GP appointment : I am new and my GP says despite... - Thyroid UK

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meshell1 profile image
20 Replies

I am new and my GP says despite ongoing tiredness, goitre, pins and needles, heavy periods, constipation and normal thyroid and abnormal ferritin results I am imagining my symptoms and have been sent away with antidepressants.

Thoughts welcome thankyo

TSH 10.2 (0.2 - 4.2)

FT4 11.4 (12 - 22)

FT3 3.2 (3.1 - 6.8)

TPO antibody 895 (<34)

Receptionist said normal

Ferritin 25 (30 - 400)

Folate 3.1 (4.6 - 18.7)

Vitamin B12 247 (180 - 900)

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meshell1
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20 Replies
SeasideSusie profile image
SeasideSusieRemembering

You should have refused the prescription for the antidepressants. You now have a diagnosis of depression on your record and so much can be blamed on that from now on.

If you have abnormal thyroid and ferritin results then how can you imagine that? Something should be done about those before anything else.

You also need B12 tested as that may be the cause of your pins and needles.

Post any results you have, with reference ranges, for comment.

meshell1 profile image
meshell1 in reply to SeasideSusie

Thankyou

TSH 10.2 (0.2 - 4.2)

FT4 11.4 (12 - 22)

FT3 3.2 (3.1 - 6.8)

TPO antibody 895 (<34)

Receptionist said normal

Ferritin 25 (30 - 400)

Folate 3.1 (4.6 - 18.7)

Vitamin B12 247 (180 - 900)

SeasideSusie profile image
SeasideSusieRemembering in reply to meshell1

And here we have another receptionist who shouldn't be passing comment on your results and doesn't seem to realise that an over range TSH and under range FT4 are not 'normal', they are far from it. And did she not notice that your antibodies are massively over range?

Are you actually diagnosed Hypothyroid and on Levothyroxine? If so you need an increase in dose. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.

If not diagnosed you need to be started on Levo immediately.

**

Your high antibodies confirm autoimmune thyroiditis aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. You can help reduce the antibodies by adopting a strict gluten free diet and supplementing with selenium L-selenomethionine 200mcg daily.

chriskresser.com/the-gluten...

hypothyroidmom.com/hashimot...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

**

Ferritin 25 (30 - 400)

Below range ferritin can suggest iron deficiency anaemia. Ask for a full blood count and iron panel.

Ferritin needs to be at least 70 for thyroid hormone to work, that is our own and replacement thyroid hormone.

**

Folate 3.1 (4.6 - 18.7)

Vitamin B12 247 (180 - 900)

You are folate deficient with low B12. Check for signs of B12 Deficiency here b12deficiency.info/signs-an... and if you have any then post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

You may need testing for Pernicious Anaemia, you may need B12 injections, you certainly need folic acid prescribing for the folate deficient, but that shouldn't be taken until further investigation has taken place and B12 injections started.

**

You also need Vit D testing.

**

If this was me I would be going back to see this GP, point out all this and insist on appropriate treatment, hand back the antidepressants or the prescription and insist the diagnosis of depression is removed from my records.

meshell1 profile image
meshell1 in reply to SeasideSusie

Thankyou not diagnosed and I have iron deficiency

SeasideSusie profile image
SeasideSusieRemembering in reply to meshell1

So go back and see GP, maybe a different one, and say your results confirm Hypothyroidism and you want a prescription for at least 50mcg Levothyroxine. Follow this up with retesting in 6-8 weeks then an increase of 25mcg Levo, repeat retesting/increasing Levo until your levels are where they need to be for you to feel well.

If your GP has actually said these results are normal then I would make a formal complaint.

All thyroid tests should be done at the earliest appointment of the morning after an overnight fast (water allowed) and leave off Levo for 24 hours (take after blood draw). This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction.

Take Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee for an hour.

Follow up those vitamin and mineral results as mentioned. All must be optimal (not just in range) for thyroid hormone to work.

