Advise for next appointment please. New to Forum, Really Struggling with GP.

[Ktlc]

Hello everyone,

Looking for advice I can have with my GP or Endo the next time I have an appointment, as I am getting nowhere and very slowly.

Briefly - I started with symptoms in 2020-2021 and visit the Dr suggesting it was my thyroid. Initially (over the phone) they said probably menopause or stress from Covid, but they eventually did bloods:

May 2021 [TSH 2.65 and FT4 9.1] so all normal.

I then did my own private bloods in Feb 2022, as I felt dreadful

Feb 2022: [TSH 5.28 and FT4 14.9 and FT3 4 - TPOab 99 and TgAB 400]

The GP wasn't interested in these. So I did them again in September 2022

Sept 2022: [TSH 8.76 and FT4 13.4 and FT3 9 - TPOab 115 and TgAB 350]

Eventually GP saw me in February 2023, but still wouldn't provide medication saying TSH needed to be over 10

Feb 2023 (at GP) [TSH 4.33 and FT4 11.4 but serum cortisol low]

May 2023 at GP [TSH 7.52 and FT4 9.90 serum cortisol normal]

referred to endocrinologist and provided with 50mg of Levothyroxine

August 2023 repeat bloods [TSH 3.37 and FT4 10.40]

... and now we're in January 2024. In May 2023 The endocrinologist said I'd need an increase in 6 weeks and would write to the GP. The GP is saying my bloods are now normal, so no increase in dose. Not heard from the Endocrinologist again.

I don't really feel under anyones care. I have written to the endocrinologists secretary and he should be calling me back next week. I'd love to be armed with some information when I speak with him

Advice greatly appreciated. Feeling generally pretty S*** and suffering with really bad muscle fatigue with exercise.

Thanks

[PurpleNails Administrator]

Welcome to forum.

Find a new GP.

Always include lab ranges as they vary between labs. I can see your levels show hypothyroid by most ranges.

Immediate treatment is given if TSH above 10. It is not the only consideration.

TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, is also criteria.

If antibodies positive this can be taken into account with low levels.

Most feel well with TSH around 1. FT4 in top 3rd of range and FT3 at least 50%.

See this post.

Which list reference/articles citing optimal treatment with levothyoxine & TSH.

healthunlocked.com/thyroidu...

You can also argue you have remaining symptoms which should be taken into account. Your TSH could drop & still be well in range (you need a increase now)

You seem to have had FT3 tested 2x one result is 9 - is that correct? as it’s likely over range & you would expect a low TSH with it.

You also need FT3 tested now to see how well you convert the levo you are taking.

Levo works best if nutrients are optimal (folate, ferritin, B12 & vitamin D) while you were progressively hypothyroid these can be severely affected - test privately if Doctor refuses.

Thyroid test should be taken first thing in morning, fasting overnight. delay replacement until after sample taken. This gives highest TSH & lowest FT4 for day. Any supplements containing biotin need to be stopped 3 days before as has potential to interfere with results.

[Ktlc in reply to PurpleNails]

Thanks for this... I'll have a good read of that article.

[Amazon07]

Hi 👋🏼

Top advice from PurpleNails there!

I’d strongly advise to change GP practice until you find someone who is listening to you! I really don’t like the way you have been dismissed by your GP!

There are good and empathetic GPs out there, what PurpleNails said about reference ranges and where you want to be, is spot on!

Please find a good new GP who listens to you and supports you!

Also please consider that you may be perimenopausal, which might contribute to or exacerbate some of your symptoms. X

[serenfach]

Your GP is an idiot and making you ill, so as others have said, find a new one. You have been treated badly and he will continue to treat you badly and keep you ill. His knowledge of thyoid could be written on the top of a match!