Can I avoid a blood test?

[Syd35]

Feeling well after a lot of ups and downs and don't want my current dose to be messed with. Saw my GP today and he said I am due for thyroid bloods as last results were a little out of range. I haven't made an appointment and don't intend to just yet but will they chase me up?

[shaws Administrator]

I think we can choose whether or not we want a blood test, especially if you're afraid your dose will be adjusted whilst you are feeling well on this dose. We really need a yearly blood test when we're stabilised and symptom-free or if symptom(s) return.

[Syd35 in reply to shaws]

Thanks that was kind of my thinking but they've had me back and forth for testing 3 or 4 times per year over the past 3 years and fed up of the dose being tweaked then feeling rubbish then tweaked again. So if I get a letter telling me to come in for bloods can I just ignore or will I be hassled to go in?

[shaws Administrator in reply to Syd35]

If you're stable on your dose - a yearly test is fine. If you've got doctors who play 'roulette' with your dose, you're better off by listening to your body and how it reacts to different doses. Once well you can stay on that dose. If you've not read the following link, you might find it helpful:-

naturalthyroidsolutions.com...

[Syd35 in reply to shaws]

Thanks Shaws

[SeasideSusie Remembering]

My surgery stopped sending out reminder letters for thyroid tests years ago.

The only time they're mentioned now is when I go for something else and my TSH obsessed GP ends up looking at my previous results and tells me I'm over treated - cue the endlessly frustrating discussion about TSH not being a thyroid hormone, and my FT4/T3 are well within range, and her saying I'm over treated, etc, etc, etc. So she gives me a slip to book an appointment for a test, and blow me - somehow between leaving her consulting room and arriving at the main entrance I always forget to book the test.

Never been a follow up, she's certainly never going to remember that she told me to book it. It doesn't bother me in the slightest but I do my own testing anyway to keep an eye on my levels because I add self sourced T3 to my prescribed Levo (which she doesn't know about) and I would never not test myself.

But of course, that's my surgery and it wont necessarily apply to yours or anyone else's.

[Hidden in reply to SeasideSusie]

I moved back to the UK back in July last year and signed up with the local GP.

I have never been and don't intend to either. I just fix myself with medication and blood tests now and feel great, no hassle, no arguments, just me.

[shaws Administrator]

One of Thyroiduk's Advisers only took one blood test - the inititial one for diagnosis and thereafter did none at all. Neither were we diagnosed by blood tests before the introduction of them along with levothyroxine- we just got a trial of NDT which was slowly increased and when symptom-free that was our daily dose.

Dr Lowe only concentrated on the symptoms being relieved. He stated that blood tests were moneymakers for the producers of the tests.

[MaisieGray]

I've definitely read reports of some people saying that their GPs have taken the stance that they will withhold their prescription if they fail to have their routine blood test, as they can't safely continue to prescribe in the absence of up to date information. Which is perfectly reasonable, and in theory, we'd rather that, than hearing tales of patients being prescribed drugs for years and years and nobody checking if they are still suitable, effective, safe and haven't been superceded by other prescribed meds etc. I fear attitudes may continue to shift a little further in that direction given the general move to dramatically reduce NHS spending on unnecessary prescriptions. Except in our case as we know only too well, they generally don't test in a comprehensive enough way, or don't properly interpret the results, such that it isn't often a positive for us ..... The CKS/NICE guideline is that testing should be done once yearly, once levels are stabilised, so you might argue that they are preventing your becoming stable, or are even de-stabilising you, by testing and changing your dose so frequently. Or you could simply ignore any request you get, and see what, if anything, happens; and then if chased, just obfuscate until hopefully they lose interest or forget that the test is outstanding. I definitely prefer benign neglect in the matter of blood testing - I'm the best judge of when things pertaining to my thyroid need checking up on.

[helvella Administrator in reply to MaisieGray]

I fear attitudes may continue to shift a little further in that direction given the general move to dramatically reduce NHS spending on unnecessary prescriptions.

Except that reduction in dose by no means guarantees a reduction in cost! To keep it simple, considering ONLY tablets of 25, 50 and 100 micrograms:

75 mcg = 253p

100 mcg = 97p

125 mcg = 252p

150 mcg = 195p

175 mcg = 350p

200 mcg = 194p

The biggest saving on levothyroxine would likely be from making it a "Pharmacy" or "General Sales List" medicine rather than a "Prescription-only Medicine" (POM).

[MaisieGray in reply to helvella]

Yes, for sure. I was thinking more generally though, about obligating patients to attend for a cyclical blood test and/or the dreaded medicine review meeting, as a requirement of all meds on a patient's repeat meds list being continued ie including, and other than, thyroid meds.

[carnation in reply to MaisieGray]

That is the case at my surgery. If you fail to go for blood tests when requested meds will be removed from your repeat list! Then you have to fight to get them. It is made worse by the fact that you only get 28 days worth at a time now.

[MaisieGray in reply to carnation]

Oh no, I'm sorry to hear that you're actually experiencing what I was theorising about, and worse, have been hit by the proverbial double whammy of 'control by blood test' and limited access to meds. Both approaches have their role in effective & safe prescribing of course, but only where necessary and appropriate; and certainly not across the board for every patient and every condition. For years I've been given 100 Levo tablets at a time, so just over 3 month's supply, and when I recently had to use my local telephone prescription ordering service because I'd been locked out of Patient Access for some unknown reason, even though I wasn't even ordering Levo that day, the guy wanted to reduce it to one month only because that's what the surgery had instructed them to do each time they came across longer prescribing times. I told him I'd been taking it for 40 years, was wholly compliant with it, and was certainly going to continue needing it until the day I died, so there was no reason to limit my access to it. Thankfully he listened on that occasion but I suspect if I used the service again, I'd have the same or worse experience. However, everything else I take is currently on 2 monthly prescribing so I don't know if that's the surgery using the one month rule more selectively and intelligently as should be the case; or if they've not yet caught up with reviewing me, and that at some point I will experience the axe falling, and be changed to 1 month's supply for everything. It shouldn't be beyond the wit of Drs, and the technology available to them, to accord different prescribing protocols to different patients, and different meds, depending on their knowledge & experience of them; but as demonstrated by your surgery, it seems that they aren't inclined to have other than a broad brush, one size fits all rule.

[Hidden in reply to carnation]

When I was living in France back in 2015/6 I was on Levo but the GP always gave a prescription for six months at a time. You kept the prescription and just collected the month's supply and the pharmacy just stamped the paper. Easy, I must say what a shambles the NHS is now, what a pity. The blood test was easy too, you actually received the results the very next day in the post, amazing.

I would never move back to France even if the NHS is giving bad service.