Can anyone recommend an open minded competent endocrinologist in London, Berkshire or the City of Oxford?

[leylandi]

I am a man aged 68, and this is my first post. Six months ago I visited my GP (for the first time for several years) because I was short of breath and and found movement difficult. A blood test showed iron deficiency, low thyroxine, and a blood cell count of 53 - the norm I was told is 130. The GP prescribed Omeprazole (a proton pump inhibitor: inhibits stomach acid), and iron tablets. A month later I saw a gastroenterologist who, after endoscopy (my stomach and gut were normal), prescribed 50 mcg of thyroxine, continued the Omeprazole, but discontinued the iron tablets. Having read about the side effects of Omeprazole (reduced absorption of vitamins and minerals) I decided to discontinue taking the Omeprazole, but to continue taking the iron tablets - without informing the GP or gastroenterologist: I will continue taking iron tablets until I have another blood test. I now realise that it is likely that I have had an underactive thyroid (extreme intolerance of cold etc.) since birth - both of my children were diagnosed with hypothyroidism in their teens.

Since I was a teenager, I have suffered from acid reflux, but six weeks ago I found that I was suffering less from reflux. Having read some fringe medical articles suggesting that low stomach acid is responsible for reflux (the argument is that increased stomach acidity closes the lower esophageal sphincter), I unilaterally decided to double the levothyroxine dose to 100 mcg. I now no longer suffer from reflux. I have now started eating curries and am experimenting to see what my mouth will tolerate; my stomach is unaffected! Before taking thyroxine, I could not tolerate any spicy food. Also, after upping the thyroxine dose to 100 mcg, I feel much more energetic and can tolerate the current cold weather (my resting pulse is pulse is now 65-70 and blood pressure is normal, and so there has been no strain on my heart).

Contrary to the guidelines for administration of thyroxine, and the NICE guidelines for treating anaemia, my blood has not been retested since my first test in July. I have an appointment with the gastroenterologist next month (6 months after my first visit). Instead, I will ask to be referred to an endocrinologist, but I would like to find one more competent than the gastroenterologist (I believe my anaemia was caused by malabsorption of iron due to low stomach acidity, hence Omeprazole was entirely inappropriate). Can you suggest an endo, please?

[Clutter]

Welcome to the forum, Leylandi.

Hypothyroidism is usually managed in primary care. I suggest you ask your GP to do a thyroid function test to check your thyroid levels, it should have been done 6-8 weeks after starting 50mcg. Arrange the blood draw early in the morning when TSH is highest and fast (water only) as TSH drops after eating and drinking. Take Levothyroxine after the blood test.

Post the results and ranges (ranges are the figures in brackets after the results) in a new post and members will advise whether you are optimally dosed.

Email [e-mail] for a list of member recommended endocrinologists. Your GP will have to refer you to NHS endos and many private endos require a letter of referral from GPs too.

[webar4780]

Sorry can't help with endo suggestion.

However, I agree with all you have said. I have had the same experience, knowing that omeprazole, was not the answer. However, you may have been prescribed omeprazole, to support the gut whilst taking iron. Not for one minute, am I suggesting that was the correct approach, I'm not a Dr. I happen to agree with you. I shelved my omeprazole, and changed my GP practice.

Good luck with your journey, and well done, taking the reigns, concerning your health!

[Chunipet in reply to webar4780]

I was also prescribed omeprazole to support my stomach when prescribed very strong pain killers, apparently because I’m over 60!

You can do your own thyroid blood tests thru Blue Horizon or Medichecks (special offers on Thursdays). If you post the results on this site, knowledgeable people will offer advice.