Recognising Hypothyroidism as a disability at work

[Mandica]

Hi I’m in desperate need of some help… I’ll try to keep it as short as possible but I was wondering if anyone has any knowledge of under-active thyroid being recognised as a disability within the work place - and if so how I can go about this whilst working for the  the Local Authority.. I was taken off t3 medication around 4 years ago - I’m now on T4 only medication and refused t3 by doctors and a private endocrinologist .. Within those 4 years I have had a reoccurring throat infection ( it’s hard to get antibiotics for this as I have no tonsils to show an infection) - it then turns into an ear infection before a doctor will give me any antibiotics and by that time the infection has taken a big hold and I’m extremely poorly. I find it takes me 2 - 3 weeks to recover properly and return back to work.. I feel this is because of my thyroid and menopause (age probably) this has been around winter time for the last 4 years. Unfortunately I do not have a very sympathetic employer and they have decided to take me down a disciplinary procedure for my absences. My boss has taken a very passive aggressive attitude with me - sort of like punishment for being Ill  and Absent from work. This is very worrying.  Any advice is much appreciated .. thanks in advance. 

[BiscuitBaby]

Hi MandicaI'm sorry you are having a bad time at work! It makes everything so much harder to deal with. I have no personal experience of this but you should have access to occupational health who should be able to advise you. ACAS is a good place to start with regard to your rights in the workplace. They have a helpline as well. I have also made sure that my employers have plenty of record of my limitations and I have asked for it to be recorded in my supervisions that I can't handle the amount of workload and stress I used to. If the *@!t hits the fan I can refer to this. I really hope someone can help with more practical advice for you!

[shaws Administrator]

I think I would make a consultation with my local MP and tell him that you used to be prescribed T3 the Active Thyroid Hormone also called liothyronine but now only get prescribed levothyroxine (T4)- an inactive Thyroid Hormone.

T3 enables us to function and levothyroxine (T4) (is an inactive hormone supposed to convert to T3 . T4 doesn't always improve some people's health). We have millions of T3 receptor cells and the brain and heart contain the most.

You now feel you are being targeted at work as not doing your job properly and you are very worried.

T4 being inactive and has to convert to T3 but doesn't always do so effectively. Few doctors will prescribe T3 as do some endocrinologists.

In the past year, T3 seems to being prescribed more often to patients. Some Endocrinologists still believe that because it is more expensive they will not prescribe.

[SlowDragon Administrator]

Roughly where in U.K. are you

It is getting easier to get T3 prescribed alongside levothyroxine, now price has dropped considerably

59,000 prescriptions in England in last year

Increased from 57,000 in last 18mths

Typically 6 prescriptions per person per year

openprescribing.net/analyse...

Suggest you get FULL thyroid and vitamin testing done before booking a consultation for T3 to be reinstated

Before getting back on T3 you will need to get all four vitamins tested and improved to optimal levels

And see where Ft4 and Ft3 levels are

You may need dose increase in levothyroxine first

Do you have any recent results?

How much levothyroxine are you currently taking

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

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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

Do you have autoimmune thyroid disease?

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 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

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

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally before 9am

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 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

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/

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]

[Aurealis]

I am sorry that you’re in this position. I have experienced this at the hands of a local authority. It’s very threatening and very unhelpful to your health.

Ask for a written copy of the full disciplinary procedure that LA claim to be following (and almost certainly, they’re not following it properly). Keep written copies of your request.

Check where on the procedure referral to Occupational Health is mentioned - probably as an option?

Keep detailed records of meetings, dates etc and always have someone with you at meetings to take notes (union rep or family member for instance).

Go to GP and ask for referral to endo, explain you will be dismissed and wish to retire on grounds of ill health and will require his backing and endo backing for that. Hopefully that will be the key that opens the T3 cupboard.

At work, do your best to comply without exhausting yourself. Be a slightly less hard working employee than you were, to conserve some energy for their nonsense.

It’s very cruel. Hugs to you.

[Catfur]

Hi Mandica, sorry to hear this about your employer. I have been in a similar situation myself. I would definitely make sure you have a current copy of your employers sickness/ absence management policy. As well as their disciplinary and grievance policy. Normally these policies will refer to one another and are useful to have. As someone else has said they will probably not be following it correctly and thus will be grounds for an appeal if needed at a later date.

It’s my understanding that a disability can be a physical or mental condition that has impacted your life in a adverse way and has a long term effect.

They should send you for a occupational health review which can make recommendations to your employer on how to adapt your workplace/ environment to support your attendance in work.

If your employer decides to recognise your hypothyroidism as a disability they have to make reasonable adjustments to support you in the workplace. This would have to be agreed between you and your employer.

Wishing you luck 🍀