blood tests.Who is thick, me or the doctor?

[fiftyone]

When I have routine blood tests and results come back 'normal', ie within normal range, the doctor never suggests any action. However, when I look back at the 'history' I often see that vitamins, hormones etc. have dropped off a cliff .. .yes, still in the normal range ...just...but rapidly on the way down. Why don't doctors pick this up. I invariably have to point this out and suggest that maybe some action should be taken. Anyone else found this?

[greygoose]

Because they do not know how to interpret blood test results. They believe that anything within the range just has to be good. They have no idea how ranges are arrived at, nor that they are just a rough guide. Show your doctor a copy of this article, and see what he says:

The normal range: it is not normal and it is not a range

pmj.bmj.com/content/94/1117...

[DippyDame in reply to greygoose]

Helpful link greygoose ....been looking for this info.

Thank you!

[greygoose in reply to DippyDame]

You're welcome.

[Regenallotment in reply to greygoose]

my GP is going to love me correcting her talking about ranges with ’reference interval’ and normal in the statistical distribution sense 🤣🤣 this is genius. 🙏 thank you for making me smile 🦋💚🦋

[greygoose in reply to Regenallotment]

You're welcome.

[Jazzw]

I suspect many of them simply don’t know that in range often doesn’t mean optimal.

They get taught many things at uni but the finer detail like how to interpret blood test results they learn from peers and colleagues. We’ve now reached a critical mass of peers and colleagues who no longer know how to read blood test results, much less fully understand much more than the basics of why one level is high and the other is low, and how results often work in tandem, for example, the relationship between Vit D and calcium, or the relationship between folate and B12 (and the rest of the B vits).

Medicine (as opposed to surgery) has always been the trickier part of doctoring. Surgeons tend to get all the plaudits but surgery is often a matter of re-routing plumbing, cutting something out or bolting on a plate.

Medicine needs a deep understanding of biochemistry and physiology. For that you need good teachers and time to read and absorb and make connections.

Our GPs these days have neither.

[SeasideSusie Remembering]

However, when I look back at the 'history' I often see that vitamins, hormones etc. have dropped off a cliff .. .yes, still in the normal range ...just...but rapidly on the way down. Why don't doctors pick this up.

I have never had vitamins tested as routine other than once I had B12 tested (probably due to age and it being common for B12 deficiency to develop the older we get) and twice ferritin tested (no idea what prompted that). Hormones (other than thyroid) have never, ever been tested.

[TiggerMe]

Absolutely! I spoke with the nurse yesterday about this and she said " we are only into General Practice if you want to optimise your results you need to go elsewhere!"

I said "I didn't realise this when all I'm trying to do is make the Levo that you give me work?"...

Then her defensive attitude changed too...

"Oh I see you have an Endo appointment coming up, they are the people to ask" and I replied "yes but I had to request a referral it wasn't offered?" her response " Make sure you go prepared, write everything down and see if you can see a nutritionalist as well!"

[nellie237 in reply to TiggerMe]

Hi Eeyore,

Please don't get your hopes up if this is an NHS Endo. NHS Endo's are less interested in optimising nutrient levels than GP's, and even if you are deficient they are likely to tell you to speak to your GP rather than prescribe..........let alone monitor. I can understand it.............they have long waiting lists.

I hope that you come back and tell us otherwise. Good luck.🙂

[TiggerMe in reply to nellie237]

Thanks Nellie, I'm giving the Endo a chance to surprise me but having read so many experiences on here I'm not expecting a lot... I'm not really looking for them to prescribe Vits & Mins but to guide me how to obtain optimal levels and how to manage this going forward and what to keep an eye on....

Having said that I'm not sure there is an Endo who could possibly relate the vast array of real life knowledge that is accessible on here!

I'm just a little shocked that they hand out Levo with little instruction and no guidance how to make it work well for you, it surely ought to be a combined approach to achieve better outcomes.

[SlowDragon Administrator]

NHS only obligated to test and treat vitamin deficiencies

Unfortunately they don’t elaborate or explain this to thyroid patients who MUST have optimal vitamin levels for levothyroxine to work

[TiggerMe in reply to SlowDragon]

You wonder why they give out T4 rather than T3 which might have a better outcome for many?

[SlowDragon Administrator in reply to TiggerMe]

T3 is much more difficult to manage than Levothyroxine …..and vastly more expensive

The majority of thyroid patients do ok/well on levothyroxine…..provided that there’s good gut function, optimal vitamins and patients understand how important it is to take levothyroxine consistently and to test early morning, last dose levothyroxine 24 hours before test

Keep good records of results and symptoms

A spreadsheet of results over time can show trends on levels of thyroid or vitamins

[blogfrog]

I think GP's are too hard-pressed to look at any patterns for preventive measures, only looking at the very latest results for diagnosis. I have seen a rapid decline in a lot of my blood results in the past couple of years and they never told me of the patterns. It was only when I actually requested printouts I saw the worrying cliff like drop (or rises). The GP had not even bothered to tell me sometimes when a few results were out of range or bang on the edge.

[fiftyone in reply to blogfrog]

It's a good thing results are now online and we can see everything for ourselves.

[TiggerMe in reply to blogfrog]

If they would just tell you from the outset that their care will be basic as they know little about this issue and that better outcomes are likely if you read up on the condition and take control...

I wrongly thought GP's referred you if they didn't know what they were dealing with, but they just string you along! I had no idea I had to make that request... 😳

[blogfrog in reply to TiggerMe]

The docs hate Dr Google. They want you to be ignorant and reliant on their poor guesswork.

[SlowDragon Administrator in reply to TiggerMe]

GP is a gate keeper and the wait for NHS endocrinologist is long

Vast majority of endocrinologists are diabetes specialists and useless for thyroid anyway

If thyroid results are “within range” referral will get often get refused

Before considering booking any consultation we always recommend getting all four vitamins as near optimal as possible

Majority Endocrinologist will also only test for vitamin deficiencies.

Retest thyroid and vitamin levels just before any consultation

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors 

[e-mail]