I have for a decade been under an Endocrinologist and been very happy under there care but in July 2024 a new consultant reviewed me in the endocrine clinic my appointment was an afternoon appointment . After waiting for 90mins beyond my appointment time this person gave me all of 5mins to explain my symtoms then dismissed me. At this point at 5.00pm she sent me to have a thyroid blood test only no other blood test were carried out . My levothyroxine was 100mg per day. These are the results that have been given TSH * 0.08 mU/L 0.27 - 4.20
Free T4 18.0
Currently my symtoms are tiredness fatigue , hair loss, itching, sleeping during the day.
Just wondering if you lovely experts can give me some advice as to what i can do to help my situation
Thank you
Val Jones
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VLJones
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Please add reference range for FT4. Ranges vary between labs so are important to quote.
As you know testing at 5pm means that TSH will be lower as it varies throughout the day.
Has Endo taken you off their list or asked you to change dose?
You can refuse to change dose until full thyroid levels tested - FT4, FT3 & TSH, also insisting to be tested at 9am or earlier when TSH is highest.
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. “
Obviously just testing TSH and Ft4 waste of time, especially testing at 5pm
Are you on just levothyroxine or levo plus T3?
What vitamin supplements are you taking
Is your hypothyroidism autoimmune
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)
T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Thanks Slow Dragon for getting back to me. I have a gp appointment on Wednesday at 9.00 am hoping to get another blood test done then but if not will do a private blood test monday week. I'm sure my appointment with new endo was just a ticking boxes exercise as i waited 90minutes after my appointment only to be given 5min consultation, i feel that she was wanting me to say i would be happy for my gp to take over my care to which i said i did not want to do that and required an appointment from the department in 12 months time which she had to agree to but said it would probably be someone else that would see me. I also have high cholestral which they tried me on statins which did not agree with me so i take ezetimibe which is reducing it. Think this forum is great thank you for getting intouch most helpful.
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
The person you saw sounds out of her depth and knew it, so delayed the appointment, was rude and dismissive and did not do the right tests. Blame the patient is a favourate form of showing their ignorance. She wont last long and seems to know it.
I would write to the hospital board and tell them what happened and how disappointed you were with your treatment. It depends what else is in her file as to what happens next to her. Refuse to see her again and ask for another endo. Good luck!
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