looking to go private as NHS waiting is more than 2 months to see specialist.

[moonieblue]

Hello all, I wonder could anyone spare a few minutes to give me advice. I was admitted to A&E last Friday by a walk-in centre doctor because of my chest pain. The blood test are all normal apart of -

Alanine aminotransferase level : 309 iu/l -- normal range should be 0 - 40

My GP contacted me on Monday and I went to have another blood test:

Serum free triiodothyronine level 14.8 pmol/L [2.5 - 5.7]

Above high reference limit

Thyroid function test

Serum TSH level < 0.01 mu/L [0.3 - 4.2]

Below low reference limit

Serum free T4 level 37.3 pmol/L [9.0 - 23.0]

Above high reference limit

Serum alanine aminotransferase level 258 iu/L [0.0 - 40.0]

Above high reference limit

I am now prescribed to take 2 5mg carbimazole twice a day and take one 10mg propranolol three times a day. Another blood test on coming Monday and an appointment to see my GP on Tuesday.

My GP has refer me to see a specialist in a hospital endocrinology department but sadly, I have to wait until December.

I have be not well for a couples of year. It begin with pressure behind my left eye, seen Doctor and were refer to moorfield eye hospital, eye test show nothing wrong.

A few months earlier, I begin to feel numbness on face, even on lips and back of throat. Have to walk slowly or I would suffer chesty pain going up the the throat and jaw.

I just wonder could I neglect all the warning of my thyroid leading to liver problem?

I was told both carbimazole and propranolol are bad for liver. Therefore, instead of waiting months to see an NHS specialist, my daughter is going to pay me to go for private as a birthday present.

I wonder could anyone help and give me advice?

[SeasideSusie Remembering]

email [e-mail] for a list of thyroid specialists. Most endos are diabetes specialiasts who don't really know how to treat thyroid problems, and if you're going to pay to see one you want to make sure it's a thyroid specialist who actually knows what he's talking about.

[moonieblue in reply to SeasideSusie]

Thank-you. I will email Louise.

[Clutter]

Moonieblue,

Carbimazole is not bad for the liver although it may increase liver enzymes in a few patients. There is no evidence that propranolol is bad for the liver. Propranolol will calm your heart rate until Carbimazole starts regulating your thyroid levels. google.co.uk/search?q=Is+pr...

[humanbean]

If you've had untreated hyperthyroidism for a while your nutrient levels may have been trashed. Low nutrients can add to chest pain. Low iron is particularly bad. You could ask your NHS doctor to test your ferritin/iron, vitamin B12, folate and vitamin D. Improving them will help you to feel better.

[moonieblue in reply to humanbean]

Thanks humanbean, I am going to drop down your advice and check with my GP

[Fruitandnutcase]

When I was first diagnosed with Graves I had to wait for three months before I saw an endo. I was kind of shocked because I felt so ill at the time but that seemed to be about the length of time people were waiting back then. I honestly don't know if it is worth seeing someone private.t unless you know your hospital endocrinology department isn't very good.

Do you know if you have thyroid antibodies as well as really low TSH etc?

I was told to take 20mcg carbimazole a day for four weeks then have another blood test after the four weeks. There was no real change so I got a letter from the endo I still hadn't seen telling me to get more carbimazole and increase the dose to 40mcg . By the time I saw the endo I was hypo. It was all sorted out once I started taking levothyroxine along with the carbimazole - my hospital treat with block and replace. I have asthma so I couldn't be given propranolol, I just had to sit it out until the carbimazole took effect.

I had been feeling dreadful for years and had always felt I had some sort of autoimmune condition, I just never thought of Graves Disease.

I don't think I would worry about taking carbimazole either, the thing to look out for is a sore throats that is caused by the carbimazole interfering with your white blood cells, read about that on the patient instruction leaflet you should have bern given with your carbimazole. First sore throats I had I went to have a blood test and things were fine.

I'm in remission but I know if I were to relapse I would definitely want to go back ontoblock and replace.

You want to have your vitamins B12 and D, ferritin and folates checked out because you want them well up within the lab ranges to help your thyroid. My pharmacist told me when I started on carbimazole that I shouldtake high strength vitamin C along with it which I did, I took 1000mcg slow release vitamin C with zinc and apart from the Graves I felt pretty well on the Carbimazole so I wouldn't let it frighten you.

Make sure you get plenty of rest, I was SO tired when I was at my worst. My poor husband shopped and cooked while I slept practically round the clock. I didn't think I would ever feel normal again but I did and still do.

[moonieblue]

update on 11/11/17

I am so lucky to see an NHS specialist at the end of October. The Specialist was surprised when I told her I complained something pushed behind my eyes two years ago and even I was referred to Moorfield eyes hospital, they failed to notice I have all the thyroid eye disease symptom. They just told me to see an optician to get a pair of glasses. Which I did, and back than, I was told by the optician I only suffer slight short sighted. To wear glasses was an optional.

I went for a blood test before I met the Specialist,

Thyroid function test

Serum TSH level < 0.01 mu/L [0.3 - 4.2]

**no improve**

Below low reference limit

Serum free T4 level 21.8 pmol/L [9.0 - 23.0] **down from 37.3

ResultSatisfactory

Serum free triiodothyronine level 6.3 pmol/L [2.5 - 5.7] **down from 14.8

ResultAbnormal, but expected

Liver function tests

Serum alanine aminotransferase level 180 iu/L [0.0 - 40.0]

**down from 200

Above high reference limit

Now, here are a few questions I would like to seek help from our communities to give me advice.

1. The Specialist suggest me to consider RDI. I only start to take the medicine for a month and is seem to improve, I am thinking should I continue to take the medication and see if, by any chance, it might go away... or am I just being unrealistic?

2. The Specialist point out because of my liver function test is abnormal, taking carbimazole could worsen my liver. ( I had a liver scan and is all clear. My GP is going to refer me to a liver specialist to find out what the causes.) I do feel some dull pain on my right side, underneath my most bottom rib. The pain is dull and on and off. In my mind, should I wait until I seen by the liver specialist to make the RDI decision?

3. Now I know taking too much Biotin may cause Thyroid problem. Many hair supplement and skin care supplement contain Biotin. I took Hairfollic by wellwoman for round two years, GOLD COLLAGEN® for more than 10 years, both contain Biotin. Add up both are miles away to exceed the daily recommended dosage. However, I also took a Chinese medicine which claimed to maintain general good health for women for just a few months before my ordeal begins. High amounts of biotin can create false positives in laboratory tests for thyroid disease. I wonder could my thyroid disease is false positive?

-- moonieblue