I saw my GP today. He was quite happy to give me a blood test request form that says that my thyroid, Vit B12 and folate should be tested. But even though my most recent Vit D test results - 3 years ago - were low, said he wouldn’t ask for Vit D test for me because GPs are being asked not to measure Vit D now.
He said that we are all advised to take Vit D supplements from October - April.
I can’t understand why this would be. Medics seem - with each passing year - to understand more and more that Vitamin D is not just an important marker of health because deficiency causes symptoms but vital as preventative of some diseases, too.
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The guidance says GPs can ‘reduce non-essential (non-clinically urgent) testing’ including stopping vitamin D testing except in exceptional circumstances and deferring routine infertility testing unless the patient is over the age of 35.
Vit D tests have been refused long before the blood tube shortage.
I've never asked for a Vit D test but some members have said they have and it's been refused due to it being an expensive test or because "everyone is deficient in Vit D so there's no point in testing" which beggars belief because if everyone is deficient they they need to know their level to know what dose to take.
I discovered my own Vit D deficiency by self testing and have addressed it myself, and I am happy to continue monitoring it with private tests (with the lab that Helvella has linked to).
Maybe because vit D is a test NHS pte labs do is the reason it's on the list or is that too cynical? Privatisation of NHS. Like you, we generally get privately.
I also agree that tests (not just D) were stopped before tube shortages. Dad's were all cancelled at almost zero notice in January - apparent reason being "clinical need"! Should be interesting in 2 weeks as he's arranged another test but they didn't ask for required tests (despite his prompt). So can't see how they can cancel with same reason.
That seems to be the way we are heading doesn't it? Pay up, or don't ask for a test. But when you think about the whole Covid thing too, why can't the NHS use just the pin prick test. If they can supply it privately, they should be using the same finger prick test to save on glass alone as a matter of routine.
Absolutely, since pte NHS lab can do pin prick, NHS directly could/should. No surprise the private labs are more innovative. Unless of course that helps the selling (avoids needles)?
But I think this is an NHS lab. That is why I get upset. They are already doing 4 drops of blood tests privately in an NHS lab anyway. So why can't we get those through our GP, instead of stopping most vitamin D tests wholesale anyway??
If there is a test tube shortage why are the nhs happy to do the test privately........oh I see thats a finger prick test so doent require a tube........but of course the nhs GP route hasnt got the sense to do the vit D test that way - that explains everything!!!!!
OMG......why oh why......cant they do that instead then....that was what I was saying. The NHS is very stretched but they are also archaic......and so slow to modernise their systems/approaches!! There answer to a oot of things is to ban this and that without really looking for proper solutions. One cant help feeling precious money is wasted because of this and the nations health suffers......despite the dedication of many medical staff. As for GPs they have become nothing more than paper pushers and as far as I can see practically no clinical work is involved. They follow their screens and refer on or tell you all is well even if it isnt. I despair. In all honestly I can see that Robots will replace them if they dont wake up and start doing proper clinical evaluations/examinations. A computer screen can only do so much!!
Sorry Slowdragon will get off my bandstand now! 🤣😂🙄
I thought we already did via National insurance! It’s only free or it used to be at the point of delivery, but we are all paying for it….& getting a pretty raw deal if you ask me. I doubt it will ever be done as a routine test by the NHS after this convenient glass phial shortage. Very annoying to know it can be by finger prick at labs used by NHS. It has to be penny pinching. How this is helping the nation’s health is beyond me, I can only conclude that noble aim has been wholeheartedly abandoned.
Well yes, we did, I worked and I have had 2 husband's who always worked and were fortunate that we never had to rely on the state, in fact my first husband has only just retired at the age of 71!
But we have to pay for our blood tests, the NHS is in limbo.
GP's still don't want to see or hear from a patient, they just want to take the money and hide in the surgery.
I haven't even heard anything about flue jabs yet this year! But I am sick of it all.
Yeah the service is being cut in all the wrong areas if you ask me. My thyroid health care has been poor on balance due to lack of choice of thyroid hormone therapy, inadequate blood testing and slow diagnosis, but it did save my life, so I have a lot to be thankful for the the one GP who listened and took decisive action plus a very good endocrinologist. I did get an invite for a flu jab from Lloyds but when I booked on line, the calendar days and dates were not correctly matched and I ended up with an appointment in the week when I wanted a Saturday. It was a right palaver to cancel it. I couldn’t face that faff again. I am waiting for a surgery invite, it was very efficient last year and available on a Saturday, but who knows if they’ll run it again. My surgery is fantastic really helpful and efficiently run. I’ve had a couple of problems that could have developed into something serious if left untreated and they were immediately on the case when I called them. I never saw anyone in person but I was impressed with what they achieved for me. You can always get through to them on the phone, which really helps. They got awful reviews on line but I have found them to be excellent. They don’t even hassle me for taking NDT.
