Results in today - Visit to doctor

[LaLuna]

I posted recently that I needed to know what to ask my doctor when I was called in to see her regarding my recent blood work.

So here are my results.

Sept 2016 TSH was 1.7

Sept 2016 T4 was 13

13 Feb 2017 TSH 27 (0.30 - 5.50)

13 Feb 2017 T4 8 (10.00 - 22.00)

13 Feb HbA1c 70

13 Feb Serum Cholesterol Ratio 5.9

My doctor has given me Levotyhroxine 50mcg and bloodwork to be done in two months time. I have also asked for blood work for B12, Ferritin, Folate. She will not do a T3. I have also asked for a referral to a endocrinologist, she wasn't to happy about this, but I said as I have raised blood sugars and now raised thyroid since Sept 2016, something is obviously going on and I need it to be looked into by a specialist. At this point she agreed that it might be a good idea.

Meds I am on.

2000 mg Metformin

48 Units of Levemir (basal insulin) night time

Humolog Insulin (when I need it)

I also take Vit D

Coq10

Vit E

So at this point from what I have read, I am wondering if this is Hashimotos, I cant believe I have gone from a low level to where it is today in just five months.

I feel very unwell all the time.

[puncturedbicycle]

Sorry you feel so unwell. Unless your antibodies were tested you won't know if this is Hashi's but the vast majority of underactive thyroids are caused by Hashi's so it is likely.

Do you have the list of TUK endos? Get a referral for someone good. Do you see a specialist for your blood sugar?

[LaLuna in reply to puncturedbicycle]

I did ask for blood work to be done for antibodies when I saw my doctor today.

Also I do not have a referral list, my doctor is doing the referral to my local hospital so I don't know who I will have, I did ask if she had any recommendations but she said you get who ever hey assign you too! So there's my answer I guess. Hopefully I will at least have another blood test done with this referral and I will make sure that the antibodies test is in there.

As for my diabetes I keep asking for an endo but as I was in good control of blood sugars, even titrating insulin with no help from diabetic nurse at GP office, the surgery would not do a referral for me. Now I have asked again, and with the thyroid results in the mix they have finally relented.

[puncturedbicycle in reply to LaLuna]

Ok, do with this what you will but I would strongly advise you to get the TUK list and choose someone and go back to your doc and say you'd like to be referred to that doc.

Your gp's recommendation would mean nothing to you, they don't really know what criteria make an endo 'good' and as far as I'm aware they can refer you to whomever you ask to be referred to if you're in their area.

[Clutter in reply to puncturedbicycle]

PB,

That is true for patients in England but may be different for patients in Wales, Scotland or N.Ireland.

[puncturedbicycle in reply to Clutter]

We can only try.

I wouldn't wish my endo experience on my worst enemy, and it wasn't a fraction as bad as a lot I read about here.

[humanbean in reply to puncturedbicycle]

puncturedbicycle Now I'm dying of curiosity. Have you posted about your bad endo experience? Could you give me a link?

[puncturedbicycle in reply to humanbean]

Lol, it is the most boring thing ever. No idea if posted about it. Happy to satisfy your curiosity though, what can I tell you?

Endo was perfectly nice but resistant to the idea that I might feel unwell due to thyroid, still raised and raised levo until levels were all good and I was still unwell, eventually prescribed t3 after I got it elsewhere, acted like it was their idea, then discharged me. So if this sounds like a huge anticlimax just keep in mind at this time I was more ill and desperate than ever before or since and the whole palaver took about two years during which all kinds of cheerful asides were made about how I should cycle to my appointments (8 miles each way) and each appointment required me to wait at least an hour during which my parking inevitably ran out (until I cottoned on and got three or four hours of pay and display just in case). Appointments took up most of the day as I had to leave an hour to get there and an hour to get back and with the waiting I might be there more than two hours. I get tired and sad just thinking about it.

I didn't mean to imply I should win an award for worst endo experience rather that this is not how people should be treated when unwell. I read far worse here every day.

[humanbean in reply to puncturedbicycle]

Good grief - cycle to an appointment while incorrectly treated or untreated for hypothyroidism. The sadism from the medical profession frequently amazes me.

[puncturedbicycle in reply to humanbean]

Tbh even when my results were stellar (on levo) I could hardly bend over I was so swollen w fluid. But yes, the cheerful callousness is staggering.

There was a doctor sitting in on one of my endo appts and and I was in tears about something (er, feeling ill I guess) and they conferred in front of me on how something I was saying was wrong, like 'Oh no, that's wrong, Dr So-and-So and I will explain to you how wrong that is.' Oh sure Dr Stranger, do call me out during my appointment I've been waiting an hour for which I expect will do me no good at all. Why not!

I'm one of the few who got what I wanted out of the endo (a good dose of levo and then some t3) and they wrote some strongly-worded letters to my gp when the surgery had an attack of the vapours in response to the cost of my t3. So the experience was not great but the outcome was good and I consider myself lucky.

Still would never knowingly encourage anyone I care about to go through something similar without telling them what to expect.

[humanbean in reply to puncturedbicycle]

I hate it when they gang up on me, as they appear to have done in the appointment you describe.

I take my husband with me to important appointments now. I hate the necessity - I'm not stupid. But in this day and age to need a witness in case of bullying and sadism is shocking in the 21st century.

I also hate it when I cry, because when I do that they dismiss everything I've said and diagnose depression and/or anxiety. They simply don't accept that they themselves are the cause of any depression and anxiety, and they assume that my original complaints are just in my head.

[puncturedbicycle in reply to humanbean]

I can't add anything to that except I'm sorry.

The way uat makes you feel is incomprehensible to anyone who doesn't know. I've been depressed before but that is a special kind of helpless, pathetic desperation, and you know when you're feeling better because it goes away. It is good to have a witness, I agree. x

[Clutter]

LaLuna,

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Ask your GP to add thyroid peroxidase antibodies to your blood order. Positive antibodies indicate autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/about_...

Taking Levothyroxine can raise blood sugar levels so keep an eye on your levels in case your Metformin or insulin dose needs adjustment. Conversely you may need to check thyroid levels when Metformin or insulin doses are adjusted.