Can you tell me what to write to get an appt to... - Thyroid UK

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Can you tell me what to write to get an appt to see an endo?

imdelightful profile image
11 Replies

My Dr wrote a referral via email to the endocrine clinic in my local N.H.S hospital. I was turned down due to the department not having treated any one in Bristol for my illness, and other excuses NOT to see me.

SMS (save my soul) can somebody help me with a letter to the endos.I shall be more than grateful .

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imdelightful profile image
imdelightful
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SlowDragon profile image
SlowDragonAdministrator

Presumably you mean because you suspect your hypothyroidism is due to autoimmune thyroid disease (Hashimoto's) .....in which case vast majority of patients with primary hypothyroidism the cause is autoimmune

First step is to get FULL Thyroid and vitamin testing

As advised in previous post

healthunlocked.com/thyroidu...

Full testing will show your current FT4 and FT3 levels...essential as you seem to be now taking T3 alongside Levothyroxine

Getting vitamins tested and supplement to bring to optimal levels

If you have Hashimoto's then trying strictly gluten free diet and/or dairy free frequently helps or is essential too

Finding an NHS endocrinologist prepared to prescribe T3 is tricky, but not impossible

Have you emailed for the list of recommended thyroid specialist endocrinologists who will prescribe T3 from Dionne at Thyroid Uk?

thyroiduk.org.uk/tuk/About_...

Have you considered DIO2 gene test?

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

If you test positive for DIO2 gene variation it can help get T3 prescribed in some CCG areas....others remain opposed

imdelightful profile image
imdelightful in reply to SlowDragon

Hello S.D .

Thank you for making contact with me. Pretty certain to have Hashimoto's. I have my results back for testing for some vitamin levels. TSH, FT4, FT3 and more. I am not as yet able to read acronyms although Helvella has given us some insight to them.

DIO1, 2 and 3 enzymes mean nothing to me other than it has something to do with management of the deiodinase - 2 enzyme . Why is this related to the thyroid and how could it help me return my health back to the way it was ?

Your question: Have you emailed for the list of recommended thyroid specialist endocrinologists who will prescribe T3 from Dionne at Thyroid Uk?

My answer: No I haven't. Is that a link to the site?

What is CCG

?

Thanks for the tip on a diet of gluten free nosh.

SlowDragon profile image
SlowDragonAdministrator in reply to imdelightful

CCG is new name for your local health authority. The holders of the purse and budget planning.

Email for Dionne is in the link I gave you in first reply

Getting full Thyroid and vitamin testing privately is your next step to see exactly what your FT4 and FT3 levels are, plus tests BOTH TPO and TG thyroid antibodies

Roughly 20% of thyroid patients have DIO2 gene variation.

If you read the link about DIO2 gene test it explains why many people need the addition of small dose of T3

"Firstly, you need to know that everyone inherits two copies of each gene, one from their mother and one from their father.

To explain this paper briefly, the DIO2 gene activates tri-iodothyronine (T3) and the researchers found that a tiny fault in this gene could mean that although the body gets enough T3, the brain doesn’t.

The researchers found that patients on levothyroxine (T4) alone felt worse if the faulty DIO2 gene was inherited through one parent and worse still if they inherited the faulty gene from both parents.

The patients on this study were given T4 only for a set period and then combination treatment of both T4 and T3. The patients who had normal genes did not feel any different on combination treatment. However, those who had one faulty gene felt better on the combination treatment and those with both faulty genes felt better still.

This means that there is a possibility that patients who are on levothyroxine alone and still have symptoms may improve with the addition of T3.

imdelightful profile image
imdelightful in reply to SlowDragon

Thanks again for such a welcomed reply. Advice taken but must look up DIO2 no idea what it is or what it signifies.

SlowDragon profile image
SlowDragonAdministrator in reply to imdelightful

Approximately 20% of thyroid patients have DIO2 genetic variation meaning they need addition of small dose of T3 alongside Levothyroxine

It's becoming more recognised....but still test not available on NHS ....apart from in Kent

Assuming you tested positive for this relatively common gene variation it's good scientific proof that you would benefit from trial of T3 on NHS

First step is to get full Thyroid and vitamin testing via Medichecks or Blue Horizon

Getting thyroid dose and vitamins optimal is first step

Perhaps consider DIO2 gene test later next year

imdelightful profile image
imdelightful in reply to SlowDragon

WOW! you're amazing for all your knowledge on this subject and more. Can't thank you enough really. x

SlowDragon profile image
SlowDragonAdministrator in reply to imdelightful

Only recovered my health with help from this fantastic forum. More on my profile

Many of us "difficult" Thyroid patients turn out to be DIO2 positive

imdelightful profile image
imdelightful in reply to SlowDragon

OK I'll check it out for sure DI02

helvella profile image
helvellaAdministratorThyroid UK in reply to imdelightful

For clarity, the gene that affects T4 to T3 conversion is called DIO2 - that is, three letters and a number. Not D102 - a letter and three numbers. Not DI02 - two letters and two numbers.

The name comes from the enzyme that this gene affects which is a deiodinase. It removes an iodine atom from a thyroid hormone molecule - it deiodinates it.

On this forum we probably understand, but if you wish to look it up anywhere, it might help to get it right. If you are discussing with a doctor, and get it wrong, you are providing an excuse for them to dismiss what you say.

(More strictly, two single-nucleotide polymorphisms (SNPs) on the DIO2 gene, rs225014 and rs225015.)

academic.oup.com/jcem/artic...

The Wiki article provides a basic introduction as to what a single-nucleotide polymorphism (SNP) is and why it can be important:

en.wikipedia.org/wiki/Singl...

imdelightful profile image
imdelightful in reply to helvella

For clarity, the gene that affects T4 to T3 conversion is called DIO2 - that is, three letters and a number. Not D102 - a letter and three numbers. Not DI02 - two letters and two numbers.

Got it , thanx. I understand the three letters and one number. Thanks for explaining this to me.

imdelightful profile image
imdelightful in reply to helvella

On this forum we probably understand, but if you wish to look it up anywhere, it might help to get it right. If you are discussing with a doctor, and get it wrong, you are providing an excuse for them to dismiss what you say.

^ Excellent piece of advice. I need all the relative information to set my self up to succeed NOT fail when asking my doctor to refer me to an endo.

Everything you give me is saved for later when I prepare notes and place facts down on paper .

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