I wish I felt that way about my GP. But this time last year I had had my flu jab by now, so I have no idea what is happening this year with that. They are usually very good at that sort of thing, but you can't get to see a GP, everything but that.
I was diagnosed hypo in 1999 and have never been referred to an Endo at all.
I have had to treat myself and it is this Forum that has allowed me to get better by treating myself. I don't think I would be alive now if I hadn't decided to just jump in to the deep end. It was scary, but worth it.
I was so ill by the time I was diagnosed, plus there was a history of rare thyroid cancer in the family, that I was referred to an endo by my then GP, who was brilliant. It took ages to get optimised. I was lucky to get a good one. I had to resort to NDT to feel fully better, off my own bat. Like you I think the forum was a life saver because I felt so dreadful on Levothyroxine and was at my wits end with it. Although the endo was very good and followed the Toft approach for optimisation, I was never considered for combination therapy which I should have been given my blood test results. I had low free T3 in comparison to the other hormones. I didn’t even know about it to ask. My relatives on Levo all felt great so I didn’t even know there were other options. I knew something wasn’t right in my case, they got better really quickly. I was never told about the options at the hospital which I feel was negligent of them. Perhaps they never offered it to anyone. But back then it was not such an issue to have it as it has become.
We’ll have to wait and see re these flu jabs I’d rather support the NHS providing it than private businesses like pharmacies.
Hi, now you have done it, I have never heard of the Toft approach! Something else to research!
Yes, I am much better on T3 alone, but I still hanker after trying NDT. I can't stop myself from thinking that that would be better than synthetic T3 alone for me.
I never got on with synthetic HRT either. My mother was great on it, but I couldn't get along with it, though you see, menopause and low thyroid both arrived at the same time. I had started the menopause at my mid 40's and had battled with that, then in 1999 was diagnosed hypothyroid. No one joined up the dots, much less me.
Anthony Toft is an eminent endocrinologist and surgeon to the Queen when she’s in Scotland. He is retired now I think but aimed for a TSH between 0.2-0.5 and free T3 and free T4 in the top third of the range is the area where most feel well on Levothyroxine. But he recognises that some still do not feel well and says there’s leeway for TSH to be suppressed as long as other parameters are met which I can’t remember. He also believes some people need combination therapy and will never be well on Levothyroxine alone. People like us. Pulse had an article where he answered questions and question number 6 is where he states all this. Admin can give people copies to try and fight the ignorance encountered in so many GP surgery’s and Endocrinology departments regarding optimisation of dose.
I think he had a bit of a sea change in his ideas and is now very forward thinking, where once he was not. Some say retiring allowed him to speak out against the current blinkered approach that’s holding our health back.
It’s possible. But I got the impression that over time he realised that t4 monotherapy was less than satisfactory for some patients by simple observation and listening to them and believing them. No doubt the entrenched backward opinions of many powerful endocrinologists would make speaking out against the supposed “gold standard” treatment a tad difficult.
helvella suggested I lie down with my head lower to get the blood out after I failed to get more that two drops out despite doing lots of exercise a shower and stroking my arm and all the other things they advise. It worked a treat ☺️ Full phial no problem. I think we called it the downward plank!
No, that is the point, you only need 4 drops of blood and it goes onto a card within a marked circle I assume. You don't have to put blood into a vial, which is why I can't understand why the whole of the NHS doesn't do this test. Saves blood, saves glass!
Thanks all. I’ve never heard doctors say Vit D was banned before.
It makes sense not to do non-essential blood tests now, given the shortage. My practice has a 10 day waiting list for patients to get a blood test time - working through their backlog of patients. You have to go to hospital to get tests done sooner.
I remember my sister (a doctor) saying that Vit D deficiency is so common in some london hospitals that doctors assume almost everyone is deficient. But didn’t realise some don’t test at all.
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
No my GP was testing my vit D level every two years so it was not banned......given that it is possible to over medicate on vit D.......& the tragic consequences of one GP who prescribed in ordinately high doses, I wouldve thought a finger prick test was the solution now and for the future......also far cheaper as you dont need a nurse to do it......
