Update and thanks - oh and pharmacists!

[Dandelade]

Hi all,

I’ve just had a medication review with a pharmacist and have had an increase to 125mg of levothyroxine from 100mg. They were amazing and overruled the doctor.

TSH 3.23 (0.27-4.2)

FT4 18 (12-22)

FT3 4.37 (3.1-6.8)

She listened to how symptomatic I was, accepted the medicheck results (NHS tested TSH only), I had my script ready using all of the wonderful information from this forum and she agreed to increase in dose. Then said I just need to check with the doctor. At which point my heart dropped. Came back and said the doctor says not to increase as you’re in range, symptoms must be something else like menopause. Before she got to the end of her sentence, she stopped and went, but aren’t you only 42? Yes I replied and having a normal period at the moment. I’m going to increase the dose anyway, she said, as you’re in range but still symptomatic.

Thank goodness it was the pharmacist and not doctor! Thank you to anyone who has ever given me advice or replied. I feel amazing on the new dose (I mean I know it might not last once my body gets used to it but hoping since I’m so close to recommended dose going by weight and 1.6mg per kilogram that this time will be alright).

Seriously, I feel I have my life back. Thank you!

[tattybogle]

Well done that pharmacist

[Capella1]

hey, dats great for you😀.

but Will they be their next time or will doc change script now do you thnk?

[Dandelade in reply to Capella1]

She’s already put an appointment in her diary for review in three months time with her 😃😃😃

[SlowDragon Administrator in reply to Dandelade]

Perhaps she’s a member of this forum!

Well done 👏

[Dandelade in reply to SlowDragon]

You, amongst others, were brilliant in guiding the way to communicate effectively. Thank you!

[PrincessAnnie]

Oh that’s good to know👍What a great pharmacist,I could honestly do doctors physical harm at times and I’m not a violent person.I hope you continue to go from strength to strength😁

[raglansleeve]

That's so wonderful, but I didn't know that pharmacists could authorize an increase on their own. Wow!

[Marz in reply to raglansleeve]

I have a feeling we will be reading this more and more as changes with GP's in the NHS take place. It sounds positive .... it's just a feeling - no concrete evidence !

[Alanna012 in reply to Marz]

Hope you're right!

[DoeStewart]

Such good news for you, she actually listened to you - Wow !!. I know there was an article pre-covid that mentioned putting a pharmacist in each GP surgery to do medicine reviews but I think this was to remove medicines from patients and maybe replace with a cheaper option or something you could purchase yourself. I have never understood why more pharmacists aren't prescribing , they are as knowledgeable as the GP. Such a great result for you, I hope you obtain good health with your increase.

[helvella in reply to DoeStewart]

In general, pharmacists do not have access to our medical records. Which places a severe limit on what they could safely do.

Also, I am not aware that pharmacists can get recorded in our records changes they make such as this. If they don't do so, the records could be misleading to any doctors in future.

[DoeStewart in reply to helvella]

Hi Helvella, your correct, pharmacists don't have access to your medical records. The idea was to put a pharmacist in each GP surgery for a couple of days a week to do a medication review, I know some surgeries have this in place already. Obviously if they are in the surgery they would have access to all your medication records just as we did in the oharmacy and could update your records on the system.. of course a lot of pharmacies are now in the same building as the GP's.

[helvella in reply to DoeStewart]

I have only ever used one in-surgery pharmacy in a very small town miles from any other pharmacy.

I am a touch unclear here. Would the pharmacist in the GP surgery have access to the pharmacy records, the GP patient records, or both?

[DoeStewart in reply to helvella]

I would imagine it will be both. We have a number of prescribing pharmacists in our area who work out of their own pharmacy. I presume they have access to medical records as they are able to prescribe antibiotics and obviously need to see any allergies or other medication reactions

[tattybogle in reply to helvella]

I think ? the 'pharmacists' who we are increasingly hearing in posts are adjusting doses , are not the pharmacists who work in the chemist shop . (regardless of whether the chemist shop is inside or outside the surgery) In my 'health hub' (massive fancy new surgery building with a chemist shop in it), the pharmacists definitely didn't appear to have access to GP records ~ just their pharmacy records ~ (which they didn't bother to read)

are some surgery's employing 'pharmacists' to do medication reviews etc. in which case presumably they would have access to GP records ? .

some surgery's seem to have 'nurse practitioners' doing it.

