Advice on what to say to gp and just got blood results

[unclefester67]

Hi everyone.

When I showed gp my private blood test a few months ago to show him I have Hashimotos I really thought I found someone who knew what I was talking about. So when I had another one, this time through the gp two weeks ago I expect a full test. Haha wishful thinking. He only did the typical tsh and t4. So I had another private one done. I'm still waiting for results. Anyway I went to gp earlier to pick up a sick certificate for two weeks and he refused it saying my levels are now fine and there is no reason why I shouldn't go back to work. If I had an office job I would be, but I'm a postman and the job is challenging enough for a fit person let alone someone in my condition. Can anyone give me advice on what to say to him later? I will request to see an endocrinologist that specializes in thyroid. Thanks

I have just got my results.

[SeasideSusie Remembering]

unclefester67

Oh my goodness, look at your B12 and folate levels!

I see from a previous post that you were prescribed a B12 injection. What's happening here? Were you tested for B12 deficiency/Pernicious Anaemia? Did you have loading doses of injections? Are you having regular injections? Are you between injections and due another one soon?

And your folate level is lower than 3 months ago. It's now deficient. You need folic acid prescribing.

You need to take up your B12 and folate with your GP, with a level that low I'm not surprised you're not fit for work.

[unclefester67 in reply to SeasideSusie]

Hi seaside sue. Thanks for replying so quickly. I had a b12 injection 2 month ago and due for another one in August. I have also been taking 5000iu b12 and b complex . I have been slowly introducing Tiromel and now take 37 1/2 mg (added quarter two days ago) and 200mcg levo. Also selenium.

[SeasideSusie Remembering in reply to unclefester67]

unclefester67

From what I understand, many people find that 3 monthly injections aren't enough, and need them more often. I don't know if your surgery will allow this. If not I know that some people self inject. Considering you're taking 5000mcg methylcobalamin, I'm surprised your level is that low even though it's 2 months since your injection.

Which B Complex are you taking? Is it one with bioavailable ingredients such as Thorne Basic B or Igennus Super B? How much methylfolate does it contain? If your GP wont prescribe folic acid, and you may be better off with methylfolate anyway, then for now I would supplement with methylfolate then when your level is raised there should be enough in a good B Complex to maintain your level.

Your FT3 could be higher, I would increase your T3 to 25mcg and retest in 6-8 weeks, see what your levels are like then.

[unclefester67 in reply to SeasideSusie]

I am taking a tablet and a half of Tiromel, 37 1/2 at the moment. Added a quarter two days ago. Scared of making a too big change. I do feel a slight improvement every time I increase Tiromel but doesn't last long.

[SeasideSusie Remembering in reply to unclefester67]

unclefester67

Sorry, for some reason I thought it was 18.75mcg T3, I should have scrolled up and double checked. My apologies. So if 37.5 is your new dose then your FT3 should be higher next time you test. I'd wait 6 weeks, retest, see what your level is then.

[unclefester67 in reply to SeasideSusie]

Thanks. I will ask my gp later. Feel better knowing I will probably have more to say to him than he does to me.

[SlowDragon Administrator]

Your TSH is likely low because of your extremely low B12 and folate. Essential these are treated as you are not able to process thyroid hormones when folate or B12 are so low

Your total T4 is pretty low. This actually suggests you need dose increase in Levothyroxine.

FT4 is only mid range, you have room for raising Levothyroxine higher. FT3 is too low, showing you need increase

What supplements are you taking?

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you did the test?

[unclefester67 in reply to SlowDragon]

Hello slowdragon. I have been increasing Tiromel slowly for the last 3mths. Originally I was on 250mcg levothyroxine . Now 200mcg levothyroxine and 37 1/2 Tiromel. I did my test at 5am just before I was due to take my meds. I take selenium, vit d, b12 and b complex around midday. I have to take other meds later (mycophenelate) for my auto immune disorder.

[unclefester67 in reply to unclefester67]

Just been to see the gp. I went there armed with info on my condition and results of my blood test. He said they are wrong. My b12 is within range. So I showed him my results again and pointed to the bit where it says "insufficient". Still went by his own results from a few months ago. Said I need to reduce my thyroxine. I said, so you think a reduced dose is need? He said yes. I told him he is wrong, so very wrong. My t3 would go down as well. That's when I told him I need t3 increased and by doing so I have been self medicating with Tiromel. The doctor asked me "what's Tiromel?" Exactly. I think I know more than you on the subject and don't want to waste an more of your time. But at least he has referred me to an endo who he said is a thyroid specialist.