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.
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)