Discharged back to GP care

[Jules0001]

Good morning,

I was after some advice…I received a letter from my consultant Endocrinologist today saying that he is discharging me back to my GP’s care.

I have autoimmune hypothyroidism and over the last 6 years have struggled to get help from my GP as they have always looked at my TSH level and said “it’s in range so your medication doesn’t need to be adjusted”.

At the start of this year I was finally referred to the Endocrinologist - he increased my dose right away. I was on 50mcg of thyroxine (for 6 years) this was increased to 75 and now to 100 (as of 27 April). My last bloods at 75mcg showed the increase had little impact on my T3/T4 levels both of which are still at the bottom of the range.

Can he discharge me if I am still experiencing symptoms and my medication is clearly not at the right level? Can I politely request to stay under his care? I finally feel I’m making progress but feel disheartened by this letter…

I’d appreciate your thoughts…🙏 x

[Lalatoot]

Yes he can discharge you. Mine did once she thought I was on an adequate dose even though I was still symptomatic. It meant that I had to keep on at the GP for appts and increases etc. When the GP could no longer cope with my levels just under a year later he quickly referred me again and the endo gave me an emergency appt - my TSH was at 32 by this point with ft4 and ft3 under range. This is when I put 'my big pants on', started reading up on this site and getting pushy with the medics. And it got me the treatment I needed.

[Jules0001 in reply to Lalatoot]

Thanks for your reply Lalatoot. Why does it have to be such a struggle?

[SlowDragon Administrator]

Previous post from 6 months ago

healthunlocked.com/thyroidu...

Showed you were under medicated

Was dose increased to 75mcg after these results

How long have you been on 100mcg

Do you always get same brand levothyroxine at each prescription

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

[Jules0001 in reply to SlowDragon]

Hi SlowDragon, yes… the dose was increased to 75mg in January and increased again to 100mcg in April - it’s too early to have new bloods done yet. I do make sure that I get the same brand - and have had several heated discussions about this with the doctor and pharmacy about getting the same brand each time. My last set of bloods were taken at 08:20am and the last dose of Levothyroxine was 24hours before the test.

[SlowDragon Administrator in reply to Jules0001]

Come back with new post once you get next set of results

If they show you need further increase in levothyroxine see GP for increase

If GP won’t increase….recontact endocrinologist

Important all four vitamins are optimal

Have you had coeliac blood test done

[Jules0001 in reply to SlowDragon]

Thank you. Yes the coeliac test was negative.

[SlowDragon Administrator]

As you have Hashimoto’s it’s very important to regularly retest vitamin D, folate, ferritin and B12

Couldn’t see any B12, folate or ferritin results

How much vitamin D are you currently taking

When was vitamin D last tested

Are you taking any other vitamin supplements

Recommend getting FULL thyroid and vitamin testing done after 6-8 weeks on 100mcg dose levothyroxine

List of private testing options and money off codes

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...

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/

Test vitamin D twice year when supplementing

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[Jules0001 in reply to SlowDragon]

Hi SlowDragon,My endocrinologist requested a full range of bloods and the only one that needed attention was Vitamin D - in the letter he detailed the results for all of the ones you mentioned but not the reference ranges so I need to go back and ask for those. I am now taking 2200iu Vitamin D3 - I am not taking any other supplements.

[serenfach]

In my experience, Endocrimoligists tend to discharge you when their knowledge runs out, your results are not normal and they dont know what to do....