I asked for my vitamin D to be tested before a consultation with the endo , in May this year ( long before the tube shortage) and I was told the it was no longer routine because "most people are deficient anyway" this was not accompanied by any advice to supplement it. The phlebotomist said she would ask the doctor to sign it off as I said it was necessary to give the endo a full picture of nutrient levels alongside thyroid hormones.
Fortunately it was done.
I can't believe it is so very expensive when other tests are being done.
You certainly do... I can't help but think that if they'd tested patients vitamin D status at the start of the covid pandemic and subsequently boosted people who are low or deficient we may not have incurred such a high death rate and such serious illness over the last year which would have been better for both the people who caught covid and the doctors and nurses treating them... but hey what do I know !
Is that what they give you when you turn 40?It was a set of basic blood tests - but ones you would not necessarily had before at that age, eg. cholesterol - and maybe a blood pressure test.
I've never been offered a routine wellness screening
It's offered by NHS England for 40-74 year olds. My brother has had these every 5 years since he was 40 and it picked up Atrial Fibrillation of which he had experienced no symptoms.
Wow, I guess I've never been invited for a screening because I can see a record that just says 'essential hypertension' when I was age 45 (and probably earlier)..........it wasn't treated until I had a heart attack aged 53 though. I don't get 5yr checks on my heart. I did ask for an ecg after the kidney injury earlier this year, and they happily agreed to do it, but its the only one I've had since the MI. Maybe I need to ask more.
Presumably a GP picked up the AF by stethoscope? I'm glad the screening worked for your brother.
So, it seems that if you are well, they'll invite you for an ecg every 5 yrs,
Yes, you get an "MOT" every 5 years if you are healthy, it's a "health screening" to try and pick up certain conditions that are common in older age.
but if you have hypertension and had an MI they don't.
Not exactly, because if you already have any of the conditions they list (which is what they are looking for with their MOTs) then you should be getting treatment and regular check ups for them anyway.
If it makes you feel any better seaside susie I live in England amd have never been offered such a blood test. .....and according to that info I shouldve had several by now! 🙄😥 Still, like a lot of us on here, have learnt not to rely on the nhs for good health.......do so at your own peril.
The latest nonsense is that I was fast tracked three weeks ago still not been seen. Am I worried? - not really as the GPs are using fast track routes to avoid having to examine patients themselves. I know the cause of my symptoms but the GP wont listen to me or examine me so I have become one of what I suspect is many clogging up a system that is meant for urgent patients. Come on GPs start doing your job and see/examine your patients again!! The government says we ALL have to start living with COVID19!!
They tell you you have high blood pressure and put the fear of god into you. It is normal to have blood pressure rise with age. Thankfully mine’s not treatable (diastolic too low 🤣🤣🤣) otherwise they’d be shovelling statins down my gob like jelly babies. Then you hear your cholesterol is too high but only the good cholesterol, the bad cholesterol is fine. I was back and forth for blood pressure tests that were enough to give me high blood pressure. I did not find the health check of any value but clearly others do. For all the stress it caused me I wish I had never done it. I am still here despite it all.
Additional testing and clinical follow up, for example, where someone is identified as being at high risk of having or developing vascular disease, remains the responsibility of primary care and will be funded through NHS England.
The heart history in my family is pretty horrendous (parents/grandparents/uncles) on both sides so during the consultation my brother would have been considered high risk and he does have an excellent GP with whom he has a very good rapport.
No it wasn’t. I had one a long time ago, due to heart pains - abnormal 😱 I was referred to a heart hospital had an exercise stress heart scan and was told there was a problem with one chamber, it was something women of my age got due to hormones and of no consequence 😳. I’m sure it was of consequence and was being caused by my undiagnosed thyroid disorder. Never been offered one again despite complaining for years of angina which reached its zenith on Levothyroxine. It has improved massively on NDT but I do still get very occasional episodes.
All I had tested was blood pressure, I was weighed, they checked for cholesterol and diabetes. I think that was it. Even though I had high blood pressure I was not given an ecg to check my heart was in order or to see if my women’s heart problem had now resolved.
A few relatives have dropped dead of heart attacks on both sides several were about my age but I reassure myself as at least it’s quick! I’ve had 8 years of pretty good bonus time already so can’t complain if the grim reaper gets his scythe out.
"but I reassure myself as at least it’s quick" Me too, Most GP's don't have a clue how to read an ecg anyway............same as most know diddly squat about thyroid function.
