Medichecks results today

[mountainice]

Hi everyone, I have had my Medichecks results back today and may I post them here please:

TSH 5.4 mIU/l [range 0.27-4.2]

Free T3 4.3 pmol/L [range 3.1-6.8]

Free T4 14.6 pmol/L [range 12-22]

TGAb 69 kIU/l [range <115]

TPO <9 kIU/L [range <34]

This was the Medichecks doctor's overview of my results:

' I understand that you have had a fluctuating thyroid stimulating hormone level over many years and in particular in the last few years you have had a number of symptoms including a throat irritation, varying body temperature, muscle aches, weakness, constipation, insomnia and hair loss as well as a others.

Your thyroid stimulating hormone is slightly raised. TSH values between 4 and 10 can be an early sign that someone is developing an underactive thyroid, and may be a sign that you have subclinical hypothyroidism if they are accompanied by symptoms. These include fatigue, weight gain, low mood, skin and hair problems. As you are experiencing symptoms I recommend discussing this result with your GP.

Your thyroid antibodies are normal.

Overall then you may have subclinical hypothyroidism and as you are experiencing some of the symptoms of this I would advise discussing it further with your GP.

There are also range of other problems that can mimic a thyroid problem which could be contributing to some of your symptoms. A Essential Blood Ultravit test covers the majority of these.

I hope that you have found this information useful and please do not hesitate to contact us if you have any queries.'

Any thoughts please?

[greygoose]

You are hypo. Nothing subclinical about it. You are hypo when your TSH reaches 3, but the NHS won't admit it, because it would mean diagnosing too many people, and that would cost money!

One negative antibody test cannot rule out Hashi's.

You need your vit D, vit B12, folate and ferritin tested.

[mountainice in reply to greygoose]

Thanks for your reply. I am trying to get an appointment with gp but I expect it will be a while. I have never heard of kIU/L as a measurement, what is it and do I need to convert it online or doesn't it matter as long as the range is there and therefore the number of your result is judged on the range - hope you can follow that.

Regarding my D, B12 and folate and ferritin, I am sure the D would still be highish as I supplement, also B12 as I am on monthly jabs plus SI.

Folate was 18.7 ug/L [range 2.6-17.3] last November;

at the same time ferritin was measured 69 ug/L [range10.0-420.0]

Thank you.

[greygoose in reply to mountainice]

Yes, I can follow that, and you don't need to convert anything. Just go by the range.

That ferritin is too low. Can you eat liver once a week, to bring it up?

[mountainice in reply to greygoose]

I thought the ferritin was ok - or is 80 better, thought I'd read round about there. Yes, I could eat liver, we love it! Eaten it all our married lives - nearly 50 years, a lot of people would say 'yuk' ! Again, should I be looking for a much higher figure considering the range? It does seem a very wide range.....

[greygoose in reply to mountainice]

It's a very wide range, so around 100 would be a better result. It needs to be at least 70 for your body to be able to use thyroid hormone effectively.

I like liver, too, if it's cooked properly.

[mountainice in reply to greygoose]

By the way, this is my second at least TPO test.

Also, just realised my Free T4 is low in the range in this Medichecks test - I have records to hand since 2003 and the FT4 is lowish on every test from the gp (12 or 13pmol/L (9-25)).

I read in the guidelines somewhere if you are under 65 and have symptoms and a TSH 5 or more they give you a trial on thyroixine, and although I was having symptoms at age 65 and under I didn't know they were any that needed reporting to a doctor, as problems with thyroid weren't on my radar and I don't remember the doctors ever asking! I am so annoyed now I think back at how I have felt over the years with unexplained things wrong and feeling terrible on and off.

If Medichecks have flagged up the TSH with a red cross and it is outside 'their' range, why do they, in the narrative, still talk about values between 4 and 10.

[greygoose in reply to mountainice]

Because the medicheck doctors are only common-or-garden, bog-standard, NHS-trained GPs. They have no special training in thyroid, and know as little about it as others GPs. And the main aim of the NHS seems to be to diagnose as few people as possible with hypothyroidism.

I'm pretty sure I've been hypo since I was about 8, but no doctor even tested for it until I was 55.

[mountainice in reply to greygoose]

should I go private then as originally planned I wonder, or back to gp

[greygoose in reply to mountainice]

Try your GP first, and see what he says.

