Dr has requested advice from Endo, what can I expect? Portsmouth, UK area

[MelonJ]

Hi again,

my Dr agreed to request advice from an endo and I have some more results to add to my collection! These are the notes on the referal letter:

10-Apr-2018

! Thyroid peroxidase antibod lev

55 iu/mL <49.00iu/mL

Slightly raised TSH with positive thyroid antibodies. UK Thyroid

Guidelines recommend monitoring TFTs annually unless new symptoms develop.

(name deleted by me) Consultant Clinical Immunologist

0-Apr-2018

! Serum TSH level - (HLS1725) - Await further results

6.38 mu/L 0.35 - 5.00mu/L

Thyroid antibodies to follow.

10-Apr-2018

Serum vitamin D - (HLS1725) - normal

36 nmol/L 30.00 - 300.00nmol/L

<30 nmol/L is deficient - replacement is recommended.

30-50 nmol/L may be inadequate in some people, consider replacement.

>50 nmol/L is sufficient in most people.

>300 nmol/L is at increased risk of toxicity.

Local guidelines for adults can be found in the Primary

Care Information Portal under Local Prescribing

Guidance. In adults, if symptomatic, advise a loading

dose of 3200 IU vit D3 daily for 12 weeks, followed by

maintenance doses of 800 IU daily. In children,

recommend 400 IU daily of vit D3 when vit D is

30-50nmol/L and pharmacological dosing for deficiency.

This advice does not apply to those with hypercalcaemia

or CKD stage 4-5.

27-Mar-2018

Anti-tissue transglutnase lev - (BSA1725) - normal

Negative (on my patient notes it is Serum C reactive protein level4 mg/L< 7 )

If present, assay detects both IgG & IgA antibodies.

27-Mar-2018

! Blood haematinic levels - (BSA1725) - abnormal make Routine GP Appointment-booked with HL

Serum vitamin B12 314 ng/L 130.00 - 800.00ng/L

Serum folate 6.1 ug/L 4.00 - 20.00ug/L

Please note change of reference range

29-Jan-2018

O/E - blood pressure reading

138/92 mmHg

01-Feb-2018

Mean platelet volume 9.1 fL 6.50 - 20.00fL

My Dr actually said that she could prescribe Levo and it would make me feel much better, but that it would make anyone feel better.... I was lost for words.

She said - [after results back]I will request A&G form endocrinology. I am only happy to start thyroxine on their advice unless bloods have changed.

Thanks for any advice x

[Highland49]

Hi,

Your vitamin D should be 125 or more to be optimum and to help with conversion of thyroid hormones. Folate is low, optimum would be at least 18. B12 is not great, should be at least 500. Would be good to have your selenium tested as this further supports conversion.

I'm not experienced enough to comment about your thyroid but your post caught my eye as I'm also in Portsmouth. I saw a consultant at QA yesterday but sadly was a waste of time. Good luck with yours. Your GP sounds a lot more switched on than mine.

[MelonJ in reply to Highland49]

Thanks Highland49, any info is appreciated.

I looked up the endos at QA and saw there was next no expertise in any of our problems, they all seem to specialise in diabetes.

I was really hoping someone might have a better experience to report.

Thanks for taking the time to reply.

[Highland49 in reply to MelonJ]

I was sent a list of recommended endos from thyroid uk and Dr Meeking was on there but he was the one that wasn't helpful. Like you say, so many are diabetic specialists. He out rightly told me he wouldn't prescribe thyroxine for fear of being sued if it went wrong and that another consultant would say the same as him as he deemed my thyroid function to be ok and that TPO abs can be seen in healthy individuals. He said he was judged by his peers and wouldn't go against guidelines.

[MelonJ]

Well, so far I know my Dr got A&G from endo 2 days ago but hasn’t contacted me yet.....