Annual Thyroid test.

[henrythewasp]

With all this lockdown I have been told I can't have my annual checkup as its not important, I have other conditions that are normally checked at the same time and I feel tossed as side. My health might not be important to them but it is to me so am I in my right to have my checkup by my local gp?

[Hypopotamus]

Same here. It helps them to just phone us up and ask us how we are instead of having to face us over a desk. In my opinion, it is setting a dangerous precedent.

Also I am in tremendous pain with a foot condition. My X-Ray was cancelled until further notice. I heard from a nurse at the local hospital that they are so short of work that some of them are getting bored!

[SlowDragon Administrator]

As NHS only tests TSH (and Ft4 if you’re lucky) suggest you look at getting FULL thyroid testing

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

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Low Ft3 frequently linked to fibromyalgia

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Come back with new post once you get results

[elwins]

Thanks for posting, you have answered my question, I am due May for my yearly test. But I do not do finger prick test, much prefer a nurse to come and do it. Which I think they are not doing. For private tests. Best of luck in getting it sorted.

[fuchsia-pink]

I think it varies by GP, but most aren't doing routine testing. I was lucky: mine did, but only because I was having annual kidney function testing AND follow-up thyroid blood tests, neither of which required a GP's involvement.

Suggest you follow SlowDragon 's wise suggestion and use this as an opportunity to get full testing done, rather than the very limited tests the NHS usually offer.

[Batty1 in reply to fuchsia-pink]

Why do these Doctors make everything so complicated, yes we are in the middle of a health crisis in the hospitals not the doctors office and if they are bogged down for some reason why can't they just send you paper work in the mail or email so you can stay on course for treatment. I do this all the time with my Rheumy and Endo they send me my lab request and I go to have blood drawl.

[holyshedballs]

Dear henrythewasp

There is no reson not have your annual checkup, provided neither you nor any members of your family have any signs or symptoms.

The NHS are reminding people that they can use NHS services for normal health reasons.

Unususally Slow Dragon has given you some misinformation. You can get TSH, T4 and T3 tested on the NHS. I have all 3 tested regularly. You have to be persisitent and give them good reasons for T3 most of which are on this site.

I suggest that if you want your annual check up you call the surgery and ask for it, despite what they have said initially.

Good Medical Practice, the doctors code of practice, says that they have to consult you and listen to your views.

Advise them of the above and ask for your annual check.

Remember, the GP works for you.

You are not doing him/her a favour.

[Mistydeb01 in reply to holyshedballs]

You are lucky to get these tested on the NHS, my doc has put them through a few times but the lab won’t do them. The GP even warned me that he can put them through with a note attached but the lab probably still won’t test them. I don’t think that slowdragon has given misinformation, just giving info from experience and many on here are in the same boat with full thyroid testing

Debbie

[Batty1 in reply to Mistydeb01]

I'm still shocked that a LAB technician can decline a DOCTORS order ...wow that's pathetic and bad business.

[Mistydeb01 in reply to Batty1]

Yep it’s really bad. It’s like a health postcode lottery all over again, some lucky people get it, others have to go private or get their endo to do them...if they are lucky to get an endo who knows about thyroid to see them Debbie

[helvella Administrator in reply to Batty1]

Yes and no.

The way it happens is entirely unacceptable.

But looking at it from the lab point of view, they do sometimes add tests which a doctor did not request. That is usually done on the basis that it might help in diagnosis and monitoring.

Equally, the lab might know that a particular test is inappropriate, expensive, not sensibly available, would take too long to get done, can't be done on sample (e.g. haemolysed).

Instead of simply dropping it, the lab should as speedily as possible contact the requesting medic and discuss/explain.

There should be a 100% solid audit trail showing all requests and what happened. Every doctor looking at records should be able to see that a test was requested, why lab didn't do it, what happened next.

[Batty1 in reply to helvella]

This is about money and I wouldn't want a lab technician who knows nothing about my health to determine a test my doctor ordered isn't necessary or too costly.... Why not allow the person who administers the cancers patients chemo dose to adjust or change the prescribed because its too expensive or not effective.

It's a slippery slope and the doctor should be consulted with every lab technicians change. Just my opinion.

[helvella Administrator in reply to Batty1]

I do agree that much of the underlying impetus is to reduce costs.

But expecting and mandating lab technicians to perform tests that they might know cost a lot of money, in circumstances where they might also know they are inappropriate, seems not the right approach either.

I did actually write:

Instead of simply dropping it, the lab should as speedily as possible contact the requesting medic and discuss/explain.

It should not be the lab technicians decision.

[holyshedballs in reply to Mistydeb01]

Hi Debbie

I have a great deal of respect for Slow Dragon. SD has a lot of knowledge and experience helping forum members.

But it is true that the NHS, GPs and Endos, WILL test T4 and T3. So to be pedantic it is misinformation to say that the NHS will only test TSH.

In my view, it doesnt help forum members to say that the NHS only tests TSH when there are many cases when the NHS actually does test T4 and T3 and even antibodies etc.

In my view, by saying only TSH testing is available on the NHS can stop forum members asking for T4 and T3 to be tested as well.

It is well known by forum members that a lot of doctors are unaware of the need to test T4 and T3.

In my view that means that the patient should advise the doctor of the need to do that. There is a lot of information on this site to help patients ask for T4 and T3 to be tested. Doctors have a duty to listen to patients under Good Medical Practice. If a patient presents a reasoned argument for T4 and T3 to be tested, the doctor SHOULD test that.

To do otherwise may be negligent.

As you rightly say, it is the experience of forum members that doctors wont test for T4 and/or T3. There is no good reason to NOT test for these hormones as many people on this forum are aware. That is why I think that patients should ask for the tests and present good reasons for them. As I say, they ARE available on the NHS.

I've heard anecdotes about the lab not testing T3 when asked to do so. In my view, the lab is acting ultra vires i.e. beyond its legal power or authority. BUT I havent seen the contract or statutory instruments empowering NHS labs. According to the GMC and the law, the patient and the doctor decide on the treatment, not the lab.

If the lab does not provide a T4 or T3 test, in my view so far, that is reason for a formal complaint to regualting authority.

if soemone does have sight of NHS labs agreements with other service providers I would be very grateful if they shared it with me.

[serenfach]

The NHS sometimes does test T3 if your TSH is way off. Sometimes. As I take NDT my TSH is usually really low, so occasionally I get the T3 and T4 results. I also make sure the nurse writes ON NDT on the blood form, but as I have to explain every single time what this is, I am not sure the lab would take any notice of it.

I have written to my MP in the past about the GP asking for tests and the lab declining them, without ever seeing our notes. He did say he would look into it, but did not hear anything. Must chase him up as all of this can be done by phone or letter.

[blondpalomino]

Hi, My annual review was due in Feb, so I guess that's not going to happen! The lab usually do TSH, T4 and T3, purely because they probably can't believe my TSH is right which is usually 0.004!