Some Good news

[Camels70]

Dear community,

I managed to persuade my GP to make a referral to Endocrinology. I now need help to identify a hospital from their list that will be sympathetic to our needs with Hypothyroidism.

Please can you kindly recommend a hospital that you have had good experience with in relation to Hypothyroidism from the list attached below.

Thank you🍀

[SlowDragon Administrator]

Email Dionne at Thyroid Uk for list of recommended thyroid specialists

please email Dionne at

[e-mail]

[Camels70 in reply to SlowDragon]

Hi SlowDragon, I have emailed Dionne as suggested but I didn’t see recommendations for hospitals. I thought it was private practices only. I have to choose from the list GP gave me. Thank you very much Slow Dragon🙏🏽

[SlowDragon Administrator in reply to Camels70]

There are a few consultants on there who are NHS ....obviously may not be at these hospitals

[SlowDragon Administrator]

Previous post showing in need of dose increase in Levothyroxine and low vitamins

healthunlocked.com/thyroidu...

Did GP increase dose of Levothyroxine to 100mcg?

If so you need bloods retested 6-8 weeks after each dose increase

Have you been working on improving low vitamin levels

Getting bloods retested BEFORE seeing and consultant strongly suggests

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Essential to test both TPO and TG thyroid antibodies to see if cause of hypothyroidism is due to autoimmune thyroid disease

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If 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.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

NHS guidelines including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

[Camels70 in reply to SlowDragon]

No, my GP refused to increase the dose from 75 to 100. I was told that I am on the right dose of Levothyroxine.

[SlowDragon Administrator in reply to Camels70]

Which is why you need to see endocrinologist

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Getting vitamins optimal will often help increase TSH so that you can get Levothyroxine dose increased

Vitamin D needs to be at least around 80nmol and around 100nmol may be better

B12 and folate near top of range

Ferritin at least half way in range

Extremely common to need to supplement some or all of these to maintain optimal vitamin levels

NHS guidelines (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo 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)

[Camels70 in reply to SlowDragon]

Thanks very much SlowDragon. I will look up Dr Toft? I don’t know in which hospital he is practicing but I will look him up. Thank you so much for your invaluable advice and contribution🙏🏽💐🍀

[MaisieGray]

"I have to choose from the list GP gave me."

No you don't, you can chose to be referred to any hospital of your choice, as long as they provide the specialty that you need.

The NHS guidance states:

Choosing a hospital or consultant

If you're referred for your first outpatient appointment, in most cases you have the right to choose which hospital in England to go to.

This will include many private and NHS hospitals that provide services to the NHS.

You're also able to choose which consultant-led team will be in charge of your treatment, as long as that team provides the treatment you require.

If you wish to be treated by a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and be treated by that consultant's team.

But this does not necessarily mean you'll be seen by the consultant themselves.

This choice is a legal right. If you're not offered a choice at the point of referral, ask your doctor why and say that you wish to go through your options.

If you're still not offered a choice or are refused, contact your local clincal commissioning group (CCG).

[Ladybex]

King George