Advice re referral for T3 please

[Zadock]

Following recent full blood tests I asked my GP for a referral to an endo in the hope of trying T3 in addition to my levo as my belief (thanks to this forum) is that I'm a poor converter (fairly high free T4 but bottom of range free T3). He consulted one who responded as follows:

'Thank you for contacting us about this lady.

I note that on both occasions, her free T3 and her free T4 are both within the normal range and her TSH is also in the target range of 0.2-2.0 miu/L, suggesting adequate thyroid hormone replacement.

These results suggest that T3 replacement is not required as per the biochemistry.

Starting T3 runs the risk of over-replacement of thyroid hormone and the associated side-effects. I do note that a recent DEXA scan shows evidence of osteoporosis at the spine, so we would ideally avoid T3 if possible.

Kind regards, '

So - what next?! My GP says I can self-refer privately to a chosen endo whereas he can only refer to a particular hospital. Do I simply try that or do I do more to try and improve my GP's understanding of the problems?

I've been on 75 levo each day for a few years.

Grateful for any advice.......

[fuchsia-pink]

Have you got your latest blood results [and related lab ranges] to share? There's a WORLD of difference between struggling along at the bottom of the lab range and being optimally medicated.

And your GP is WRONG. You don't need to see the nearest endo (who sounds woefully ill-informed about thyroid and is prob yet another diabetes specialist) - so get the list of T3-friendly endos from Dionne at Thyroid UK - [e-mail] - and see if there is anyone reasonably close x

[Zadock in reply to fuchsia-pink]

Thank you so much - yes, I have the list.

[Sparklingsunshine]

Hi

Have you got latest blood tests, if you're only on 75mcg of Levo maybe it's not enough.

[Zadock in reply to Sparklingsunshine]

Yes - thanks. Here they are:

TSH (0.27 - 4.2) 0.44 mlU/L

Free T3 (3.1-6.8) 3.53 pmol/L

Free Thyroxine (12-22) 20.6 pmol/l

Folate serum (>2.9) 15.84ug/L

Ferritin (13-150) 58.7ug/L

Vit B12 - active (25.1-165) >150 pmol/L

Vit D (50-200) 133 nmol/L

CRP HS (0-5) 1.75 mg/L

Thyroglobulin antibodies (0-115) 30.2 IU/mL

Thyroid Peroxidase Antibodies (0-34) 172.0 IU/mL

[SlowDragon Administrator]

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3

...NHS and Private

[e-mail]

Meanwhile

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Have you had coeliac blood test done …..or are you already on strictly gluten free diet

If not already on strictly gluten free diet get GP to do coeliac blood test BEFORE trailing gluten free

What vitamin supplements are you currently taking

Vitamin D, folate and B12 are good

Ferritin could be better.

[Zadock in reply to SlowDragon]

Thank you so much! Yes, I have Hashimotos and already have the Thyroid UK list but wasn't sure if I needed a GP referral? I am gluten free and am not coeliac. I've been taking Vit D, multi B, K2, selenium and magnesium so have tried to optimise vitamin levels prior to doing the latest tests in the hope it raised my T3 which it barely did. I eat liver every week but not sure how to improve Ferritin.

[SlowDragon Administrator in reply to Zadock]

Roughly where in U.K. are you

Many endocrinologist are currently doing consultations on zoom, so distance no object

Some private endocrinologist require letter of referral from GP ……but a private consultation that’s pretty much a formality

[Zadock in reply to SlowDragon]

Thank you - I'm in Yorkshire but as you say they can be anywhere if it's a Zoom consultation.