Stumbled upon this interesting geeky medics page on thyroid status examination, sounds very thorough but I wonder how often it is actually performed:
geekymedics.com/thyroid-sta...
[ Admin edited: Link had been pasted twice so duplicate removed. ]
Did you get a geeky medics thyroid status exami... - Thyroid UK
Did you get a geeky medics thyroid status examination?
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TSH110
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Can’t seem to see it. Just seeing a “this page no longer exists”-type message?
Try again!
SeasideSusie
👍
It's the video I found, you have to laugh though, he introduces himself as a final year medical student but do they really get taught that and do they actually do that examination when they are qualified and see real patients? I really hope someone replies to confirm they've had such a thorough examination.
Worked for me
That's because Helvella fixed the link.
Oh dear what was wrong with it i wonder….I must have botched the cut and paste. Thumbs up to helvella
🤣🤣🤣 what a saviour!
SeasideSusieRemembering
Link didn't work for me either but I used the search facility and found a video of a thyroid examination, I'd love to know if anyone has ever had an examination that comes remotely close to it, I had no examination at all.
Pretty much my story until months after diagnosis
I was dx’d by an astute allergist in exactly this way in 1993 . My GP never bothered. Follow up labs and studies showed Graves Disease.
Not remotely close - NHS GP did palpate thyroid itself after I had found a lump, no other questions or physical, just referral for u/s, biopsy and out it came (partial). Years later Dr Peatfield did lots more incl. reflexes, blood pressure sitting/standing, skin.
Yes, I saw Dr P about 25 years after initial diagnosis back in 1975 when there were no time restrictions on GP consultations, you turned up and waited your turn if I remember correctly. Dr P did those tests with me, NHS doctors have never, ever, done any kind of examination.
helvellaAdministratorThyroid UK
Somewhat more than a GP could do in a ten minute appointment!
Looks an interesting site - will be having a wander!
No video....just text.
If that is actually what med students are taught then why, for heavens sake, are so many doctors making such a mess of diagnoses. And that is before a blood test!.
Nobody ever examined me in a remotely similar manner.
In my case I was on my knees and had to ask for a thyroid blood test... it was downhill all the way thereafter until I found this forum recommended on an NHS page, and the real experts.
I'm rather miffed about excessive sweating always being considered to be a sign of hyperthyroidism. I've sweated gallons while waiting for a bus in a snow storm, and I'm hypothyroid.
Ha ha me too! My running vest used to be stained with salts after a race I sweated so much.
in reply to humanbean
It's the one symptoms I'm hoping to keep hold of! 😂 I used to sweat masses, only ever found a men's sports deodorant worked for me, just for daily use.
These days I don't wear deodorant because I stopped sweating. It's my silver lining! 
bookish in reply to
I used to feel like you! I too used to sweat prolifically and had for years. Always a problem to cope with. After my partial thyroidectomy I stopped, virtually nil sweat, and it seemed like the one good thing in a mire of yuck. But it means you are losing an exit route and makes temperature regulation even more difficult. I have now been diagnosed with small fibre neuropathy which closely ties with dysautonomia. I also found for myself that I have a genetic COMT issue potentially affecting adrenaline which makes you more prone to sweating excessively. Working on getting diet, vits and minerals ( esp magnesium for the COMT) better has slowly restarted a tiny bit of sweat - such joy!
TSH110 in reply to
My running vests aren’t salt stained any more but my armpits still need quelling!
Learned something else!
I reached the stage where I used to sweat buckets but never connected it to my thyroid problem which back then I knew little about. It was hugely embarrassing.
Looking back it coincided with my feeling rubbish as (I can only assume) my cellular T3 levels were seriously dropping. The least exertion, physical or mental, and the flood gates opened. I was taking levo.
Gone, after I started T3.
The medical profession need to make some serious changes to their thyroid teaching syllabus....but we all know that.
in reply to humanbean
Hypo here but "glow" (where a number of people have said "but you look so well") and also sweat more than I used to in the past.
had a quick look.. nope..... nobody has ever looked at my thyroid . let alone examined it. however i have had the "hold hand out /tremor test" and it was a true indicator of overmedication, and also a visual test of 'ankle reflex relaxation' rate at diagnosis of Hypo..
Both were done by GP's who would be ? over 60 now.
I question the reflex bit in the web page .... it looks at elbow and knee reflexes .. and at first glance it looks to be assessing the actual reflex .... but i had always thought that the sign that indicated hypothyroidism was a slow rate of 'return' from the reflex, rather than the reflex itself. Woltman's sign ? sciencedirect.com/topics/me...
tpauk.com/main/article/asse...
