Hashimoto’s diagnosis questioned by new GP - Thyroid UK

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Hashimoto’s diagnosis questioned by new GP

Lisalisajay profile image
37 Replies

So I was diagnosed in 2019 privately after fighting with the NHS for 6 years.Raised antibodies and massively symptomatic. Been on 125mcg L4 for last 2 years with no symptoms and feeling amazing.

I had a surprise blood test done for anaemia because of a Gynaecology procedure that caused 6 weeks of heavy bleeding and as already anaemic felt terrible.

The blood test done at 0900 (meds at 0600) came back with elevated TSH levels and my new GP who doesn't know my history has told me I was misdiagnosed and I have Graves not hashimotos.

My previous GP understood my bloods had surges and lows and was happy to discuss symptoms rather than rely on blood tests.

I've been symptom free since diagnosis and healthy. Managing my weight (just about) and no other issues.

They cut my dose to 75mcg immediately after the blood test and I'm now feeling symptomatic, progressively worse now after 12 weeks.

Hoarse and irritated, shaky, palpitations, swelling legs etc

Has anyone experienced anything similar?

She told me biopsy was the only diagnostic tool.for hashimotos which I've never heard of. And despite all communications being on file sge hadn't read my history.

She has a masters in medicine but isn't a specialist in this area.

She told me just because I paid doesn't mean it was worth the money or the clinic was any good.

I am upset and angry to be back at square one with this argument.

Please let me know if you can relate or have any advice.

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Lisalisajay profile image
Lisalisajay
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37 Replies
TiggerMe profile image
TiggerMe

I don't understand? If your TSH was raised that suggests you are under-replaced and needed an increase not a decrease??

Time to request a retest and be sure to get a 9am, fasted water only and you can leave the 24 hour last dose gap before testing

Lisalisajay profile image
Lisalisajay in reply to TiggerMe

I don't understand either.This woman GP has never spoken to me before and just jumped on without any prior knowledge and totally trashed my whole experience. If I was symptom free and no issues why mess around. I'm now feeling terrible and very poorly.

They wouldn't give me the results and I'm waiting on my full records to be released. Now back to paying for full tests because they aren't supporting me and it's brought back every ounce of anxiety and stress.

TiggerMe profile image
TiggerMe in reply to Lisalisajay

They are legally obliged to give you results, especially if they aren't making them available via the NHS App or online access... I'd ask at reception rather than the GP

If you have enough stock I'd increase gradually back to your happy place after testing, honestly we have to deal with some hopeless GP's 😟

What did your frees look like before this reduction?

Lisalisajay profile image
Lisalisajay

Last blood test was fine and wasted to carry on. Last August that was.

I hadn't approached for a consultation, she just took it upon herself to call me and tell me misdiagnosis.

I used to swing between hyper and hypo before meds and suffered all the negative aspects of both. The meds stabilised and stopped the swing.

Will postpone blood test until after private results are in. Then I'll see what NHS says. Honestly I feel terrible and very very sick again. Crying literally from the stress.

Sparklingsunshine profile image
Sparklingsunshine in reply to Lisalisajay

My lovely named GP who I'd had for 30 years retired after Covid and another female GP took over. I had a consultation with her found her dismissive, patronising, tried to fob me off with anxiety ( not something I'm known for) in short a right beatch.

I wrote a letter to my surgery just asking I be removed from her list and they complied. I didnt go into detail why I didnt want to see her again. I'm getting too old and too impatient to be putting up with that crap.

J972 profile image
J972 in reply to Sparklingsunshine

amen to that

helvella profile image
helvellaAdministratorThyroid UK

It sounds like the person you saw is utterly ignorant of thyroid.

Biopsy is rarely done for Hashimoto's. (Like, I don't remember reading of a single one here. But that could be my memory.) Fine needle aspiration is done for anything which could be cancerous - and might incidentally identify or confirm Hashimoto's.

Ultrasound scan can be helpful.

