Can they refuse my Endo referral request?

[WiddyWooo]

Hello everyone,

I've been hypo for about 5 years now and my symptoms have never really gone away. Recently they have started getting worse again, weight gain, hair falling out, all the usual ones. I've been back to the doctors twice this year and have asked to be referred to an Endo but they are refusing because my levels are normal. I've just asked for a T3 test after they have refused again, and they've said I can't have that done for another 8 weeks because I've just had tests done. I'm at my wits end. Is it best to give up with the NHS and go private?

TSH 0.61 (0.27-4.2)

Free T4 19.2 (12.0-22.0)

Thanks for your advice in advance.

[SeasideSusie Remembering]

WiddyWooo I think possibly if you were to be offered a referral, with those results an endo might refuse to see you anyway.

Also, with those results then it's very unlikely that the lab will do FT3. Even if a GP requests it, it's the lab who makes the decision to do it and then only when TSH and FT4 are out of range.

In your last post three months ago, it was suggested that you do a private test with Blue Horizon so that you could get your FT3 tested along with the other thyroid tests, plus vitamins and minerals. That suggestion still stands.

With those results and the fact that you still have symptoms indicates that something isn't right. It could be that you're not converting T4 to T3 well enough, or that your nutrient levels are too low for thyroid hormone to work properly.

If you do the Blue Horizon Thyroid plus Eleven as advised previously, then come back with the results, we can possibly throw some light onto why you still have symptoms with what, to all intents and purposes, are good test results.

[WiddyWooo in reply to SeasideSusie]

Thanks for your reply Susie, I'd forgotten about the other post and have just found the link, it looks like this is going to be the only way forward for me now, it's so frustrating.

[shaws Administrator in reply to WiddyWooo]

The guidelines decree that only the TSH and T4 is to be used as diagnosis (pre blood tests we were diagnosed upon symptoms alone and given NDT). UK is the only country in the world, I believe, to make patients wait till the TSH is 10 - other countries it is 3+.

They dismiss the patient's disabling symptoms and tell us it 'couldn't possible be lack of thyroid hormones' as TSH is 'in range'. They are unaware it should be 1 or lower.

[Simba1992]

Read this interesting article on when thyroid med in hypothyroidism doesn't work.

drlam.com/blog/adrenal-fati...

[Clutter]

WiddyWooo,

FT3 is rarely tested in primary practice now and even when it is NHS labs often decline to analyse it unless TSH is suppressed.

NICE CKS on Hypothyroidism says:

Advice should be sought from an endocrinologist (or referral arranged) if the person:

Has adverse effects from treatment with LT4.

Has cardiac disease.

Has an abnormal thyroid gland structure, atypical thyroid function tests, or an unusual cause of hypothyroidism (for example due to drugs such as amiodarone).

Has persistent symptoms despite treatment with LT4.

cks.nice.org.uk/hypothyroid...