Optimal levels:

Vit D: 100-150nmol/L

B12: top of range

Folate: at least half way through range

Ferritin: minimum 70

SeasideSusie profile image
SeasideSusieRemembering in reply to meshell1

I see you have edited to say you have iron deficiency. Have you been given anything for that? Normally ferrous fumerate is prescribed 3 times daily. Take each tablet with 1000mg Vit C to aid absorption and help prevent constipation. Take iron 4 hours away from thyroid meds and 2 hours away from any other medication and supplements as it affects their absorption.

You can help raise ferritin by eating liver regularly, maximum 200g per week.

meshell1 profile image
meshell1 in reply to SeasideSusie

No iron and vitamin D 28 thankyou

SeasideSusie profile image
SeasideSusieRemembering in reply to meshell1

So, something else to complain about then.

Ask for treatment for your iron deficiency anaemia - see cks.nice.org.uk/anaemia-iro... and scroll down to

"Treating iron deficiency anaemia

How should I treat iron deficiency anaemia?"

Show this to your GP if necessary.

Also, Vit D is severely deficient and you need loading doses - see cks.nice.org.uk/vitamin-d-d...

Again show your GP if necessary. Don't leave surgery with a prescription for 800iu, you must have the loading doses.

Come back and tell us what your GP is going to do and prescribes.

Get appropriate treatment sorted then consider a formal complaint for negligence.

Greybeard profile image
Greybeard

Your results are NOT normal your thyroid is underactive. Your gp should have started you on 50mcg of levothyroxine and address your deficient readings for ferretin and folate you really need to up your b12 but as it is within range gp may not want to. The numbersin brackets are the reference range, your results are outside those ranges and need addressing. Someone here will give you more details.

meshell1 profile image
meshell1 in reply to Greybeard

Thankyou I might stick with this forum then

Rmichelle profile image
Rmichelle

I am no expert but they dont look normal results they are showing you are hypothyroid as your tsh is above range and your frees are heading below range, your gp is a idiot, please listen to the other people on here as they are brillant and will help you and please take the advice of not taking the antidepressants as im sure you know that you dont need them-gps will chuck anything at you to get rid!!. Im sure others will comment on this-please correct me anyone but even i as a learner can see that tsh is higher in range!.xx

meshell1 profile image
meshell1 in reply to Rmichelle

Thankyou I might stick with this forum instead then

Rmichelle profile image
Rmichelle in reply to meshell1

I would stick around here as you need to gain as much info with regards to your disease as gps are nit trained enough, so so ignorant of your gp to not medicate you and hand out antidepressants like sweeties and the receptionist who does not know what she is talking about to give you incorrect information, i wish they would just keep out of important issues!!

You will learn so much from this site and everyone is great.😊😊

Hillwoman profile image
Hillwoman

I can't add anything to SeasideSusie's excellent advice, but I just wanted to point out that this is the umpteenth post I've read in the past 7-10 days where a goitre, an obvious sign of thyroid disease, has been mentioned, but completely ignored by the poster's GP. Just incredible. :-(

Rmichelle profile image
Rmichelle in reply to Hillwoman

It makes me wonder what the hell the medical profession is playing at, is there some hidden agenda to keep patients unwell. I really have no faith in the medical proffesion😠

SeasideSusie profile image
SeasideSusieRemembering in reply to Rmichelle

I think they're trying to kill a few of us off, my recent dealings with my surgery certainly makes it looks that way!

Greybeard profile image
Greybeard in reply to SeasideSusie

If they kill a few of us off they rest might buck up their ideas

Hillwoman profile image
Hillwoman in reply to Rmichelle

Me neither. All those AD prescriptions do bring in the dosh though. ;-)

SlowDragon profile image
SlowDragonAdministrator

As others have already said you are hypothyroid and very low vitamin levels as direct result

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

It's essential to get vitamin supplements and levels improved

Hashimoto's can cause Poor gut function and 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 never mentions 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

Ask GP for coeliac blood test first before giving up gluten

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

I would make an official complaint to the practice manager about this GP. Your blood results show overt primary hypothyroidism - TSH over 10 and under range free T4. Do not take antidepressants, they will make you worse. Get an appointment with another GP, show your results and ask for 50mcg levothyroxine. Being hypo and untreated can cause heart disease and dementia. Depression is an opinion, not evidence -based science and your bloods show scientific evidence of hypothyroidism. GP should be struck off!

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