How do I convince the Senior Partner of my GP practice that I need a referral to an Endocrinologist?

I have a diagnosis of Hypothyroid since 1964 and although treated through Thyroxine at 150mcg daily, I have been suffering from depression, mood swings and irregular eating pattern since 2001. My blood results of TSH, T3 and T4 have come back normal recently? I have been on Anti D's since 2001- Sertraline, then Citalopham.

Appt is tomorrow morning :(. Thanks

18 Replies

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  • Hi

    Please detail the test results including the ranges.

    Which levo are you on? Do you always get the same make?

    Do you take your levo with water only, at least an hour before food and well away from any other supplements?

    Louise

    x

  • Hi Louise,

    The brand make is Actavis

    The active substance is Anhydrous Levothyroxine sodium

    Thanks,

    Si

    Btw, Don't think that pingy thing is working so will sort bank trans!

  • Hi Louise,

    Sorry for delay, awaiting Dr to give me exact results for those tests. Will also look on packet for type. TSH is 0.65. Apparently this is normal and then they don't give result for T3/4! Is this normal to omit?

    Only just realised by reading matter that the tabs have to be taken before drinking coffee or eating. Started that this morning.

    Thanks

    Si

  • Hi Si

    The coffee thing could make a big difference!

    It's quite usual to not get the tests/results that you are expecting! *sigh* This is why people have their own testing done...

    thyroiduk.org.uk/tuk/testin...

    Louise

    xx

  • Hi It sounds as it you have not had the tests for T4 or Free T3You need to check and your ranges, print out ask the receptionist. T4 usually needs to be in top third of range. FT3 a lot of us need that to be near the top of range. Depending on this you may need a scipt of T3 from GP. If difficult I should ask for a referral to an endo., make sure it is a good one, decide first who to see.Just make a fuss if necessary,it is your body!!!

    Jackie

  • Hi Jackie,

    The strange thing is that when I asked the Receptionist last night, she could not find the T3 or T4 and after consult with Dr, she came back and told me that if the TSH is in range, the Lab doesn't bother sending the other results back!! I have my appt at 10.30 this morning with the Dr....will take your advice. However, my Surgery is refusing to refer me on the NHS as they don't want to spend the money!!

    Thanks again Jackie!

  • Doctors! The standard tests used to be TSH T4 and Free T3 now not because of costs. i originally had very bad problems but all due only to low T3. In those days no T3 but I had to have armour ( T3 and T4). Now I still have less armour and T3 for the best and in range.If a problem re dOCs you can Pay through TUK bloods, Blue horizon , they are TDL and the normal Labs for any private hospital so well known by medics. In that case it is the intermediate test, quote TUK 10 for a discount and it is around £ 60, same test at a private hospital over £200.

    You should be able to sort out the GP, good luck

    Jackie

  • Jackie, looking at the Blue Horizons blood tests , can you confirm that their intermediate test of TSH, FT3, FT4 is a sufficient test?

    I don't understand the difference between T3 and FT3 etc... Are they the same thing?... Thanks Anna

  • it is called the intermediate test and covers the basic requirements for a thyroid diagnosis , that was always done by GP`s and mostly still done by endos. Of course, there are a lot of other tests if these prove positive, which would be useful. however to get treatment safely and more easier you just need this intermediate test. the results at TDL ( Blue horizon) are always checked by their consultant and if they consider other tests advisable re thyroid they will tell you, up to you then.Do not send blood at the end of the week ie between Friday and Saturday, Thursday if post bad as you do not want the blood to be stale and of course, we all know about the bad postal service. Any queries phone or e mail Paul Harris, MD very helpful, Finger prick or syringe.

    Jackie

  • The lab where my tests go to wont test got T4 if the TSH is within range too!

  • Not only me then!! Thanks for your reply!!

  • If your lab won;t test, your GP has to talk to the Head Person (Bio Scientist) about why your FT3 and FT4 NEED to be tested. If he can explain a reason (mine said that I was about to take supplements to see if it improved my T3/4 even though TSH in "normal" range as I was still symptomatic. They accepted that and I got the tests. If your GP won't contact the hospital then write the request down and give it to your GP with your reasons (I wan't to take supplements ???) Maybe give a copy of some of the info on here to back it up because if you are low on a lot of Vitamins then you won't be helping your T4 convert into T3..

  • Hi Phoebe,

    Thanks for reply, I had meeting today with Snr GP and not only am I not getting a referral, She's not going to do a test for T3! However, GP has requested another blood test for B12, Vit D, Iron and Ferrite?

    Past T3 tests are 2005-7.5; 2006-5.5; 2009-6.8; 2010-4.2

    And surprise, surprise! Another Anti-D to be taken alongside Citalapham, Quetiapine!

    What can I do but to report back in two weeks when blood tests are back?

    Regards,

    Si

  • Dear Si,

    Quetipine is not an anti D. I work as a psychaitric nurse a good website you could look at about you meds is 'choice of medication' at AWP.

    Take care

    Mandy Jane

  • Hi Phoebe,

    Thanks for reply, I had meeting today with Snr GP and not only am I not getting a referral, She's not going to do a test for T3! However, GP has requested another blood test for B12, Vit D, Iron and Ferrite?

    Past T3 tests are 2005-7.5; 2006-5.5; 2009-6.8; 2010-4.2

    And surprise, surprise! Another Anti-D to be taken alongside Citalapham, Quetiapine!

    What can I do but to report back in two weeks when blood tests are back?

    Regards,

    Si

  • If you do decide to go for private blood testing then be careful if you use Blue Horizon. I discovered that some of their so-called list of hospitals for testing is a blatant lie. Two hospitals I contacted from their list said they have never carried out blood tests without a doctor's request and were most concerned that this misinformation was being given out on BH's website.

  • Hi CG

    Please can you send me an email re this - louise.warvill@thyroiduk.org

    Thanks.

    And I will also point Paul from BH here...

    Louise

    xx

  • Hi Cinammon Girl,

    Sorry, I don't log in much here!

    All of our blood tests are requested by a Doctor. Please let me know if I can help any further - not all hospital staff read their emails.

    Paul.

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