What I need to do to be refered to an endocrinologist?

[Lauraf82]

My GP doesn't refer me to an endocrinologist. They say I have an anxiety condition, however, in October my TSH level were below the range, and the GP told me to suspend levothyroxine for one month. After just 2 weeks that I've stopped the medicine, the right side of my neck got swollen. I went straight away to the A&E and the GP there told me to retake levothyroxine. At this moment in time, my TSH levels are above the range and I've been subscribed 25mg of levothyroxine.. I have also discovered that I have nodules and I want to know what is the right treatment, diet and any advice a specialist can give me.

[SlowDragon Administrator]

Standard starter dose of levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Which brand of levothyroxine are you currently taking

Anxiety is common hypothyroid symptom

Essential to test vitamin D, folate, ferritin and B12 plus thyroid antibodies to see if cause of your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s

[SlowDragon Administrator]

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.

Very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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 and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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...

Both Medichecks and BH have offers at moment

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...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.

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 too

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...

Come back with new post once you get results after 6-8 weeks on 25mcg ….highly likely to be ready for next 25mcg increase

Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

[SlowDragon Administrator]

In October my TSH level were below the range, and the GP told me to suspend levothyroxine for one month.

How much levothyroxine were you taking

What were TSH, Ft4 and Ft3 results

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Even if you were slightly over medicated (perhaps unlikely) dose should only be reduced by small amount

[shaws Administrator]

Unfortunately, the majority of doctors have been told not to refer patients who they think may have a dysfunctional thyroid glands to an Endocrinologist.

It is 'assumed' that GPs can do the usual blood tests and interpret the results and prescribe levothyroxine.

Unfortunately for me, even with a TSH of 100 GP phoned to tell me that there was nothing wrong!.

God help those who consult the same person.

If you want to read my 'story' you can click on my name and it will take you to my page.

[SlowDragon Administrator]

Sounds like you have autoimmune thyroid disease (hashimoto’s) and possibly had a slight swing in levels

Come back with new post once you get FULL thyroid and vitamin testing results

[thyr01d]

Hi Laura, you have a right to be referred to an endocrinologist so you can insist, in a very nice way of course. They are not all good though!

[Lauraf82 in reply to thyr01d]

Yes. Unfortunately is 6 months that I have this problem and I feel I cannot work, study, do sports because I cannot focus and with nodules is even worse. Is only adding more panic

[thyr01d]

Best of luck and if you don't find an endo who helps you keep posting and the good people on here will help.