as important to diagnose from clinical symptoms. I was tested for menopausal symptoms for a long, long time, even going down the road of HRT which was horrendous, before my thyroid was accepted as the root cause. When I eventually started with thyroid meds, all those problems cleared up too. If you get no joy, I'd ask for a referral or go and see another doctor.

[Hidden in reply to GM50]

Thanks GM50.

I was hoping she'd retest & take me seriously.

I was pleasantly surprised that she looked at the BH bloods & took to the time to explain the thyroid to me (she didn't tell me anything I hadn't found out in my research, but I appreciated that she took the time).

I'm aware that there are a lot of crossover in the symptoms with hypo & menopause so I'm interested myself to see what the blood results show.

I'm pretty sure it's my thyroid and I'm just hoping that the bloods back it up & she's willing to offer some medication.

The help on here has been invaluable.