This link is to a search on the Radiopaedia site which is all about diagnosis - of everything:

radiopaedia.org/search?lang...

And this is a link to a specific article about Hashimoto's:

radiopaedia.org/articles/ha...

Trouble is, what to do next.

I think you have to complain to the surgery manager. But I completely understand why you would be waiting, and not wanting to do so. Is there anyone who can help you? Go with you to an appointment?

Although someone who understands thyroid would be ideal, the absolute basics can be explained in five minutes if the person is receptive. And they are there for support rather than detailed understanding.

What???? Raised TSH means hypo, not hyper/Graves. You need to see a different GP or request endo referral - this doctor is extremely misguided

Hedgeree profile image
Hedgeree

Hi Lisalisajay,

She may have a master's in medicine but it appears and your experience shows that she doesn't know what she's doing.

If I was symptom free and no issues why mess around. I'm now feeling terrible and very poorly.

I think you need to tell her that and request that your prescription is put back to what it was previously when you felt well.

Lisalisajay profile image
Lisalisajay

I sent a letter in yesterday and copied it into an email. They have 6 weeks to respond.

I detailed my struggles with 3 missed diagnoses via NHS and my lack of trust this has brought on. She knew nothing of my history and didn't ask how I was doing. I lost my cool on the phone and she's noted on my record that I'm clearly traumatised by my experience in the diagnosis pathway.

I cannot believe that in one blood test with no prior knowledge of my case she tells me the last 5 years are incorrect? Surely I would be feeling poorly if on the wrong meds and if misdiagnosed?

Thanks for all your input. I have found a thyroid specific clinic should the need arise for another private appointment.

If anyone has recommendations please message or leave a comment.

1tuppence profile image
1tuppence

So very sorry you are going through this wretched experience. The "TSH Monster" and "Ignorance" strike again, from folk who are not trained thyroid specialists.

I see an NHS Professor privately. He prescribes NDT privately for me. I last saw him Friday 2nd August. He is writing to my GP surgery, and thus it will be on my notes, that my <.001 TSH is not a problem.

Recently, early July I was in hospital awaiting surgery, when the anaesthetist came to do her preop....hmmmm. She told me that my thyroid results were so bad that she would have refused to anaesthetise me if the op wasn't so important.

Despite my having No symptoms of being hyper, afterwards she wrote to my GP surgery, copied to me, and told them I was hyperthyroid and my meds needed adjusting. Oh Wow!!!! I totally understand the enormous stress these interfering medics can cause us.

I don't know where you live, but should you want details of my endo, please feel free to private message me.

Lisalisajay profile image
Lisalisajay

Mine has been consistently <0.005 and remarked as expected due to thyroid diagnosis.

greygoose profile image
greygoose in reply to Lisalisajay

The blood test done at 0900 (meds at 0600) came back with elevated TSH levels

0.005 is very low, not elevated (did she say it was elevated or is that your word?) and that is why she thinks you have Graves'. She still very, very ignorant, knows nothing about thyroid, but we do need to get our vocabulary right if we're going to talk to doctors. They consistantly get it wrong, but we should be in a position to correct them is necessary. :)

Marz profile image
Marz

As your GP only tested the TSH, then reducing your dose, is bang out of order... What was the actual TSH result ? Without FT3 & FT4 results you do not have the TRUE picture. I would not reduce my dose until everything was correctly tested 🌻

Anthea55 profile image
Anthea55

Is there another doctor in the practice who you can see? She may be your new GP but you don't have to see her.

In my experience you're lucky if you see the same GP twice these days.

If no other GP available then definitely contact the practice manager. Details should be on the practice web site.

Good luck.

Lisalisajay profile image
Lisalisajay

So TSH was <0.005The t3 and t4 were elevated

Wasn't fasted and had taken meds so.wasntexpecting thyroid to be taken

Low tsh has been present for years in all my blood tests but was told it was expected due to treatment and diagnosis.