[helvella in reply to tattybogle]

Yes - if the pharmacist is in the surgery on that basis, would they have access to the pharmacy systems? Or just the surgery systems? Or both?

I think we need to get this clear because there any many issues.

[Alanna012 in reply to helvella]

Last year when doctors weren't having face to face appointments I got a spot of what I suspected was gout in my toes. Quite painful. Anyway I was given an appointment with the GP stand in pharmacist. He prescribed naproxen and sent me for blood tests which included Rheumatoid factor, CRP, Liver protein and something else I can't remember. I was surprised by authority he had to do this. He clearly had access to my records.

[Dandelade in reply to helvella]

Hi there, she was based in the gp surgery and definitely had access to records she was scrolling back and finding results from November, then she was saying out loud what she was typing about the conversation we had. I wonder if this is the new thing to relieve pressure from gp’s? She did say I was her first levothyroxine review. I was very dubious she would be able to increase the dose and review reading but I was very mistaken!

[SarahJane1471]

👏👏👏👏👏👏👏👏👏👏

[Ellie-Louise]

I thought a pharmacist had to dish out what is on a prescription. How could she increase it?

[radd in reply to Ellie-Louise]

Yes, me too Ellie-Louise, and considering the fuss they make when there is/isn't a stipulated brand or the brand name doesn't match the exact amount prescribed, it is surprising they can do this.

But really pleased she has Dandelade 👌

[radd in reply to radd]

Ellie-Louise & Marz

Haven't read all this but ...

rpharms.com/Portals/0/RPS%2...

'PRINCIPLE 15

Changes in medicines legislation must empower pharmacists to use their professional judgment to improve patient care'.

[Dandelade in reply to radd]

I was telling my tale to a friend who is apparently going out with a pharmacist (I’m a bad friend who didn’t know this). Anyway, she says yep, the jobs in gp surgeries are really competitive (I’d imagine the regular hours), and they can overrule doctors if they think they are wrong as they have an overview of all medications prescribed in case they interfere with each other. I mean that wasn’t the case with me but I’m not complaining!

[radd in reply to Dandelade]

Dandelade,

Yes, my old father-in-law (bless him) used to sleep all the time and have med after med just added to the bottom of his prescription.

When after years & years they eventually did a med review they discovered many of his meds had drowsiness as a side effect with one med compounding the effects of others. He literally slept his life away.

[Dandelade in reply to radd]

That’s so awful and I’m sure there are many more out there too. I’m never going to underestimate the power of a good pharmacist again!

[radd in reply to Dandelade]

Nor me!

Mind you doctors are so flipping economical with our meds now days, we would never have the chance to be comatosed by an overflowing medicine cabinet and ever expanding supply of meds added to bottom of our prescriptions.

[Otto11]

I’m really pleased you’re feeling better. I’m in a similar position currently as I’ve been so unwell with severe fatigue since November. My GP hasn’t seen me but did bloods for ferritin folate etc which were a bit low but never thought to do a Thyroid check & it hadn’t been done for a year so I requested it. I’m on 75mcg Thyroxine & extra 25th at weekends. My TSH is 3.4 but GP says it normal. So have arranged a private blood test next week. We use Boots for our prescriptions but doubt they can overrule our GP’s. Can I ask where your pharmacist is based please. X

[tattybogle in reply to Otto11]

Hi Otto11 Re. the TSH 3 being 'normal' so no increase from GP:

please see my reply to this post healthunlocked.com/thyroidu... (4th reply down)

It gives 4 or 5 references advising GP's to keep TSH below about 2 ish .... perhaps put them under your GP's nose

[Dandelade in reply to Otto11]

I hope you have some luck soon, it’s awful in the beginning but keep asking questions. Experienced people like tattybogle guided my path and you will get there eventually.

My pharmacist is based in my local gp surgery in Sunderland! I’m envisioning a flood of new people signing up here 😂

[Otto11 in reply to Dandelade]

thanks for that. We have a pharmacy at our GP's but we prefer Boots so guess we wont have that option. Glad you got the help you needed though. x