Hypothetical question- would a GP/endocrinologist have to keep prescribing for you if you refused blood tests

[Buttercupsareyellow]

This is a hypothetical question. If you were doing your own private blood tests and happy with the results, but the usual thing of slightly reduced TSH , which you know freaks out the GP (‘your TSH is too low, reduce the dose’) and potentially the endocrinologist (‘we like to aim for normal range’) it has led me to musing of alternatives.

I don’t have a thyroid, so have to take medication or basically I would die. I usually get told ‘you need a blood test so we can safely prescribe’ , but if I know my bloods are ok and I feel fine, but I know it’s only going to be the same old argument with the doctor, what would happen if I just refused their blood tests? They threaten to stop prescribing, but know in reality they can’t as I would be life threateningly ill very quickly without it (would they stop prescribing insulin for a diabetic…)

I was hypothetically curious to know if anyone has ever fronted up to the medical world in this way and what the outcome was (obviously keeping a close eye on their own results)

I hasten to add I’m not advocating this as the best option, as we should really ideally be working with our doctors to keep ourselves safe, but have read so many posts about disputes with doctors about dosing and blood results, my imagination of alternative realities started to muse with a ‘has anyone ever done this and how did it go down…..’

[Lalatoot]

They would stop prescribing as they are not monitoring the results of their prescription which they are bound to do. The diabetic argument doesn't really work as diabetics are meant to be monitored regularly even if that means annually.They could argue that as you are not allowing them to monitor your drug use by using private monitoring then you can use private doctors to obtain your prescriptions.

[Alanna012]

My doctor straight out stopped prescribing even after I had submitted the results of private blood tests several weeks before. I got no warning. Just no prescription in the pharmacy. Private tests not good enough. They are required to test every year.

I'm actually sympathetic to this (although I wasn't at the time, I can tell you that) They have to obey the rules. But it is as you say a real pain if you treat yourself by symptoms.

With no thyroid I guess you'd feasibly have the backup option of going A&E or if you have a main pharmacist you always collect your meds from, they could possibly give you a small emergency supply in lieu of you getting the prescription to cover it later. But neither of those options are good the second not being guaranteed.

You can't get round it I'm afraid

I'm due for one. I was asked to get a B.T. but didn't do it. My last prescription still came through, but the next may very well not.

[SlowDragon Administrator]

I haven’t had an NHS test in 8-9 years

My GP is happy to accept copies my private test results at annual review

I do full thyroid and vitamin testing

NHS here only tests TSH …..even if GP puts on test form patient on Liothyronine

As my TSH has been suppressed for years ….a TSH test doesn’t tell GP anything

[Buttercupsareyellow]

It’s interesting when you consider consent. I work in the NHS and we aren’t allowed to force treatments on people. I wonder if you would be covered under the Mental Capacity Act in that you have capacity to make an ‘unwise decision’ (in their view -refusing blood tests) but if they stopped prescribing they would kill you. Mexican stand off as it were……😉

[Alanna012 in reply to Buttercupsareyellow]

Yes you are effectively coerced. In my case I couldn't get my prescription reissued until I had the test. Mental capacity is an interesting angle.

I have a relative with a life ending illness. I've noticed capacity of mind being taken extremely seriously.

I cannot give consent for anything my relative doesn't agree to, even if they refuse to believe the diagnosis and their decision making is coming from a place of thinking that isn't rational and works against their best interests. So I wonder what the difference is?

[Zephyrbear]

I used the “you wouldn’t withdraw insulin from a diabetic patient” argument with an endo who wanted to try and stop my liothyronine once and he responded with “well, going without T3 wouldn’t kill you…” to which I answered “perhaps, but I would end up feeling so bad I might do the job myself!”

Ultimately, it turned out that, because I was across the border in Wales, he had no jurisdiction there and he signed me up for another 12 months of T3!

I do have an annual NHS blood test, but the appointments are by telephone only now, which suits me fine as it saves me an 80mile round journey to attend the clinic for a 10 minute meeting!

[Buttercupsareyellow in reply to Zephyrbear]

Interesting response from GP, although arguably he is in the wrong for those without a thyroid (perhaps he needs to go back to med school 🤭)

I read an interesting article recently about a man who had a thyroidectomy who had been ‘persuaded’ by an alternative therapist to stop taking his thyroid medication as his ‘thyroid would grow back with this particular strand of alternative therapy’. Needless to say it didn’t end well, he ended up in hospital very very unwell…….

[Zephyrbear in reply to Buttercupsareyellow]

The guy I went to see was an actual endocrinologist, not a GP… which makes it a whole lot worse!

[Buttercupsareyellow in reply to Zephyrbear]

Scary! I had an endocrinologist tell me they wouldn’t prescribe any T3 medication as they didn’t agree with it. If I wanted to buy some I should just Google where to buy it.

I refer back to the insulin parallel. Would they tell a diabetic to go google where to get there medication if they didn’t agree with the prescription 🤷‍♀️

Thankfully I’m now seeing someone privately. The only slight issue is even they are pushing for TSH in ‘normal range’ whilst on NDT……🤦‍♀️ it’s not that low compared with what it has been in the past and everything else is well within range (actually at lower end of range). At least I’m getting the NDT

I’m also curious to know if you need another blood test say for iron or whatever, can you refuse consent for your thyroid bloods to be screened on that sample and what your rights would be if they screened without your consent…….

[Zephyrbear in reply to Buttercupsareyellow]

If you go for a blood test for anything other than thyroid panels, you absolutely can refuse permission for them to do so.

[1Cazza]

That is why I buy thyroid meds as they do not care how you feel only care about tests/results, which are usually skewed in my opinion... It is very satisfying to be told that your TSH is suppressed your over medicated to reply no that is what T3 does it suppresses TSH... Oh I will refer you... At referral Consultant laughed... and said to me in this area we can talk of NDT but in the last one I worked for as soon as it was mentioned you was discharged. He said to me I bet you'r GP panicked when you told them that T3 does suppressTSH its normal. I do not know why but where I am now they do TSH and T3 and T4 from GP Surgery. I do my best not to have a blood test for it.

[Buttercupsareyellow in reply to 1Cazza]

It’s a bit like whack a duck where we are the duck and if our head pops up for too long they hit you with a blood test. I need to see the GP about a problem with my hand next week, I’m worried while I’m there he’ll say ‘oh while you are in, you are over due a blood test…….’

[SlowDragon Administrator in reply to Buttercupsareyellow]

You don’t need to agree to a blood test that day

You could always say…..”oh but I am taking high doses of biotin supplement, therefore I would need to stop taking this for at least a week before any blood test”