And also that the usual place to check was the achilles / ankle, rather than knee or elbow.
It does look like an interesting site .. will have a proper look later.
How would the Achilles reflex be tested I wonder - hammer the sole?
you kneel on the chair with your feet off and they tap at the back of the ankle .. or i think you can do it with legs dangling off the table. then the GP repeats it numerous times and stares and looks puzzled and does it again just to be sure. If the foot jerks normally but is slow to return to normal position it's a positive sign for hypothyroid ,, and /or some other things.
I think it was my knee reflex that was tested not that one
I had my knee tapped once! It didn’t react much it shows very slow reflex. I thought they did this in the older days when symptoms were better understood by medics. Once diagnosed some of the things in the list were done but not before, including the knee tapping
if i remember correctly it was the slow return on achilles reflex that prompted My GP to order TPOab.. i wasn't overweight , and didn't 'look' very hypothyroid apart from a puffy eyes and bridge of nose, which wasn't very obvious unless you know me, and my TSH wasn't overly high at only 5.7/6.8 + TT4 94/91 [65-155ish].. so he wasn't expecting to treat me .. but when the TPOab came back off the chart, twice, he went ''oh, i see, you'd better have some Levo" Which was fortunate cos i could hardly form a full sentence or hold my body upright by that point.. so i REALLY don't want to know how broken i'd be if my TSH ever got to 110.But ive always wondered how much longer i'd have had to wait for treatment if i'd seen a GP who didn't have a bash at the reflex test. Bless 'im.
I tell you for me TSH of 110 was grim but people on here have had over 200 I think I’d have died long before it could have climbed to that unless it did go higher after the test. I don’t think I’d have lasted another day if I hadn’t got some Levothyroxine I just laid in bed so cold it must have been like freezing to death in the artic the cold was unspeakably terrible I just though I’ve had it: I was quite surprised to wake up the next day and think good god I’m still here! I felt just a tiny bit warmer I’d taken 25mcg Levo they kept me on that for three months I felt dire the endo zipped it up pronto - I had seen his stupid Icelandic side kick who thought I was euthyroid with a TSH of 77 😵💫
i've alway's wondered what happened to that person who was on here last year with TSH 430 ish..... she never came back on.. seriously hoping it was lab interference. she could still walk and talk.
Blimey I never knew it could go that high. I do hope she pulled through. Mine went from undetectable to 110 in a week or so - small wonder I had angina! A nursing friend said I was lucky not to die of a heart attack with that much sudden alteration - my thyroid swan song it was not a melodious ditty, but rather cacophonous!
Lol not even close 😂 the fourth GP I saw felt my neck but not as thoroughly as that. Pretty sure none of them did most of the other tests.
I've had some doctors do some of those examinations, but for the most part, they don't touch you at all! I've only had one doctor do the lot - I think he did all of them - and he was an anti-aging doctor, not an endo.
Nope! Never been examined. I have no eyebrows after 30 odd years of ‘treatment’ 😩
Mine are like Dennis Healeys huge wirey hairs that twist and turn crazily the outer thirds are Spartan with maybe two or three crazies twisting away unchallenged. I had beautiful eyebrows before all this - never needed plucking, neat and tidy and nice and dark - not these spidery multicoloured monsters I’ve got now
I shouldn’t moan really as before I became decrepit (😂) my eyebrows were monstrous snarly things that sprang out rather than snuggling close to my face all neat and tidy! My makeup skills usually result in me sporting a Marlene Dietrich look!
Cool! But do you have her voice? 🤣🎵 🤣
I’m a Doctor and we were taught all that at medical school. It is true that as a GP we wouldn’t have time to do all that but some of it should certainly be done and I’ve been shocked that I’ve never had my neck examined either, even by the endocrinologist. However I was trained in Scotland and I do think we had a better level of training than the English doctors. I noticed the difference when I moved down here.
I would confirm though that we were always taught to judge thyroid function by TSH which I now know is incorrect.
MirandaIV
I would confirm though that we were always taught to judge thyroid function by TSH which I now know is incorrect.
That is a massive statement from a doctor.
Now you know, are you spreading the word and trying to educate other doctors on how utterly wrong the treatment of hypothyroidism is by relying solely on TSH?
