Tips to tackle GP!

[DaisyTed]

Hi Everyone, it took me a (long) while but I finally got my thyroid re-checked, as well as iron, B12 and folate. Results are below (this was over the phone with the secretary so hard to catch everything):

T4 18.8 (12-22)

TSH 2.58 (0.3-4.2)

Free T3 not recorded

B12 554 (191-663)

Folate 10.7 (3.9-26.8)

Iron 8 (13-30)*

serum 34 (13-150)

Ferratin “normal”.

I fasted and took last dose of Levothyroxine 24 hrs before and had test around 9.10am.

I have been prone to anaemia for a while and take Floradix daily. I’m not sure if GP is planning to ring me about the low iron, but I know she will say TSH is fine. Any links to support my conversation with GP or helpful tips on how to proceed would be much appreciated. I have felt this way for so long it is hard to know what normal is anymore, but definitely fatigue and tiredness are a big issue, along with bloating and stomach issues. Currently trialling dairy-free and have been gluten free since January.

I know it would be good to other things checked like vitamin D.. Can’t really afford to go private for this at the minute.

[Jaydee1507 Administrator]

What dose are you on now and was it increased from last time?

Folate is only 30% of its range. What are you taking for that?

If you are in England you can get the NHS app and some surgeries allow you to see your blood results on that if you ask permission at GP reception. Perhaps get a print out to see the ferritin/iron? I wouldn't rely on GP phoning you, might never happen and 'normal' by GP standards can be dire in reality.

Obviously for thyroid results as we don't have a FT3 we cannot see if you are converting. As and when you can Monotor my Health would be your cheapest option and dont forget the discount code here. thyroiduk.org/help-and-supp...

Approaching your GP takes practice and preparation. It also depends if you have a more helpful open minded type or stick in the mud type. Do whatever you can to speak to the former type and get a little bit of knowledge from here plus print outs if the appointment is face to face.

This post contains references you can refer to or print out regarding keeping TSH lower.

healthunlocked.com/thyroidu....

There is also the NICE guidelines that GPs work to for treatment.

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility”

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

Above all you need the courage of your convictions to challenge your GPs way of thinking.

[DaisyTed in reply to Jaydee1507]

thanks so much for the swift reply! I am on 50/75 every alternate day of Levothyroxine, which hasn’t changed for years.. I am in Northern Ireland so unfortunately we don’t have the NHS app. Ironically I work in the NHS so can access my patients records and check their blood results, but it’s absolutely forbidden to access your own 🙄

Thanks for the references - I will take a look before speaking to GP. I had thought she was quite understanding, but last conversation didn’t go so well- she was reluctant to re-do TFTs and FBC since I only had them done 6 months ago and they were “normal”. It took a bit of persuading to get these tests done… so we shall see.. might see if can chat to another GP. Thanks again!

[Jaydee1507 Administrator in reply to DaisyTed]

If at first you don't succeed, try, try, try again. Don't stop asking about it and try different doctors. One day one of them will cave in.

Good luck!

[Regenallotment]

I’m not alone in finding that I had fewer symptoms after my TSH went under 1.

Normal isn’t normal if you still have symptoms.

You will struggle to feel the full benefit of Thyroid replacement diet and vitamins with your iron levels on the floor. I’d request a full iron panel and focus there in addition to titrating up on T4 as a trial.

Good luck 🌱

[SlowDragon Administrator]

Iron is below range and ferritin at 34 (13-150) is only 4 points above deficient

[DaisyTed in reply to SlowDragon]

Is serum the same as Ferritin then? I didn’t quite understand what she meant on the phone. Would an increase in Levothyroxine help ferritin and iron levels also? Sorry I am still learning!!

[SlowDragon Administrator in reply to DaisyTed]

it’s a mix

assuming you aren’t vegetarian or vegan

Iron/ferritin low because not on high enough dose levothyroxine and/or low Ft3 due to poor conversion of Ft4 to Ft3

For good conversion rate we need good vitamin levels

Presumably you are still getting periods

How much levothyroxine are you currently taking

Which brand of levothyroxine

Approx how much do you weigh in kilo

[DaisyTed in reply to SlowDragon]

Accord brand of Levothyroxine and dose 50/75 alternate days. I am 62 kg and still having periods. I am not vegetarian or vegan. I am on a gluten-free diet but eat lots of fresh fruit and veg. Try to eat iron-rich foods but I have tried liver yet!!