I'm a newbie here and i'm just unsure as to whether I should accept what my GP is telling me and put up with it or go private.
A bit of history - I'm 46, female, overall good health historically but diagnosed with Premature Ovarian Deficiency (Early menopause) in my early thirties. I have been on HRT since then and have had all classic menopause symptoms for years -weight gain (despite good diet and exercise), loss of libido, brain fog etc. The HRT has helped somewhat, but I've had a nagging feeling that something else has been going on for a while. I asked the GP for a Thyroid function test a year ago and it come back TSH 5.8 and Serum Free T4 10. I appreciate that this is high but not terrible so was told to retest in 3 months. I have had multiple retests since then all similar most recently creeping up to 6.3. I have also had a Se thyroid peroxidase AB con test and my results were over >999. Doesn't this indicate Hashimotos? The GP has made no mention of this at all and just keeps saying test again in 6 months. I have told him i'm so tired all the time and struggling to focus at work, and the weight gain is miserable - but I just keep getting dismissed. Should i push for meds? Should i go private and ask for a full endo screen? I'm stumped! Any input gratefully recieved.
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Ruthio77
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Also request/insist on coeliac blood test as per NICE guidelines
And testing vitamin D, folate, ferritin and B12
Low vitamin levels highly likely when hypothyroid
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
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.
TSH should be under 2 as an absolute maximum when on levothyroxine
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and…….once on levothyroxine …..last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
It's criminal that people are left to rot, become more ill and unable to function because you have a GP who thinks only blood tests state how hypothyroid you are. They are not trained in thyroid issues and this one is likely to only treat once your tsh is over 10 ( this is a crime).It that's the case then sadly you'll need to go private ( wrong I know ) as likely they won't refer you to nhs endo and even if they did then waiting time will be months if not over a year.
In the mean time while waiting for all this I suggest if not already on testosterone, then definitely time.
I'm hoping you were prescribed this when you had your hysterectomy being so young.
Testosterone helps with energy, brain fog, aches and pains and a general well-being feeling..oh and libido
If occurring spontaneously it is thought to be due to autoimmunity as POF is associated with certain autoimmune diseases such as Hashimoto’s thyroiditis.
Thanks for the feedback! A bit more background - I had my son at 20, then had a mirena coil fitted and my periods stopped. No more thoughts about it for may years until i met my husband when i was 29 and had the coil removed a couple of years later to 'see what happened'. Nothing happened. No periods at all so GP investigated and my FSH levels were 136. I had a grumpy nurse practitioner inform me that i was now post meno and there would be no more children for me. bit of a shock a week before i got married. I had a mirena put back in, and prescribled HRT - no testosterone - Just sandrena gel and vaginal estrogen. This was 10 years ago. have been bumbling through since then getting more tired and putting on more weight despite regualr exercise ect. I don't actually thing the GP did any Thyroid tests back when i was diagnosed with POI. The thought that i might have had Hashimoto's since my early 20's (looking back, there were symptoms) and that could've led to my POI actually makes me feel a bit sick. I will definitely insist on a face to face consultation and further tests/meds. Thank you, i thought i might have been overreacting,
Definitely insist on testosterone blood test along with thyroid. As testosterone is mainly made in the ovaries then you will likely have been deficient all these yesrs. This will likely be reason for low libido. It really could be beneficial to you.Good luck with everything, you've got some great advice so don't give up. You've been fobbed off far too long
So, after my slightly ranting response (via the app if course) to the GP yesterday asking them at what point am i going to be considered for treatment - he relented and prescribed Levothyroxine 50mg od. I'm still considering going private though, it seems like they have not been treating my holistically at all and have been looking at each test result on it's own. I would very much like to see what's going on fully with my hormones, as it looks like they've been all over the place for years and years. I'm furious that the GP didn't explain about Hashimoto's and what the Peroxidase antibodies presence actually means - he just told me that its an indicator for eventually developing hypothyroidism, not that it was a condition, with a name, that meant my thyroid was being compromised. It's so frustrating!
If I do go private, can I assume that if I have a full set of bloods done, they will now take into account that I have started on Thyroxine?
Its not unusual to see thyroid problems in someone who is going through menopause and definitely if you have had hysterectomy … Women’s healthcare is so atrocious.
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