I haven’t been a GP for 10 years, so don’t really mix with other doctors who are not in my field. I now work in the aesthetic‘s industry, so don’t really have anything to do with general medicine.I certainly help my aesthetic‘s patients if I think they have any possible thyroid problems by doing blood tests and trying to point them in the right direction.
My own GP is absolutely useless and talks down to me as if I have no personal medical knowledge as well! I bypassed him by going to a functional doctor and then to a consultant.
Lord, I wish my GP had the time to do that! On the whole, he would have done half of the tests. He did say that he thought I was hyperthyroid, as I have a tremor, but I had to remind him he diagnosed me with essential tremor years ago and the symptoms are similar. (I am euthyroid.)
Actually tbf my NHS thyroid Endo doctor did examine me like this - but he left me on 50mcg of thyroxine and discharged me back to doctor post RAI treatment soooooooooo you know, you win some, you lose some
shawsAdministrator
My answer is 'NO' as few doctors (and I think I consulted a majority) could diagnose a person who was hypothyroid - just by 'looking at the patient' as our 'old-fashioned doctors' did and who could spot that the patient was hypo at ten paces without the need for blood tests.
You just need to read 'Tears Behind Closed Doors' for confirmation and this is just the story of one person's long, long journey.
thyroiduk.org/product/tears...
🙂
I had to diagnose myself as few doctors seem to be unaware of clinical symptoms any more.
Never had any physical check because of covid
They ask on the phone, do you see a lump when you swallow water?
I say ummm not sure, don't think so! (I've never liked touching my own neck area too) I have graves and all tested with bloods no physical check!
Dr P did all those tests and more, plus looked at blood results, concluding that I needed T3 in the equation. Only within the past three years have I had a thyroid palpation done, and once when a lump was being assessed, which needed a scan and biopsy and was negative and caused by scar tissue from a sub-total thyroidectomy for Graves.
There was a student doctor in with my GP when I went asking for more Levo. The student doctor was asked to examine my thyroid. He felt behind my ears, and I gently moved his hands to my neck! No Endo or GP has ever touched me or done any tests apart from TSH.
A neurologist found my lack of ankle reflexes years ago and on the strength of that diagnosed me with sciatica, although I have no sciatic pain and a subsequent MRI showed no impingement on the sciatic nerve. About ten years later I got an ultrasound, which apparently showed my thyroid to be 'of normal size and vascularity'. I then developed a lump in my neck and was sent to ENT for that and told it was caused by acid reflux (which I have never had). That lump disappeared overnight after I took my first dose of thyroxine and has not returned in eight years. A recent scan for something else showed an atrophic thyroid, but in terms of a hands on examination of my neck, never, not in any of my 14 endo appointments.
When I was called into the surgery following Hyper blood results in April, the GP (actually a GP trainee) did everything in the video except tapping my chest and asking me to drink some water. I can see that I've been lucky. He seemed to have all the time in the world but because of Covid, I think us and the secretary were the only people in the building. Crying shame the endo he referred me to is hopeless.
Good you were so thoroughly examined, very few seem to have been if this is a representative sample but as you say shame about the next one…..
I bet they take more care over hypers than hypos incase we drop dead. My friend has just had a bloodtest - the secretary only gave her the TSH (possibly all that was tested) - it was 6.7 with a range of 0.5-5.3. The doctor had written no further action. Her twin had also just been fobbed off with ‘borderline’ hypo.
It’s awful I know how bad I felt when mine was 6 when I was being optimised. They really should be offered medication there’s more and more evidence that it isn’t good for health and that’s apart from it being patently obvious to anyone with half a brain that thyroid hormones are not a bit of bling that you can opt out from - they are essential to well being at the correct levels - a TSH of over 6 is NOT normal for anyone.
Thank you, TSH110. She's not an internet user but I will try to encourage her to be, and tell her what you have just said. I leant her my Take Charge of your Thyroid Disorder book (Alan Christianson).
Pity, she’d get a lot of support here if she did use the internet. I hope she can persuade her doctor that she should be treated. These days they are leaving it until TSH is over 10 - which is criminal - but some will treat if it goes over range and the person has symptoms. Thyroid U.K. have a list of sympathetic medics that might be worth getting hold of if she can afford to go private.
Turns out my friend has an iPad, so I have given her our web address and hopefully she will appear. I've said that she will feel tons better (as I have) simply by engaging with the warm and knowledgeable support here.
Couldn’t agree more, this forum helped me get my life back!
Great information, thanks for the share. I was also impressed by a doctor who explained a procedure BEFORE doing it and said thank you to the patient!
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