GP didn't want to give out results

[sanpellegrino]

I checked in after an annual review/ blood test and came back a bit later to pick up my results. The receptionist told me that I wasn't allowed to have them. I couldn't quite believe it because I'd never had trouble getting a printout before. I just stood there (I actually thought he was joking) and he printed out the results.

I can now see why they didn't want to give them out.

TSH: 4.3 REF .27-4.2

T4: 14.2 REF. 10.8-25.5

But the note under the TSH said "TSH result suggest marginal under-replacement or poor compliance"

Ha ha.

Anyway, I'm sick of feeling like crap and and bumping around the top of the reference rage and only getting anything at all when I go slightly over. I feel like crap, I'm symptomatic again where I knew I'd be a bit over the ref range, e.g. painful hips and napping at the weekend - but I'm always tired, always fuzzy headed even when I'm below the current level, but I can't seem to get them to take me seriously.

I'm booked in to see the GP again in a week and it's one I've not seen before for thyroid. I really don't know what to do.

[Clutter]

Sanpellegrino,

Doctors are supposed to sign off the results for release to patients before receptionists given them to patients. This is so that doctors can discuss abnormal results with the patient without the patient being alarmed by the results.

Poor compliance can mean not taking Levothyroxine daily or taking it with food and drink which reduce absorption. 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.

TSH 4.3 means you are under medicated. 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.

It may be worth asking your GP to test ferritin, vitamin D, B12 and folate. Low/deficient levels are common in hypothyroid patients and can present musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms.

[SeasideSusie Remembering]

sanpellegrino From ThyroidUK's main website, Hypothyroidism page, under 'Treatment Options':

'Dr Toft states in Pulse Magazine:

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)." '

Dr Toft is past president of The British Thyroid Association and leading endocrinologist.

You can obtain a copy of the article by emailing [e-mail] the above quote is Question 6. Print it out and take it along to show your GP.

I am assuming you're diagnosed hypo and are prescribed Levo. Ask for an increase in your dose to bring your TSH down to the lower end of the range and free Ts to the upper end of the range (providing that is where you will feel well).

After your increase, re-test 6-8 weeks later, another increase if necessary, another retest 6-8 weeks after each increase until your symptoms abate.

Always book the earliest appointment of the day for your test, fast overnight (you can have water) and leave off Levo for 24 hours. That way the TSH is highest which is what you need when looking for an increase in your dose or to avoid a reduction. Make sure you keep conditions the same for every test, keep a record of your results, ranges, dose of Levo, how you feel, etc, and then you have a proper basis for discussion when future alteration to your dose is suggested eg "I felt better when I was on XXXmcg and my results were in range, so I see no need for a reduction" or "I have xxxx symptoms which are still indicative of Hypothyroidism, I am only half way through the range for FT4 (or very high in range for TSH) so there is room to increase my dose". You get the picture

[shaws Administrator]

Next time you see her you can tell her it is the LAW in the UK that if we request our blood test results we get them.

[bluebug in reply to shaws]

While you personally have a right to all or part of your medical records under the Data Protection Act 1998 there are occasions when they can refuse to give them to you.

Clutter has explained one reason why the receptionist was being difficult in handing them over, and in fact the doctor themselves could refuse to hand them over if they decided doing so would cause distress or alarm.

Also while it may be a law it is up to the person whose rights are being breached to enforce that law.

[Glynisrose]

I always ask where the receptionist got her medical degree as they are fond of repeating results. Tell your doctor the results are YOURS and you will have them!