Answers to Doctors

Hi I would be grateful for any thoughts or answers to doctors who say I will have a heart attack or stroke if my TSH goes too low. I have an appointment on Monday when I will be saying that I have been taking NDT and am very well. I'm preparing myself for a grilling!

[Angel_of_the_North]

Ask them to show you a study that proves this when not associated with high thyroid hormones or Graves disease. I don't think there is one.

[Hidden in reply to Angel_of_the_North]

Thanks for your reply, I'll remember that response. X

[Rapunzel]

First of all I'm glad that you're feeling well on NDT. Secondly, I hope that you don't have a tool for a GP, such as my ignorant mysoginist buffoon. Walk through what could be said and prepare your answers.

Remember that he may feel cornered, resentful ( I know, what a bunch of sh*ts, they really need to get over themselves...) because you are sourcing something which is making you feel better without his influence or prescription pad coming into play.

Finally remember that he is not instrumental in your continuing thyroid health; that his opinion doesn't matter if you are feeling well, that as Angel says there isn't an authoritative study ( although there are studies to show that the devil drug, I mean T3, can be used successfully to treat some heart complaints and finally that he can't withdraw your medical exemption card as you're not taking his magic potion of choice, T4, as it is the condition, not the prescription which means you have an entitlement to exemption.

Good luck. Here's hoping you can remain calm - something I find difficult but, having appreciated it results in my GP feeling ever more useless, is a state of mind that I try to maintain on the rare occasions I'm hauled before him. I will not curtsey, although I know he would appreciate it if I did. Dream on, monkey.

[Hidden in reply to Rapunzel]

Thanks very much for replying, especially about the condition not the T4. I'm going to ask for irons, vitamins d and b12 to be checked on the NHS. X

[humanbean]

You could show this to your doctor :

Source : circ.ahajournals.org/conten...

Low-T3 Syndrome

A Strong Prognostic Predictor of Death in Patients With Heart Disease

Abstract

Background— Clinical and experimental data have suggested a potential negative impact of low-T3 state on the prognosis of cardiac diseases. The aim of the present prospective study was to assess the role of thyroid hormones in the prognosis of patient population with heart disease.

Methods and Results— A total of 573 consecutive cardiac patients underwent thyroid function profile evaluation. They were divided in two subgroups: group I, 173 patients with low T3, ie, with free T3 (fT3) <3.1 pmol/L, and group II, 400 patients with normal fT3 (≥3.1 pmol/L). We considered cumulative and cardiac death events. During the 1-year follow-up, there were 25 cumulative deaths in group I and 12 in group II (14.4% versus 3%, P<0.0001); cardiac deaths were 13 in group I and 6 in group II (7.5% versus 1.5%, P=0.0006). According to the Cox model, fT3 was the most important predictor of cumulative death (hazard ratio [HR] 3.582, P<0.0001), followed by dyslipidemia (HR 2.955, P=0.023), age (HR 1.051, P<0.005), and left ventricular ejection fraction (HR 1.037, P=0.006). At the logistic multivariate analysis, fT3 was the highest independent predictor of death (HR 0.395, P=0.003). A prevalence of low fT3 levels was found in patients with NYHA class III-IV illness compared with patients with NYHA class I-II (χ2 5.65, P=0.019).

Conclusions— Low-T3 syndrome is a strong predictor of death in cardiac patients and might be directly implicated in the poor prognosis of cardiac patients.

The entire paper can be read here : Source : circ.ahajournals.org/conten...

[Hidden in reply to humanbean]

Thank you so much for the article, I have read it but need to read it again as it's difficult for a non scientific person like me.! May be I'll just give the Dr the reference, they are supposed to be clever enough to read it! X

[serenfach]

I found this useful in this sort of situation - go into Mrs Thatcher mode. Speak slowly in a low voice and glare! Tell them it is a shame they do not have the time to keep up with medical research (ie not their fault!) and as they will not have done any reading, it is a good "get out" for them. Once they have an escape route, they are more liable to listen.

Good luck.

[Hidden in reply to serenfach]

Thanks, I'm also going with books and research.