Best to ask an endo? Or go to a private doctor?

[ShatteredofLee]

Is it better to make an appointment with a private doctor - or go to a endo? I've been checking out the list of private doctors and endocrinologists, and my eyes have been watering at the costs. I understand why an endo may charge £180 or £300 for a 1/2 hour session, but I can imagine I will be so tense at an appointment watching the clock whirl around and the bill mounting that I won't be able to get a word out. Also there doesn't seem to be the facility to share test results prior to an appointment - meaning at a first session is there a facility to share the crucial blood test results. Or in essence does that mean a minimum of two sessions with an endo? Sorry, long post.

[Buddy195 Administrator]

I email my Endo my private blood results prior to the consultation. He’s also happy for me to email him between appointments if I have any concerns.

It may be useful for you to say which is your nearest town/city, so members can private message you recommended Endos.

[ShatteredofLee in reply to Buddy195]

Hi Buddy, I'm based in south east London? Really would like to source a good endo,

[SlowDragon Administrator]

Before considering booking any consultation

Get FULL thyroid and vitamins tested.

Usually that means test privately via Medichecks or Blue horizon

First step is to get all four vitamins improved to optimal levels by supplementing

What vitamin supplements are you currently taking?

Optimal vitamin levels are

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

Serum B12 at least over 500

Active B12 at least over 70

Meanwhile

As you have Hashimoto’s are you on absolutely strictly gluten free diet

If not, get coeliac blood test done BEFORE trial on strictly gluten free diet

Approx 80% of Hashimoto’s patients are gluten intolerant and further 5% coeliac

Then retest thyroid levels after 2-3 months on strictly gluten free diet

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Obviously most recent results will show high Ft4 as you took levothyroxine before blood test

healthunlocked.com/thyroidu...

[ShatteredofLee in reply to SlowDragon]

Thank you, that's really helpful. I've now got the printed out version of my blood test. They only tested TSH and T4.

TSH is 6.51 (range is cited as 0.27 - 4.20miu/L) so its high

T4 is 26.5 (range is cited as 12 - 22 pmol/L) so its high too.

Am I right in thinking there's something wrong if the TSH is high (eg trying to get the thyroid gland to work harder) yet at the same time T4 is high?

Given that I'd take T4 an hour before the test I'm not surprised its high.

My symptoms are alllll low. Most worryingly my heart rate is always around 60 bpm, and I recorded a temperature of 35.1 the other day when I felt very crook.

I've been on levothyroxine for 28 years. Last saw an endo 25 years ago. Not felt good for years.

Thank you for the advice about vitamin supplementation. I hadn't been taking any, and since reading about how important it is on this site, I've started taking a multivitamin (viridian multivitamin and mineral).

Question: should I wait a bit for the vitamin tablets to kick in before having another comprehensive blood test (with T3 and vitamins)? Also, should I not take a multivitamin prior to a blood test?

Many thanks

👍

[Jazzw in reply to ShatteredofLee]

Well there could be your answer. You took T4 an hour before the test? No wonder it was quite high. How much levothyroxine do you take?

I wouldn’t bother with seeing a private endocrinologist until I’d seen my blood tests from taking my levothyroxine 12-24 hours before the test (and I favour 24hrs before—I don’t take my daily dosage of thyroid hormones until after doing a test). I suspect you’re undermedicated, odd though that might sound right now.

[ShatteredofLee in reply to Jazzw]

I'm on 125mcg daily. Feel hypo all the time that's why the test results are puzzling. I've got a phone call with my doctor on 21/3, at his request, and scared he's going to cut my dose. If the dose is cut, I'll def feel worse. I'm also really worried about the slow heart rate thing. Sorry, fretting....

[Jazzw in reply to ShatteredofLee]

I’m not surprised—but hopefully your GP won’t be that daft. Tell him that you think you might have accidentally taken a double dose during the week you had the test and that if it’s ok with him, you’d like to have another blood test before your dose is reduced because if anything, you feel a bit undermedicated. OK, so it’s a bit of a fib—but at least that way you’ll know what the real state of play is, instead of having a few months on a reduced dose feeling even worse.

[ShatteredofLee in reply to Jazzw]

ha! ok, got it. The fib will probably work. The last thing a GP wants to hear is that you know more than they do lol.

[Jazzw in reply to ShatteredofLee]

Hope it works out for you!

[SlowDragon Administrator in reply to ShatteredofLee]

Of course Ft4 result is high as you took levothyroxine before blood test

It’s a false high result

Make sure all future tests are as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test