Is this correct?

greygoose profile image
greygoose in reply to Lisalisajay

I don't suppose she even looked at the Frees, just the TSH. Ignorant doctors, who don't understand how it all works, believe that a suppressed TSH means you've 'gone hyper' and that hyper = Graves'. They don't know enough about it to understand the difference between a suppressed TSH due to Graves' and a suppressed TSH due to thyroid hormone replacement. And, as you said, she didn't read your notes.

I agree that a formal complaint to the practice manager is in order to get your thyroid hormone replacement dose restored - and, hopefully, a rap on the knuckles for this negligent doctor!

SlowDragon profile image
SlowDragonAdministrator in reply to Lisalisajay

So TSH was <0.005The t3 and t4 were elevated

Wasn't fasted and had taken meds so.wasntexpecting thyroid to be taken

Ft4 would be false high result as you took Levo before test

Never agree to dose reduction without getting full thyroid and vitamin testing and testing with correct timing

Low vitamin levels, especially low iron/ferritin will significantly affect thyroid levels

with Hashimoto’s many patients need TSH very low or suppressed to stop the swings in levels

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and 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

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Lisalisajay profile image
Lisalisajay in reply to SlowDragon

I didn't agree They just reduced it so my next prescription could only order 75mcg

SlowDragon profile image
SlowDragonAdministrator in reply to Lisalisajay

Which is outrageous

Dose should only EVER be reduced slowly and at maximum reduction of 25mcg daily…..even that many people will react very poorly to

Completely unacceptable

Which brand was 125mcg

Which brand is 75mcg

How long have you been on 75mcg

Bloods should be retested 6-8 weeks after any dose or brand change in Levo

Lisalisajay profile image
Lisalisajay in reply to SlowDragon

The brands change all the time. I've been on 75mcg since April and I'm symptomaticI upped it last week as was feeling dreadful but when I requested more they refused. I have some stock remaining and will make sure I'm on the correct dose from today.

Honestly, it's been a whirlwind of chaos and stress and now I'm fighting something that should have been put to bed in 2019 when I was diagnosed.

This is massively unprofessional and not one person has apologised to me.

SlowDragon profile image
SlowDragonAdministrator in reply to Lisalisajay

and now I'm fighting something that should have been put to bed in 2019 when I was diagnosed.

This is massively unprofessional and not one person has apologised to me.

Unfortunately far too common and you are highly unlikely to ever get an apology

Work out which brand suits you best and always aim to get same brand at each prescription

consultation with thyroid specialist if GP still won’t increase

Get bloods tested after 6-8 weeks on constant unchanging dose and brand Levo

Test vitamin levels as well as TSH, Ft4 and Ft3

Lisalisajay profile image
Lisalisajay

I've booked an appointment for November with a specialist. I've also sent the info regarding medicated TSH levels being mistaken for Graves and requested I be removed from her list. All info going to advocacy group and CQC, and for my notes to be flagged with abnormal results expected due to diagnosis/medication. No action to be taken unless directed by a specialist and I will be seeing a specialist to confirm my diagnosis again.

SlowDragon profile image
SlowDragonAdministrator in reply to Lisalisajay

Well done

Lisalisajay profile image
Lisalisajay

Thank you to all for your incredible advice and support. I have gone back on my meds and will be cancelling all future appointments until this GP has been removed from my case.

Lisalisajay profile image
Lisalisajay

Oh my goodness I feel so unwell.

I am absolutely struggling with body buzzing, mind racing, can't sleep

I haven't felt this poorly in years.

I'm adding to this post because I don't know what else to do, I've got no one to talk to.

Absolutely fed up with this situation now. Can anyone offer an idea of how long the correct dose will take to level me out. I am literally in crisis right now.

FallingInReverse profile image
FallingInReverse in reply to Lisalisajay

Hi! It’s midnight here in the states , but know others will wake up soon over there to also reply.

You’re dealing with two things. The hypo which is challenging enough.

And being completely and totally mistreated by a heartless, uninformed, person with a huge ego and a lot of power. Infuriating. It’s too common and completely dehumanizing. I am outraged for you. Speechless.

