endocrinologist appointment today

[ianskelly]

Hi all, I've just had an endocrinologist appointment this morning (at Chorley hospital in Lancashire) I explained my medichecks test seemed to indicate that I am not a good converter of t4 to t3, i was expected for that to brushed aside but to be fair the Dr said well we can confirm this via blood test (encouraging as i have been told point blank before this is not something they test ) when I asked if it shows I don't convert can I then be prescribed T3 he said .... no surprise surprise. my area does not prescribe t3 as it is on a "black list." I pointed out i had recently seen a a graph which shows i would be much more likely to get the medicine i need if i lived in Cornwall, he said he saw my point and admitted it is price related but if he recommended it to his health board it is highly unlikely they will approve it. I then asked if I bought it privately (which I already do) could they monitor me to make sure my dose is correct (currently taking 100mcg levo and 25mcg t3 in the morning and 12.5 mcg t3 about 1pm and he said lets cross that bridge when we have the results.. so I am being tested monday morning, am i right in thinking i need to take my t4 and t3 as normal on sunday and not take anything on the monday ? can i still drink coffee that morning and go to the gym to lift weights as i usually do at 6.30am ?thank you Ian

[SeasideSusie Remembering]

I am being tested monday morning, am i right in thinking i need to take my t4 and t3 as normal on sunday and not take anything on the monday ? can i still drink coffee that morning and go to the gym to lift weights as i usually do at 6.30am ?

You take your last dose of Levo 24 hours before the blood draw, and your last dose of T3 8-12 hours before your blood draw. So depending on the time of your test on Monday, you can work out when your last doses should be on Sunday, eg if your test is 9am on Monday then you take your last dose of Levo at 9am on Sunday and your last dose of T3 between 9pm and midnight on Sunday.

You don't drink coffee, tea or any caffeine containing drink on Monday morning before the test, drink water only. Coffee affects TSH level (so one presumes does any caffeine containing drink). No breakfast either as that can lower TSH.

I don't know what effect exercise has on any of the levels so personally I would miss the gym until after the test.

As you already take a combination of Levo and T3 then don't expect the results of this test to show how you convert. It's impossible. You can only tell how you convert T4 to T3 when you take Levo only. Once you add T3 then your results show the effect of the exogenous T3 you are taking so can't possibly show your normal conversion.

You will probably have to confess that you are already taking self sourced T3 with your Levo and that your results reflect that. If your results show levels of FT4 and FT3 that your endo is happy with, and you feel well, you can then try and persuade the endo that the combination you take is perfect for you. If your TSH is suppressed and the endo tries to tell you that you are overmedicated, then you will have to explain that taking T3 lowers, and can even suppress TSH.

[SlowDragon Administrator]

healthunlocked.com/thyroidu...

Medichecks test showed very high ferritin

Have you had testing for heamochromatosis?

Vitamin D too low - have you increased levels of supplement

B12 borderline

What vitamin supplements are you currently taking?

As you have Hashimoto’s....Are you on strictly gluten free diet?

[ianskelly in reply to SlowDragon]

Hi slowdragon thanks again for your quick response

i have had a test for heamochromatosis and (kind of) had the results a week or two ago, i say kind of as my doctor phoned whilst i was at work so i couldn't really ask questions and he said i havent got haemochromatosis but i have a genetic flaw which means i have preposition to store excess iron ,this has confused me as i htought the test would be black or white yes or no, i i have a liver test booked for monday (so i will do the t3 test the same time) and then i will book a proper appt with my doctor and hopefully get clarification

I have been taking vitamin d3 2200iu since novemer and also take b12 and magnesium

i went gf earlier in the year for 6mths and felt no difference and when i reintroduced gluten i had no adverse effects

[SlowDragon Administrator in reply to ianskelly]

Well high iron can impact or be linked with thyroid, especially hashimoto’s, so you need to get to the bottom of this

redriverhealthandwellness.c...

functionalhealthnews.com/20...

ncbi.nlm.nih.gov/pubmed/182...

Rather technical article

hindawi.com/journals/jir/20...

Suggest you retest Vitamin D

Are you also taking vitamin B complex or just B12 ?

Usually we recommend a good quality daily vitamin B complex one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Hidden]

You don't need to go to Cornwall. You can get T3 in Merseyside (includes WestLancs CCG) according to a letter I have so long as you have the approval of a consultant endocrinologist in an NHS establishment.

My CCG told me that this rule applied to NDT rather than T3 ie they are totally incompetent or liars, I know not which! They also repeated this fallacy to the Health Ombudsman.

I await their reply to me to my complaint about this and several other matters for their refusal to give me a IFR.

This is the truth, not something I am inventing for some form of cruel personal amusement.