Good morning, some may recognise me now I've had so many questions over the last 2 weeks! I am struggling to get any medication as GPs at my surgery are all refusing to medicate until TSH reaches 10. Regardless of anything else. We have been trying to conceive for 2 years and I have found out that TSH needs to be below 2, ideally closer to 1. I tried another GP today at same surgery and although he said the same- he wont prescribe until TSH reaches 10- he did say he had "knowledge gaps" and he was open to finding out more about it.
So I'm now looking up info to find the best document to email to him- can anyone recommend something he should be following? I've found info on the Nice Guidelines website but it doesn't seem to be downloadable as a pdf where I could highlight the bits I want him to read- and I'm thinking if I just send him a web address he'll dismiss me as nagging him or giving him away too much work that he hasn't got time for.
Anyone got any links to official documents I could send him?
Thank you
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Qwerty11
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Thanks- that is what I did in the end- I highlighted the bits I especially wanted him to read and dropped it off at reception at lunch time to pass to him... so hopefully he might be open to finding out more. I just don't know if he will even look at it, or if he would go over what the other 2 GPs have already said as that will already be in my notes- don't need medicating until TSH gets to 10. He also said TSH is all they need to look at and I can have a Vitamin D test if I want one as levels have fallen through the floor in the past- but it wont have anything to do with my thyroid... which I'm not sure is the case. I'll leave it a few days and then make another appointment with him. I will be getting pretty unpopular there I suspect.
If your GPs won't read or act on the BTA Statement and NICE recommendations I suggest you change GP practice. Don't go quietly either, make a formal complaint to the practice and to the GMC.
I'm sorry to say I can see that situation coming- and I will certainly make a strong complaint. I checked on the other gp websites yesterday to see which other catchment areas I live in- found one other that was closed to new patients last time I looked but is now open, so I think I will swap anyway after this. I've lost confidence in their knowledge, no matter what the issue is and I don't like the air of 'we' (one Dr in particular) look after your health and tell you what needs to be done- patients don't need to do anything. I want to understand and I want to be involved! Sorry, rant over!!!
Unfortunately, the part of the NHS constitution that is supposed to promote a doctor-patient partnership, and also ensure that patients can participate in decisions about their care, doesn't appear to have made much impression on GPs.
Don't pander to his misogynistic and archaic out-of-date or non existent knowledge of thyroid. You clearly have Hashimoto's and should be treated regardless of TTC.
If I can't get anywhere after one more appointment to discuss the documents and guidelines, I will complain of course- but as I won't know which gp surgery will have a better attitude towards this- I'm wondering about arranging a private appointment- with endocrinologist or would a private GP be able to prescribe if I took my nhs blood tests? Is that an option anyone has resorted to?
Just to update you, I gave the surgery one more go- I printed out the documents NICE guidelines etc, highlighted the bits I wanted them to take note of and made another appointment... this time with a locum GP... who it turns out was hugely knowledgeable- I didn't have to even mention my 'research' he just looked at my blood test results and said we need to get you on medication. Hurray! Started with 25mcg levothyroxine, I'll see him again in a month or so to retest bloods and see where that takes me. Good for him! I was so relieved. Just got to work out if that is enough to make a complaint- if I were less internet savvy in getting help on this forum I would have been dismissed and that's it. Thank you for all the info and support, I'll update soon.
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
I see you are now strictly gluten free. A huge number of us find it essential
Selenium supplements can help too
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.
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