But - you have been your own hero.. the hero none of us want to be! But you did it. That is not easy. Well done.

So remember even though you feel like death, you actually are out of the crisis… you addressed the doctor issue. Did you say you have enough Levo? Are you ok to get the right dose prescription when you run out?

So with your hypo… yes, you need to titrate back up to your optimal dose and it’s different for everyone but we give it 6-8 weeks for the dose to settle due to the half life of Levo overall.

You might rmemeber this, but those 6-8 weeks are not always a straight line. In that time there are good days and bad days. But there is a light at the end of the tunnel!

But everyone is so completely different. You can only take the next step and find all that patience and hope you have inside you.

Are you clear on your next steps - the dose you need, and how you will get back up to it?

I hope you’ve managed to fall asleep when I send this 😴

Lisalisajay profile image
Lisalisajay in reply to FallingInReverse

Thank you for your comforting reply. 0330 I fell asleep. I've taken additional 25mcg than the reduced dose thyroxine and my T3.Rough I can handle. I have enough to last me until November when I see the private endocrinologist.

Awaiting acknowledgement of yesterday's email request from my medical centre.

I will update here as soon as I know something more.

FallingInReverse profile image
FallingInReverse in reply to Lisalisajay

Keep us posted, especially on how your increasing dose goes if you need any support through the adjustment.

Lisalisajay profile image
Lisalisajay in reply to FallingInReverse

It's rough so far but the palpitations and the anxiety aren't quite as intense today. It totally exains why I've taken a nose dive over the last couple months.

I've also reported both GPs involved to the GMC today. I'm not waiting for responses, contacting every organisation in one go.

serenfach profile image
serenfach

Personally, I was going to suggest you hold her down and I will beat the cr*p out of her, but your way sounds better. They absolutely hate people who complain properly as you have done. Well done and I hope you feel better soon.

To get more emergency supplies while you up your dose, tell the chemist you dropped some in the sink and now they are all squishy. They can arrange for a replacement prescription.

Lisalisajay profile image
Lisalisajay in reply to serenfach

I really did want to slap her into next week. Arrogant woman. Everything she did was incredibly unprofessional - never tell anyone theyve been misdiagnosed... I mean... but to then say I wasted my money etc... I was gobsmacked.

I have never been so angry, upset and insulted. I felt hijacked and pushed into a corner.

Lisalisajay profile image
Lisalisajay

**UPDATE**Received 2 frantic phone calls from my medical centre on Friday afternoon.

1st was to understand what the initial issue was - I.e. GP changing meds and what my appointment was for (iron - blood test).

Message to reduce dose, not even a call to discuss any symptoms etc.

2nd call from a lady who was very empathetic. I have a being it was a shock to them and they were in a flap.

All requests to be confirmed in writing and a meeting to be set up to discuss.

Very positive response (finally).

Thanks again to you all

Lisalisajay profile image
Lisalisajay

Further update...

The short story is unless I see a second specialist to have my diagnosis redone mu GP surgery is pulling the pin on my medication.

Despite being symptom free.

Because I'm in a "transitional phase" of my life and the HRT plus thyroid hormones could be producing issues.

But I was symptom free... until they messed with my dose.

Please help!

Dahliasanddaisies profile image
Dahliasanddaisies in reply to Lisalisajay

That's insane but that's the NHS for you. If you have enough stock to last you until you see the specialist, then just go with that. In the mean time can you change GP surgery? I had to change mine when they refused to increase from 25mcg.

Lisalisajay profile image
Lisalisajay in reply to Dahliasanddaisies

Unfortunately I can't change as I have no others I'm in the catchment for. I am so frustrated.

Dahliasanddaisies profile image
Dahliasanddaisies in reply to Lisalisajay

I feel your pain, I have washed my hands of my NHS GP doing anything to help with my thyroid. I had to go private too and just learn everything I can for myself. I have wasted years being unwell thinking they knew best etc.

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