Ah, Maybe. I don't remember being tested, but it would have been 20yrs ago. My online blood results only go back to when I was diagnosed hashi's in 2007.
I’ve been told for years they won’t test it due to it being ‘expensive’ and everyone being deficient too. I’m sure a bunch of people walking around deficient and ill is a hell of a lot more expensive…
Told by a neighbour who is the parent of a medic married to another medic that they and other doctor friends are scrabbling to get private health insurance for themselves.
The new social care NI tax is going to go straight into the NHS, not social care. I just hope it is enough to stop the whole lot sinking.
As SlowDragon has said I was told similar once they’ve done a vitamin D test and you supplement it doesn’t need checking regularly.However how they know that your levels are adequate never mind optimal is any ones guess.
I have had similar attitude placed on B12 but to be fair my B12 is excellent now with 3 monthly jabs, vitamin D however fluctuates and I now take the Better you 3000 D3&K2 I’ve not been tested whilst on this yet.
I asked my gastroenterologist to make sure all my tests were done annually after being messed about with some being done some not, he put to my GP if they cannot do these tests to refer back to him (gastroenterologist) and he would take care of these annual reviews.
I was told by practice pharmacist they’re an expensive test but I have no idea.
My gastroenterologist said I only required an annual review, that saying my Vitamin D levels were better then after loading dose and months on maintenance dose.
Who is recommending this ... I’m always sceptical if money is involved, regardless if it’s an approved company. There’s nothing stopping anyone being told one thing then the other to keep tugging at the purse strings.
If someone has a condition that requires these tests NHS should do them, however we do know the levels are not necessarily what we all feel better at and we all seem to be getting a varied outcome from our surgeries and our healthcare professionals regarding testing and more places are popping up to fill in the gaps in these areas.
There’s a lot of money being made from people, who are not getting their needs met at the GPs surgery unfortunately, but these places should be regulated.
If I’m not satisfied with how I feel and my levels are within guidelines and my GP thinks this should be fine... I ask if I go and have a test which I’m willing to pay for firstly do they know a reputable company and will they act on it if it’s different to theirs or with added information as in full thyroid panel.
If you want NHS to sort the long term conditions out for you then you have to have your GP on board at each step really.
Unless you’re completely going private without NHS intervention then thats totally up to you, most consultants do need a referral letter, which can be both blessing and curse.
Some blatantly ignore patients needs others if you put your needs to them should oblige.
Consultants that don’t need a GP referral I’d question as who knows what treatment & tests you didn’t need but it’s out of your pocket.
In the Netherlands - a friend who lives there tells me that - when you need to see a specialist you make that choice - it doesn’t need to go via your GP. They aren’t famed for having an expensive health care system - and have a very pain meds free approach to eg. child birth, so aren’t big on giving out too much medical help - so I wonder how they manage it. They have a national health insurance system which you pay into monthly, like in some other European countries. I don’t know whether you pay an excess and the state pays the rest.
Money and who wants to make it is the root cause of all things health, in my opinion.
GP's get paid just the same for not seeing patients, so why would they bother having a surgery full of patients who want to be seen? It's a no brained.
I thought it was because they've told everyone to take Vitamin D during the winter months as I recall something being said about low Vit D levels being more susceptible to covid. Mine is always low so I supplement anyway in the winter, but my GP always orders a Vit D check when I get my thyroid levels checked.
Yes, that is why I thought it was a backward step, not testing Vit D levels, because there was news months ago saying that decent vit D levels helped with Covid patients and recovery wasn't it? Or have I got it the wrong way around? But now that is all forgotten??
Here in Wales the labs are following a policy outlined in "Prudence Wales" and will not test for Vit D unless you are diagnosed with osteoporisis. Several years ago it took my GP 3 goes to get mine tested - it was 7. I think the range starts at 30. She gave me a prescription for some sachets of chalk which did not mix with water and stuck to my teeth for hours. I bought my own.
I got a list of vitamins tested last year through my GP as well as TSH, FT4 &FT3 The only one I didn't get was Selenium, which he said wasn't available on the NHS. I supplement with that anyway.
I suspect that this may have been because this was the beginning of me becoming very stroppy and he may not have wanted to refuse my requests. It hasn't stopped him refusing a lot of other things though.
Cost cutting, assuming most will be deficient.Get it done privately. Won't cost that much about £60 and will give you information to base any supplementation required on.
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