Top Trumps Endocrinology

[Lalatoot]

Have you got what it takes to be a top endocrinologist? Take my test and find out.

The patient is on 100mcg levo and 10mcg lio

TSH suppressed, Ft4 13 (9 - 19) Ft3 5.1 (2.9 - 4.9)

During a telephone consultation, the patient complains of pain around the thyroid area, an enlargement of the neck at the thyroid and her voice is raspy and husky. These changes have occurred often over the last 3 years though intermittently - ie they come and go. The patient currently has a sore, enlarged throat and a very husky voice.

Do you:

1. Arrange for a physical appointment to examine the patient

2. Make an appointment for an ultrasound on the thyroid area

3. Suggest that the patient is referred to ENT as this cannot be thyroid related

4. State that it could be related to the lymph nodes as you have never experienced anything similar in your career

5. Suggest a reduction in levo as you admit to not knowing what else to do and Ft3 is slightly over top of range

If you answered that you would do 3, 4 and 5 above, TOP SKILLS you are a top endo and could have a job with the NHS in the north of Scotland.

[Murphysmum]

😂😂😂 I LOVE this!

[Buddy195 Administrator]

Oh no Lalatoot; I know some endos are clueless.

I feel lucky as actually saw my (private) endo in person today…. And he was ok about suppressed TSH 👍and he examined my neck area, took pulse & did eye & tremor checks. Wish there were more like him!

[Lalatoot in reply to Buddy195]

Hang on to him Buddy. Not much option here as I rely on NHS for lio and there are no private endos for 200 miles.

[NIKEGIRL in reply to Buddy195]

Yay buddy195. Sounds like ubud a good day. 👏👏👍

[NIKEGIRL in reply to Buddy195]

Sorry. Sounds like u had a good day

[NIKEGIRL in reply to Buddy195]

You gotta take the wins when they turn up

[Buddy195 Administrator in reply to NIKEGIRL]

I’m very grateful to have an understanding endocrinologist who has supported a private trial of T3 & encouraged my GP to continue supply via NHS. I only wish training of all thyroid ‘specialists’ was comprehensive & that all with thyroid issues received the same care and could access T3 if Levothyroxine alone does not significantly improve symptoms.

[NIKEGIRL in reply to Buddy195]

That doesn’t sound like an unreasonable request but sadly is not the standard of practice. 😞 when it will change who knows. U gotta take the wins when they come and be thankful always in life. I say that to my children all the time. Be thankful for what u have because it can all be taken away in an instant.

[Handsome14 in reply to Buddy195]

Are we allowed to share details of good endos?

[humanbean in reply to Handsome14]

If you have the name and some details of an endo you've seen that you thought was competent and worth passing on you can't mention them on the forum (there is always the risk that someone might slag a doctor off and the forum might get sued for libel.

What you can do is send the details you have to Thyroid UK (who run this forum).

thyroiduk.org/about-thyroid...

They keep lists of private and NHS endos and doctors who have been good for at least one patient. They get taken off the list again if they are horrible to other patients!

[Buddy195 Administrator in reply to Handsome14]

Only by private message

[pennyannie]

If only it was just a card game and you could reshuffle, cut the cards and start again.

Sending a hug as this simply exacerbates the situation as confidence in the system is all but lost.

[Lalatoot in reply to pennyannie]

Thank you.

[fuchsia-pink]

Well at least s/he didn't freak that TSH is suppressed ...

[Lalatoot in reply to fuchsia-pink]

Love your thinking x

[Tythrop]

And they get paid what?

[Lovecake]

🤣😂🤣

[Lovecake in reply to Lovecake]

Although I know it’s not funny really 🤦🏻‍♀️🙄

[duckegg56]

😱🤯 Wow unbelievable! So sorry you have to tolerate this kind of treatment...sadly it's more common than we think it is. 🤫

[serenfach]

You also have to have a very condescending tone, add "my dear" at the end of your pronouncements and suggest some ADs may be in order, my dear!