Endocrinologist appointment

[Charltonjl]

I am finally meeting an endocrinologist (named on the list provided by Thyroid UK). Since I last posted on here my GP flatly refused to increase my Levothyroxine dose (of 50mg). My symptoms still remain. Are there any tips before I see him? I don't want to be dismissed again. Thank you

[fuchsia-pink]

I'd ring his secretary and tell her what recent-ish blood results you have and ask if the endo would like anything else testing before the appointment [perhaps suggest free T3 along with free T4 and TSH as I'm not sure you had free T3 last time] - and if so to send you the blood form / arrange a blood test at the endo's hospital.If it's a face-to-face appointment, it's always worth bringing someone with you (ideally a MAN) - both to vouch for you not being properly well and to remember to as things that you might otherwise forget. Often helpful anyway because we girlies are so often dismissed as foolish/ hormonal /just plain wrong - but I'm not saying that someone on Dionne's list behaves like that!

Good luck - let us know how you get on x

[Charltonjl in reply to fuchsia-pink]

Aww thank you. You're so right. My GP just thinks I moan and when I say my bloods aren't optimal she just says they are because they are 'within range'. So archaic and doesn't have a clue of what optimal means. Unfortunately becaus did Covid-19 I have to go alone. I've already sent my recent bloods through though. I had my t3 tested 4 months ago x

[fuchsia-pink in reply to Charltonjl]

"in range" and "normal" aren't anyway near good enough - you are aiming for "optimal"!For example, the range for free T4 might be 12 - 22. If your result is 12 .5 you will probably feel dreadful; but if it's 19.5 you'd feel much better. But both are "in range"

Work out how far through each range your free T4 and free T3 results are - and take the numbers to the appointment - most of us feel best if these are at least 2/3 through range ... x

[Fruitandnutcase in reply to Charltonjl]

If you’ve seen any of my previous posts you’ll know that saying ‘within the range’ is like a red rag to a bull as far as I am concerned. How dare we want to be optimal.

Good luck with the visit.

I’d take a notebook in which you have jotted down any questions you want to ask him. I used to always say I had to do it because I didn’t want to forget anything I needed to say - forgetting things being something that goes with thyroid territory. Then I’d just read out what I wanted to say.

I’d work out exactly how you feel too - I used to get to appointments and when asked how I was feeling say ‘fine’ which was beyond useless because in the beginning I was feeling awful, so work out exactly how you feel. your symptoms etc. before you get there. It will save ‘thinking’ time if you do. Time that can be better spent sorting out yourself ur problems.

Add how much levo you are taking, how long you’ve been taking it for and why you feel you need more etc.

List all of your bloods plus vitamin D, B12, folate and ferritin levels and anything else you have.

Any supplements you are taking down why.

Any other conditions you may have or may run in your family - such as other thyroid conditions, rheumatoid arthritis, osteoporosis anything really especially autoimmune conditions.

Maybe anything you have read on here or in books that you feel is pertinent. I used to collect articles (and keep them in my notebook!) that fitted with my view of how I wanted to be treated.

I’d quietly let him see that you are taking an active part in your treatment and don’t just want to have treatment ‘done to you’.

I hate to say it though even if you got your consultant from TUK - prepare to feel let down after your appointment - you can never tell with endos out of a year’s worth of endo visits I only had one where I came away feeling on cloud nine.

Good luck anyway. Let us know how you get on.

[Charltonjl in reply to Fruitandnutcase]

Wow, this is great. Thank you sooooo much. All noted and good idea about the note pad too! Will update you shortly xx

[DippyDame]

I suggest you make a list of all the questions you wish to ask this endo along with any labs you already have and a list of your symptoms ( use the TUK list to tick those off), use it to focus your mind during the appointment and leave a copy with him/her. It means you can sound in control of your thoughts ( because you may be feeling nervous) which will hopefully avoid the " just another hormonal woman" scenario!! Try to be polite but not overly assertive.....it can happen in stressful situations and is counterproductive!!And, yes! ....It is rediculous in the 21st century, but take someone with you because they realise you have a witness. My husband was just a listening presence but that did make a difference.

You need to have the full thyroid panel tested ( and not just TT3 as my endo tested!)

50 mcg is the starter dose as I'm sure you know....how long have you been left on that dose.

Looking at your results of 2 months ago you are quite severely undermedicated.

Are you ensuring your nutrients are optimal.

Your GP joins the ranks of medics with little idea about thyroid disease I'm afraid......madness!

But....looking at responses to your previous posts you have already had some excellent advice. Bear that in mind.

Well done for this move forward

Please keep us posted

Best...

DD

[Charltonjl in reply to DippyDame]

Thank you! I started on 25mg of Levothyroxine and she increased it to 50mg about 4 months ago. But since then she's refused to increase it as she believes they are optimal 🙄. Unfortunately due to Covid-19 I have to attend alone but thanks so much for all the advice ☺️x

[DippyDame in reply to Charltonjl]

Oh dear....you need much better care.If results were optimal you would not be feeling symptomatic!

She is confusing "optimal" with 'in range"....a completely different ball game!

That lack of knowledge is why over 100,000 patients have arrived here desperately looking for help, and a way forward. I was one among them a few years ago...this is where I found the experts who helped me recover from a complex thyroid problem...and the encouragement and support I needed as I researched and treated my condition.

You are not alone.

[Charltonjl in reply to DippyDame]

Aww thank you! Your words mean a lot. It's crazy but hopefully we get somewhere today. Really hope you feel much better too x

[DippyDame in reply to Charltonjl]

Thank you, I'm feeling quite good now for an oldie of 75!!So it's never too late to change things.... x

[SlowDragon Administrator]

Email endo

Your recent thyroid and vitamin results

Your current dose and brand of levothyroxine

Your list of supplements

Have you had thyroid ultrasound scan yet?

a short list of ongoing symptoms

Perhaps use this tick list

thyroiduk.org/signs-symptom...

[Charltonjl in reply to SlowDragon]

Great thank you! Will do

[Charltonjl in reply to SlowDragon]

That's a great list, thank you so much btw. No, not had a thyroid ultrasound yet. Maybe something the endocrinologist can refer me for? X

[tattybogle]

Definitely try and avoid doing what i did last time i met my GP face to face... got too tired on the way there, couldn't speak properly and then had a big rush of adrenaline out of sheer frustration at something he said ..... and let out 10 yrs worth of frustration in a manner that didn't look very rational at all...... Yes try and avoid that :).... maybe splash out on a taxi

[Charltonjl in reply to tattybogle]

Thank you. It's only a 5 min drive but yes easy to get emotional x