I’ve been struggling with under active thyroid for about 30 years or so. I saw an endocrinologist in the beginning and he suggested I had Hashimotos but it has never been mentioned again. I’m at the end of my tether with constant exhaustion and wanting to make the most of whatever time I’ve got left I’m now seeing an endocrinologist for the second time in my life, next week. I am using my private health care. My GP kindly wrote a referral letter admitting the NHS can’t do as much for this condition as private health care! What I’m asking is what should I be sure to tell or ask him, so I can make the most out this precious appointment please? (Does having different makes of thyroxine make a big difference.)
Appointment with Endocrinologist : I’ve been... - Thyroid UK
Appointment with Endocrinologist
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In an ideal world you should get FULL thyroid and vitamin testing done BEFORE booking consultation
There’s probably not enough time now to get tested before you see endocrinologist
Was this an endocrinologist from the Thyroid U.K. recommended list?
Most endocrinologists are diabetes specialists and useless for thyroid
Vast majority of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
U.K. medics never call it Hashimoto’s
Technically it’s Hashimoto’s if there’s a goitre
Ord’s thyoiditis when thyroid shrinks and shrivels
Both are autoimmune
First thing is, do you have any actual blood test results?
if not will need to get hold of copies of ALL previous test results from at least last 5 years, to take with you to consultation
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
Link re access
healthunlocked.com/thyroidu...
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Far too often only TSH is tested and is completely inadequate
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Also EXTREMELY important to test vitamin D, folate, ferritin and B12 at least annually
What vitamin supplements are you currently taking, if any?
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Which brand of levothyroxine are you currently taking
Do you always get same brand
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
List of hypothyroid symptoms
thyroiduk.org/if-you-are-un...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
About 85% of Hashimoto’s patients benefit from strictly gluten free diet
If still eating gluten get coeliac blood test done BEFORE cutting gluten out
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Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private
tukadmin@thyroiduk.org
The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2
When adequately treated, TSH will often be well below one.
Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
20% of Hashimoto's patients never have raised antibodies
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies