writing a letter to the gp

[malohant]

Hi all

Haven't been on for a while (sorry) but I'm writing a letter to my GP and hoped someone might be able to help... I have a completely unsympathetic GP but managed for a while to see a different GP who, while not great, at least listened to me - but they've now stopped me seeing her. In response I am writing to the surgery to express my dissatisfaction and want to give it to them belt and braces - that I know what I'm talking about, that they have consistently not supported me in trying to manage my condition, that I want a referral to an endocrinologist and I won't stop requesting it until it happens (using the RMOC Lio prescribing guidelines to back that up) and that for some people T4 just doesn't restore a decent quality of life.

I wondered if anyone had a reference to an article citing the (usual) optimal levels of T4 and T3 for hypo/hashi's? I seem to recall it's something like T4 in the top half of range and T3 around the 75% mark (but I might be wrong!)

Also any article around T4 not working for people.

TIA

Mx

[Lalatoot]

Malohant please be aware that even if the GP had agreed to refer you to an endo that doesn't mean that you would get an endo appointment. The endo decides who they will see and they can refuse any referral by a GP if they don't think it merits their attention.

[malohant in reply to Lalatoot]

Thanks Lalatoot , Yes I am aware, that's partly why I want to put my case as clearly and strongly as I can to my GP. I know this is likely to be a long and painful process akin to bashing my head against a wall but I have to try.

[HashiFedUp]

You could make reference to the NiCE guidelines in the treatment paths of hashimotos patients. Have you read them? The treatment path tells GPs what they should be doing if a patient does not feel better after standard levothyroxine t4 supplement. You need i would suggest to make reference to it, highlight the relevant parts, and include it in your appendix!

[malohant in reply to HashiFedUp]

Ah yes of course, how did I forget the NICE guidelines! Thanks HashiFedUp