If you're going to go private, research your endo very carefully before spending your money. Some people have had some nasty surprises with private endos, because they don't necessarily know anymore than NHS endos - and often do both at the same time!

[mountainice in reply to greygoose]

The endo I was going to see was one recommended by gp who also does private - not that that is any recommendation! She wanted me to see this one in the first place but I got sent to the other one who talked down to me.

[greygoose in reply to mountainice]

Why did she want you to see him? I'm afraid I suspect all GPs motives unless proved innocent!

[mountainice in reply to greygoose]

Only just saw this. She recommended this particular consultant and i looked him up and saw he had written many papers, books etc - the one i did see didn't seem to have anything to recommend him.

[greygoose in reply to mountainice]

So, being a cynic, I imagine that the books and papers he's written, back up her opinion.

[mountainice in reply to greygoose]

I've no idea, as i haven't seen him. I was prepared to give him a go.

[greygoose in reply to mountainice]

No reason why you shouldn't give him a go, except that if he says the opposite to what you think and want, the GP will probably side with him, not you.

[mountainice in reply to greygoose]

Just found this on UK Guidelines for the use of Thyroid Function Tests

acb.org.uk/docs/default-sou...

' There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis. '

How will I argue my case? Is this a guideline doctors would follow?

[greygoose in reply to mountainice]

They probably would, yes, it gets them off the hook because they hate treating hypos. But a guideline is not the same as a hard and fast rule, so they do have room to use their own discretion if you can persuade them you need treating.

[mountainice in reply to greygoose]

Thanks. I will print it. Last tine, b4 i saw the endo, she said I can’t treat you, but now i have the Medichecks results plus I'll bring my symptoms into sharper focus and this printout, i might get somewhere . I had a text to say they wanted to talk to me about the hospital report letter because i complained about the endo.

[greygoose in reply to mountainice]

Sounds ominous! Don't let them brow-beat you.

[helvella in reply to mountainice]

From the document you linked to:

Mechanism for updating

The guidelines were completed in June 2006. Comments on their accuracy and

relevance are invited during the first year after publication and should be directed to

[e-mail]. It is intended that a full review will take place after

three years.

gbeastall has retired.

The document is not formally managed. There is no mechanism in place for getting corrections made. I know, I have tried. There is an egregious mistake in the middle - confirmed by gbeastall himself. Even he couldn't get it updated. And he was amazed that no-one else had noticed it - it is that obvious.

Insofar it has any control, it should NOT be used after June 2009 - ten years ago.

If a doctor attempts to use it, point out the lack of document control and update paths. Ask for the latest version.

[mountainice in reply to helvella]

Thank you helvella and greygoose . I have managed to get an appointment today with gp by logging on early to online services. Did I say I have puffy swellings just below my knees which hurt? I am wondering if it could be pretibial myxoedema as the puffiness hurts. The gp had previously told me it was caused by veins and didn't take any notice at all!

[greygoose in reply to mountainice]

I don't suppose he has any idea what it is. He certainly wouldn't know what pretibial myxoedema was. And, I don't think there are that many veins just below the knees! lol

[mountainice in reply to greygoose]

I am really nervous about going to the GP even thought I get my husband in for support. I find it really difficult to talk face-to-face and get info over, I am much better using the written word. We'll see what happens.

[mountainice in reply to greygoose]

Hello again. I went to the gp with no luck at all. She looked like she had heard of pretibial myxoedema but categorically said it is not that. She suggested I explore all the avenues I have been given - including seeing the psychiatrist (!) and the private endo as well. Also, she had an extra note from the other endo who had second thoughts and had discussed me with another doctor and thought my stomach might be microbial something or other and to send me to a gastroenterologist. My gp is part-time and I have been to see the doctor she shares with, and someone else I know was treated at a lower level tsh by this other doctor. I didn't know whether to write to both of them to say consider my case or just go ahead with the private appointment this month. Well, so far my decision is going to the private one and sending a letter ahead by email and hard copy. When I said to my GP will I get the same result with the private doctor, especially as he also works in the NHS, she said not necessarily, therefore perhaps she just doesn't want to make the decision herself to treat me.

[greygoose in reply to mountainice]

Well, you can but try. But, at least you have the back-up plan of writing to these two GPs if the private endo doesn't want to commit himself.