A letter from my GP. What should I do next?

[A1Amber]

I now have a letter from my GP after I gave him copies of thyroid/vitamin and ultra sound done in Cyprus. He says he would be happy to refer me to an endocrinologist for a further opinion but this may mean a wait of many months on the NHS. He said if I would like to see someone in the private sector it would be my decision but he would fully support it. What should I make of this and who should I see?

[SlowDragon Administrator]

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

Roughly where in the U.K. are you?

[A1Amber in reply to SlowDragon]

Skegness Lincolnshire

[SlowDragon Administrator in reply to A1Amber]

A lot of endocrinologists on the list are doing zoom consultations

Obviously you need to get vitamins optimal and highly likely need to be on strictly gluten free diet, but rule out coeliac first

[A1Amber in reply to A1Amber]

Thank you Slow Dragon. I have e mailed Dionne.

[SlowDragon Administrator]

Ferritin 80.08 ng/ml range 10 - 329

Vitamin D 14.9 ng/ml desirable level >30

Folate 3.34 ng/ml 4.6 - 18.7

Vitamin B12 473.5 pg/ml 197 - 221

TSH 0.30 mIU/L 0.27 - 4.2

Free T4 17.34 pmol/L 12 - 22

Free T3 4.18 pmol/L 3.4 - 6 8

Thyroperoxidase >600.0 IU/ml <34

Thyroglobulin 3302 IU/L <115

Results from previous post

Vitamin D is far too low at 37nmol,

Helpful calculator for working out conversion from ng/ml to nmol

endmemo.com/medical/unitcon...

GP should prescribe 1600iu everyday for 6 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

With your Vit D, important cofactors - magnesium and Vit K2-MK7?

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Folate is deficient

GP should be prescribing folic acid

But supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be more beneficial.This can help keep all B vitamins in balance and will help improve low B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B is another option that contain folate, but is large capsule

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

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

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

low B12 result being under 500 - taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/vitamins/vit...

[Jazz61]

I see Dr (name removed by admin) privately in Nottingham, she is amazing and sorted me out so quickly, message me if you want details

[SlowDragon Administrator in reply to Jazz61]

Only give details about specific medics by private message please

[stockman27]

I dont know what your problem is but be warned the Endo may do a full thyriod blood test and look at your T3 levels but if you Tsh is right then thats it, even though you may feel rubbish.

[waveylines]

There is no need for your GP to leave your vitamin D so low. They normally prescribe a short course to boost your vit D up.......at your current level usually at a much higher dose than slowdragon has recommended but for a shorter period of time. They should then retest. Low vitamin D causes non restorative sleep, exhaustion and aching bones. Its important it is addressed to maintain bone health -you will also feel a lot better!! I would raise your vit D level with your GP.

[SlowDragon Administrator in reply to waveylines]

Her vitamin D is 14ng/ml = 37nmol

So Guidelines for GP would only prescribe 1600iu daily for 6 months

[waveylines in reply to SlowDragon]

Apologies slowdragon -my error. Thanks.