GP appointment update

[j345]

Hi so I have come back from GP and it has been a really promising appointment. He has upped my thyroxine from 100mcg to 125mcg with a repeat test in 6-8 weeks time. He has accepted I have Hashimotos and that it is a confusing illness that can cause fluctuations in hormone levels and symptoms. He told me I need to go gluten free and that I have no medical need for any of the other medications and they are just plastering over the symptoms which are most definitely either hypothyroid or low vitamins/minerals. He looked at my family history and has ordered a reproductive hormone panel, diabetes blood test and autoimmune profile because of the family history of polycystic ovarian syndrome, autoimmune disease and diabetes as well as possible sjogren's because of past complaints of dry eyes and dry mouth. I underwent a short test where I had a piece of paper held under my eye and not a lot of tear was coming out onto paper which he thinks could be from sjogren's. Had knee and ankle reflexes tested, absent reflexes in knees and ankles. Blood pressure was 110/60 and heart rate 46.

Onto the vitamins and minerals, he has given me a loading dose of 300,000iu D3 and to take a maintenance dose of 2000iu D3 a day.

Folate he has said I need to take folic acid 5mg once a day but not before being tested for pernicious anaemia, at any rate I need to be treated for the almost deficient B12 and has given me loading doses of B12 injections. I have been booked in to have a blood test for intrinsic factor antibodies and that will be in 2 weeks time.

He has also given me iron tablets to take 3 times a day and to be retested along with the thyroid levels and I am having complete blood count and iron panel monitored with ferritin during that time. He says he will see how I go with the iron tablets because they can cause stomach upset and if I don't get on with them he will refer me for an iron infusion.

As for the other medications he has told me since I have not been on the antidepressant and antipsychotic very long (2 weeks for both) I can just come straight off them and he has taken everything else off my prescription list. I have spoken to practice manager as well, she has said the GP I saw before has been very neglectful and put my health at a big risk, she is happy for me to complain not just to her but also to PALs since she believes I have not only been ignored for my symptoms and levels but also fobbed off. She is also going to talk to him to find out why my care has been so poor.

Thankyou everyone

Ferritin 21 (30 – 400 ng/L)

Folate 1.7 (2.5 – 19.5 ng/L)

Vitamin B12 188 (180 – 900 pg/L)

25 hydroxy vitamin D2 <6.0

25 hydroxy vitamin D3 24.9

Total 25 OH vitamin D 24.9 (<25 nmol/L severe vitamin D deficiency. Patient may need pharmacological preparations)

Red blood count 4.31 (3.8 – 5.8)

White cell count 7.16 (4.0 – 11.0)

MCV 77.6 (80 – 98)

MCHC 375 (310 – 350)

MCH 28.2 (28 -32)

Haemoglobin 123 (115 – 150)

Platelets 261 (140 – 400)

Haematocrit 0.390 (0.370 – 0.470)

Neutrophils 1.4 (0.0 – 2.0)

Basophils 0.0 (0.0 – 0.2)

Monocytes 0.5 (0.2 – 0.8)

Lymphocytes 1.8 (0.2 – 2.0)

Iron 9.0 (6.0 – 26.0)

Transferrin saturation 13 (10 – 30)

TSH 3.40 (0.2 – 4.2 mIU/L)

Free T4 13.3 (12.0 – 22.0 pmol/L)

Free T3 4.2 (3.90 – 6.80 pmol/L)

Thyroid peroxidase abs. 94.5 (IU/mL)

Thyroglobulin abs. 288.3 (<115 IU/mL)

[Marz]

Congratulations ! Has your GP been reading this Forum ? So refreshing to read 😊

[j345 in reply to Marz]

Thankyou I wish he had been! I took in my iPhone with the articles I downloaded and told him I have a right to be treated adequately and he said he agreed 100%. He was very thorough

[Marz in reply to j345]

Hang on to him - Clone him too 😊 Everyone needs a Doc like him. So glad you have found a good one ....

[SeasideSusie Remembering]

RESULT Well done!

Thank goodness this other GP knows his stuff, and he does!

I'm not 100% sure, but you might need testing for intrinsic factor before starting B12 injections and folic acid.

Don't forget D3's important cofactors plus the timing of D3, magnesium and iron tablets.

When taking any form of B12, it's important to keep all the B vitamins balanced and we do this with a good B Complex.

When having thyroid tests, always book the earliest appointment of the morning, fast overnight and leave off Levo for 24 hours. This gives continuity of conditions for comparing results, but importantly gives the highest possible TSH which is needed when looking for an increase in Levo or to avoid a reduction.

I hope you start feeling better soon.

[j345 in reply to SeasideSusie]

Thankyou yes all blood tests are done fasting and early morning, GP has no problems accepting this. The receptionist I spoke to questioned why I want an early morning blood test and fasting, another receptionist overheard and said if that was what I have been advised to do who was she to question. I will get the testing for intrinsic factor done first.

[Inana]

Your:

Ferritin 21 (30 – 400 ng/L) is very low and that can cause havoc on its own. Before coming to this forum, I had persistent body pains, joint pain and ringing ears. So, I went on and supplemented my iron, Vitamin Bs, Folate, Vitamin C and I was already taking Magnesium. After about 3 months, my body pains had decreased significantly, so do make sure that all your vitamins and minerals are adequate.

Now, my ferritin is great, but I am still sick. But, at least some symptoms are being crossed off the list. I still get some pain, especially my gums being sore, but the muscles are better. I am still dizzy, and weak but hey... One problem at a time. Besides, you need Ferritin to convert T4 to T3. Ferritin and other vitamin levels need to be good in order to help your medication work.

All the best.

[Hidden]

If this new GP proves to be as good as they sound perhaps their info should be passed on to Thyroid UK to add to their recommended GP list? Something worth considering...

thyroiduk.org.uk/tuk/About_...

[j345 in reply to Hidden]

Yes of course.

[brighter84]

Positive news, liking it!!! Hoping for better health for you in the future, hurray!

[humanbean]

Well done! So pleased it has all worked out for you.

[spongecat]

Wow! So pleased that this doctor has listened to you and knows what to do. Brilliant stuff!

Hope you will be feeling a lot better soon.

[Cazzie91]

I was just above all your levels for vitamins and iron levels and i was pratically dead!!

Put on antidepressants, everything just told all was normal. Saw multiple doctors and still all normal. Now on b12 injections, folate, iron and vitamin d, although had to go private.

So glad you had a doctor that listened and actually wants to sort you out. Def make that complaint, i have one filed against my GP practice!!