GP advise

[Stephcourtoy]

Hello, I have an appointment to see the gp to ask for a blood test. What should I ask for specifically to diagnose a problem with my thyroid? My symptoms are fatigue, hair thinning, unable to regulate temperature, low libido, painful gums, memory loss. Any help would be much appreciated.

[SeasideSusie Remembering]

Stephcourtoy

You can ask for the following, you may not be able to get them all done through your GP though

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

When booking thyroid tests, always book the very first appointment of the morning and fast overnight (water allowed), this means have your evening meal/supper the night before then delay breakfast until after the blood draw, drink only water, no coffee, tea, etc, before the test.

This gives the highest possible TSH which is needed when looking for a diagnosis, an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It can also lower after eating and coffee also affects TSH. [Also, when diagnosed take your Levo after the blood draw because if you take it before then your FT4 will reflect this and show higher than what is normally circulating. We usually advise 24 hours between last dose of Levo and blood draw so if you take your Levo in the morning then delay until after the test, or if you take it at night then delay that dose until after the test.] These are patient to patient tips which we don't discuss with doctors or phlebotomists.

It might be useful to print off this list of signs/symptoms of hypothyroidism, tick any that apply to you to show your GP. This may help.

thyroiduk.org/tuk/about_the...

Post your results when you have them and include the reference ranges as they vary from lab to lab. Members will then be able to comment.

[Stephcourtoy in reply to SeasideSusie]

Thank you so much, that’s really helpful

[asiatic]

Although in complete agreement with SeasideSusie I feel that if you are a Newbie you need to be warned of the realities of thyroid diagnosis and treatment.

Your GP is likely to have scant knowledge of thyroid issues and unlikely to agree to all the above tests. Prepare yourself for a long frustrating journey before you reach optimal health. Look on it as a challenge !

I would suggest keeping the first consultation short. Present your symptoms and hopefully the list is long enough to suggest a possible thyroid problem and initiate testing. Ask what test is to be done. ( if only TSH - change your GP ! ) More than likely it will be TSH and fT4. We know this is not enough but as your 10 min. Consultation will be coming to an end, I would settle for this. When you have your results post them here for comment and move on to stage 2.

Good luck with your journey.

[Stephcourtoy in reply to asiatic]

Thanks for taking the time to reply, I will have my armour on for that appointment! To be honest the fatigue alone is so depressing, I’m going to be quite explicit how these symptoms are ruling my life- hopefully they will see sense and give me what I need. Thanks again

[alchemilla12 in reply to Stephcourtoy]

and dont be fobbed off with anti depressants -thats often the first recourse for GPs faced with someone with thyroid issues

[Stephcourtoy in reply to alchemilla12]

Thank you, I’m desperate so hopefully that’ll keep me strong!

[RockyPath]

If you have funds for the 23andMe Health and Ancestry, I'd do that and check for DIO genetic variants that will prevents the recommended tests from detecting the success of treatment. I have variants that require me to take T3, as LT4 won't work. It only makes me sicker. I have a variant that produces an antibody for which they don't test.

If you're fortunate to be average and have convincing enough lab results, you'll succeed on LT4. If not, you may be left to languish doing "watch and wait." Watching and waiting is fine for the doctor whose body it is not, but watching and waiting in your case is just writing yourself a sentence for an even worse chronic disease as you age -- atherosclerosis, heart failure, orthopedic problems from hyper mobile joints, for example -- all provoked by untreated hypothyroidism.

See if you can get the rT3 tested too. Then if you go on Levothyroxine, you will have a baseline. If rT3 goes up with treatment, you have the genetic variant that impairs conversion of Levothyroixine. My endocrinologist nearly killed me before I figured out what was going on. Now I'm doing well on T3.

Good luck.

[Stephcourtoy in reply to RockyPath]

Really interesting, I will check it out thank you