Advice on talking to GP

[BobbyTC]

Hello All

I'm new here and looking for some help. I have all the symptoms of an underactive thyroid but according to my GP my thyroid is perfect! I had some private blood tests done as I can't access the ones at my GP surgery at the moment. Results were as follows:

TSH 5mU/L (range 0.27 - 4.2); FT3 5.5pmol/L (range 3.1 - 6.8); FT4 12 pool/L (range 12 - 22).

Thyroglobulin Antibodies 162IU/ml

Thyroid Peroxidase Antibodies 174 IU/mL

Ferritin & Iron fine, I take supplements

Folate Serum 19ug/L; B12 87pmol/L; Vit D 79nmol/L

I will be seeing my GP in a couple of weeks and would like advice on how to have a sensible conversation with her about thyroid which isn't all about the numbers but more about symptoms. I have a constant pressure in the base of my throat, fatigue, aches and pains, numbness and tingling in toes/fingers/feet, cold feet, weight gain, joint stiffness etc. I initially put many of these symptoms down to menopause but having tried HRT and seen little improvement I assume something else but my GP sticks to the line that it can't be thyroid related. There is a history of hypothyroidism in my family, both brothers have been diagnosed and seen specialists, my mother had the same.

[Regenallotment Ambassador]

those antibodies… your GP needs a firm hand! I am sure the admins will pick this up with their incredible support. But yes, totally, classic symptoms and results to match. Very similar to my early results. Have a good read through previous posts you will learn so much here. Wishing you all the best 🦋💚🦋

[BobbyTC in reply to Regenallotment]

thank you, I’m working my way through past posts. Such a lot to understand.

[DippyDame]

Welcome!

You are absolutely correct... symptoms should be factored into a diagnosis....but sadly, and frequently, they are not!

Please can you edit your post to add reference ranges to those results....these vary from lab to lab

I fear your GP lacks the knowledge to recognise a "perfect thyroid"!

There seems little doubt that you are hypothyroid with thyroid autoimmune disease ( Hashimoto's)

With ref ranges added, members will be able to offer further advice.

You are legally entitled to request test results from reception at your surgery.

[BobbyTC in reply to DippyDame]

thank you.

[SlowDragon Administrator]

welcome to the forum

Is this a private test ?

Was test done early morning, ideally around 9am?

Please add ranges on Ft4 and Ft3 results…..

or say which company did test if privately done

High thyroid antibodies confirms autoimmune thyroid disease

GP will want to repeat test in 6-8 weeks

Meanwhile request GP do coeliac blood test

Two thyroid tests with TSH over 5, plus high thyroid antibodies and symptoms…….you should be started on levothyroxine

Starting levothyroxine - flow chart 

gps.northcentrallondonccg.n...

How low were vitamin levels BEFORE you started supplementing

How long have low vitamins been a problem

How old are you approx

What’s your diet like

Are you vegetarian or vegan

Standard starter dose of levothyroxine is 50mcg

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

Typically dose levothyroxine is increased slowly upwards in 25mcg steps until on full replacement dose

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. 

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range. 

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

[BobbyTC in reply to SlowDragon]

Yes I had the test done through medichecks as couldn't get any sense out of GP, I did as directed early morning.

Vitamins mostly ok, although previous problem with low iron, B12 etc, but ok since hysterectomy. I'm 57, not veggie and eat pretty good balanced diet.

Will edit to add ranges.

thank you.

[BobbyTC]

free T3 range = 3.1 - 6.8

free T4 range = 12 - 22

[Catseyes235]

Symptoms are all!! You sound like you have the classic symptoms of being hypo ...I know them well as I’m sure you do. Thyroxine is a cheap med so maybe tell her about your family history and ask if you can at least try some and see if there’s any improvement. Ask if she’s read any of the latest research on thyroid conditions? You could also try saying that heart conditions and strokes are more associated with being hypo ...it can raise cholesterol. And of course take the private blood test results with you!

I wish you luck. Btw what did the private bloody come with any advice? Medichecks do.