Lab Cut Backs (blood testing)!

[Fluffysheep]

I've read on here numerous times about people being refused T3 tests because "we're not allowed to test that any more" etc etc. Clearly appalling when trying to get a full picture of what's going on with your thyroid.

I've just spoken to the GP about some other blood tests I'm having done tomorrow (not thyroid related) as I wanted to get my ferritin, folate, B12 and vitamin D checked at the same time, as I've not had it done for a while.

The GP told me "I don't think the lab are allowed to do vitamin d testing any more, as basically everyone is low."

Excuse me, what? If that's true, what an absolutely crazy situation. What other blood tests are being cut back on?

She has put the request in anyway, but doesn't think the lab will do it!

Madness!

Why have the labs become the decision makers in what is and isn't required? Why aren't GPs who are requesting tests being listened to?

[DippyDame]

Thyroid care in general is so poor it's beyond belief....it starts in med schools where only the minimum is taught....and that is wrong.

[SlowDragon Administrator]

Test twice yearly when supplementing

Most members test full thyroid and vitamin levels annually

Extra vitamin D test in between times via NHS private testing service

vitamindtest.org.uk

[Fluffysheep in reply to SlowDragon]

Just looking back at my spreadsheet, my vitamin d was checked around a year ago, along with the other tests I've said in the post. That was an NHS blood test, probably requested by me as I didn't have thyroid done then so there would have been some other tests done.

My thyroid tests are usually requested twice a year by the GP. I'm fairly fortunate, in that because I'm on T3 only medication and therefore both my TSH and T4 levels are out of range, the lab do actually do the T3 test that is requested by the GP 9 times out of 10 (I've been told before that the lab usually only do it if one of the others is out of range).

The non-existent TSH and T4 levels then usually end up with a panicked call from one of the GPs, in spite of the fact that they themselves issue me the T3 every month, as they don't seem to connect being on T3 medication with the low results of the other two levels. But that's an entirely different story!

I'm staggered that something like a vitamin D test is seemingly being withdrawn from being tested on the NHS because 'everyone is low.' It's just not good enough.

[DippyDame]

"I don't think the lab are allowed to do vitamin d testing any more, as basically everyone is low."

Was that just the opinion of your GP, or is it fact?

There is a lot in thyroid-land, based only on accepted views, rather than on verifiable fact

as basically everyone is low.

As medics is it not their job to keep the population as healthy as possible.....seems not!!

Why do GPs accept this judgement of their professional decisions, by lab staff.

Strikes me as undermining authority!

One less test to pay for !!

[Fluffysheep in reply to DippyDame]

To be fair, that was the opinion of my GP when I spoke to her on the phone this morning. She seemed quite certain, but I guess I'll wait and see if I get a result for my vitamin D or not!

Obviously we know the lack of T3 testing to be fact in lots of areas, as it comes up an awful lot. I do not understand why labs have so much power to make decisions?

[helvella Administrator Thyroid UK]

The idea of not testing vitamin D has been widespread for years.

At one point, it cost towards £100 per test in many areas.

Then finger prick blood spot testing arrived. While price has gone up, now, to £31 for a single test, it cost much less than many other NHS labs.

vitamindtest.org.uk/

That any NHS lab is spending more than that on vitamin D tests strongly suggests they have not used the most cost-effective technology and management. (Allocation of blame is another matter.) Even when they do a test, I suspect they incur the overheads of phlebotomy and a vial for the blood, etc. Not just a lance and blotting paper (more or less!)

[Fluffysheep in reply to helvella]

Surely NHS labs are not paying that kind of price for a vitamin D test though? That seems unbelievable, especially as most other general blood tests (the most common ones that are requested) are a few pence or a couple of quid at most (I'm still talking about NHS tests here, not private ones).

I've never had a problem getting my vitamin D checked on request along with my other vitamins, iron etc when asking my GP previously. I try and tag them onto other blood tests I'm scheduled to have, as I'm not a fan of blood tests at the best of times!

Obviously it's possible the GP got it wrong this morning, and I'll get my vitamin D result along with everything else. It seemed a strange thing to say though, and she seemed quite certain about it.

[helvella Administrator Thyroid UK in reply to Fluffysheep]

From a 2021 document:

Cost of testing for vitamin D was obtained from the National Institute for Health and Care Excellence (NICE) economic evaluation published in 2014, which estimated the cost per vitamin D test to be £16.50.

bmj.com/content/372/bmj.n484

So the cost did come down - but it is still one of the more expensive "simple" tests.

[Fluffysheep in reply to helvella]

I am honestly shocked. Had no idea a "simple" test was so expensive.

Sounds as if what my GP is saying is correct then, but the reasoning isn't. Although they're never going to admit it's all about the money (same as the lack of prescribing T3 isn't about the money!!!).

[serenfach]

A recent blood test showed I was low in serum inorganic phosphate. One of the reasons this could be low is low Vit D. The GP had asked for Vit D to be tested, but it was not done, with the note that it would only be tested if the patient was suffering from osteoperosis. I have not been tested for this. I suppose I will have to find out myself and self treat....

[Fluffysheep]

Just to update this post, my vitamin D was indeed checked (much to my surprise!) and was also at a good level of 202 nmol/L. 🙂