Holiday and medication

[75458854]

Could I go on holiday to get treated for my thyroid disorder since the tsh limit for the uk is 10 and tsh limit for America is 3.0. Would I be able to get treated and come back to the UK still receiving treatment?

[MMaud]

I know our doctor doesn't acknowledge tests carried out in UK labs, so would repeat her own consultation and diagnostic process.

If you are talking about going to the US and seeing a medic there, I don't think it'd be cheap, and likely much cheaper to see a thyroid sympathetic UK consultant.

I don't know what your bloods have been like, but if your symptoms have been ongoing for some time, could you consider asking your Doc for a trial period on Levothyroxine?

[Aurealis]

Smooth!

I understand why you’re tempted. If you’re going to the states anyway, I can’t see a reason to not try it!

But I think I’ve read on this site of someone who was experiencing difficulty getting treatment here after coming from states on medication. Perhaps you’ll get more helpful guidance.

[bantam12]

Don't assume treatment is any easier in USA, my sister has lived there for 30 years and getting proper thyroid monitoring and treatment can be just as difficult and it's expensive.

[Hidden in reply to bantam12]

I was untreated in the US for over 25 years. The range in the US for TSH was .5-5 at the time. My TSH was 4.5 and I had every symptom in the book, including "treatment refractory depression." I spent those years as a mental patient. I kept pointing out my thyroid symptoms but was brushed off every time and offered more psychotropics. I was hospitalised repeatedly for depression, made several serious suicide attempts. Still kept bringing up the thyroid, still kept getting blown off.

We spents well over $100K on "treatment" that barely kept me alive. I lost a good career, many friendships, my self worth. I nearly lost my marriage and home. One hospital stint alone (there were 12) cost our insurance company $58K. I ended up on disability for over 25 years. Lost income mean lost taxes to fund services (and wars). I was nothing but a drain on society.

Eventually the US endo group decided to make the TSH range .3-3. They were accused of drumming up businss by creating new customers. (The US is a profit-based system. Forget that at your peril.)

I happened to see a Nurse Practitioner who followed the new guidelines. She prescribed levothyroxine. Within two weeks the depression was gone. That was over 20 years ago and it hasn't returned. She has noticed her patients do best if they stay in the 1.0 range so she's kept me there. My Irish GPs have concurred, mainly because they're sensible people who believe "if it ain't broke, don't fix it."

However, many practices do not recognise the new guidelines and still use the .5-5 range. The cost of a GP visit is at least $150 IF you can get in. Most practices are closed. Attitudes towards hypothyroidism are often rigid but really, using 10 as you upper range for TSH is so absurd you probably would get treated. You have to use the right lab unless you want to be very poor at the end of it all. Case in point: Concord (NH) Hospital will draw your blood for a Vitamin D test They actually send the blood down the hill to Quest Labs for testing. You pay $700 to Concord Hospital, thinking CH has done the testing. If you go to Quest yourself (500 yards away) they take your blood and test it for $300. If you go online, sign up on a website to arrange an appointment in a Beford, NH lab (about 35 miles away) they will do the job for $95. The US medical system is profit-based and totall cuthroat. It would be my last choice unless you are Bill Gates-rich.

You might do better in the US to find a nurse practitioner in private practise. Some states allow that. They are cheaper (relatively speaking), listen better and are more likely to use the .3-3 range. I would definintely ONLY see somone who does.

Or... you might do better in Canada. Or Ireland. Is Ireland a possibility? The two GPs we see in Munster are terrific. It's better if you can have someone help you, but self treatment is a possibility I see. I get quite tangled up in all the numbers involved with TSH/reverse this and that so I'm happy to have my GP in my corner. His take is "they did a lot of research on this in the 1930's and think they're done now." They are not.

[DogLover518 in reply to bantam12]

That is correct. I’m in the US. I have To drive from Pennsylvania to Baltimore to a specialist 3 hours away. It took years and years to get to that point.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

If you have high thyroid antibodies you should be started on Levothyroxine

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

What are vitamin D, folate, ferritin and B12 results and ranges

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. 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?

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_...

Email Dionne at Thyroid Uk for list of recommended thyroid specialists

please email Dionne at

[e-mail]

If you add recent test results and ranges members can advise on next steps

[Ju17]

I lived in the US for 2 years(2014-15). I was hopeful that my Levothyroxine would be increased and I would feel better than I did in the UK. However my dose was reduced from 125 daily to .88 and I not only felt worse I ended up on antidepressants and in a very bad place mentally. I kept having blood tests but they insisted I was receiving the correct dose of Levothyroxine. On my return to the UK my GP, following a blood test, upped my dose again to its previous level. The psychologist I saw over the next year put the depression down to the low dose of Levothyroxine (he stopped the antidepressants immediately) and as the year progressed my mood got better and I have had no further problems. So my advice is to think very hard about what you do. Good luck.

[BadHare]

Have you thought about self-treating?

I couldn’t afford the private tests & endocrinologist, as well as buying meds, so just do the latter with NDT & T3. I did this slowly, & had a few blips, but overall success.

Important to make sure your micronutrients are optimal to make this work.

[Lovecake]

I wasn’t getting the correct help from my GP, although they had decided I had under active thyroid. The nhs endo helped to a point.

I saw a private endo (he’s actually on the thyroid uk recommended list) and he is much better (although not as good as much of the advice on here, especially vitamins and minerals etc).

He sent a list with me to my surgery for loads of blood tests. He didn’t see why I should have to pay for blood tests when the nhs could do it. And also I’m saving them money by seeing a private endo.

The surgery did all the tests he requested.

I did ask them for a referral to him, they agreed after supposedly checking if there was a better endo closer to where I live. (He’s a 50min drive away).

I get Thyroxine from GP and T3 from private prescription and Germany. (I don’t have to see him each time for a prescription and there’s no extra charge for that).

And the help on this forum - invaluable 😊

[Katurajo1]

I live in the US and I can vouch for the fact that it’s not easy to get treatment here. You would likely need to see a functional doctor which is expensive and have lengthy wait times to get into. I agree with what others said and self-treat. The functional doc I go to insists on bloodwork every single month to renew my prescription and I have to see him every month as well. It’s a pain in the rear end but it’s worth it for me. For you, I don’t know if a prescription from a doc here would keep you going there, if you believe it would then it’s worth a shot. If it were me, I’d self treat.

[DogLover518]

What is NDT?

[BadHare in reply to DogLover518]

Natural desiccated thyroid. It was the hypothyroid medication used prior to synthetics.

[Irishjen]

I have a fantastic endo in belfast which I'm sure would work out much cheaper than the states. I pay private for him and then my thyroxine is paid by nhs. Where do you live