Does anyone know of any good NSH consultant/endo in London?

[Ocean2]

I am in a bit of a difficult situation right now. See my recent post here thyroiduk.healthunlocked.co...

I think it is going to be a long battle at work and unless I get my thyroid illness recognised on NHS tough times are ahead of me...

My GP is nice enough but he has no clue about thyroid and unreliable TSH/T4 testing. I am going to try and persuade him to send me to an NHS consultant.

Does anyone know of any NHS consultants/endos who is more clued up on diagnosing not just by the usual blood tests??

I need to see someone who knows why TSH and T4 alone are not reliable to diagnose and who doesn't just go by prescribing T4.

It is important for me to know this before I ask to be referred as I am within the NSH so called reference range. I have not been diagnosed by the NHS. I was diagnosed by Dr Peatfield 6 months ago. I need to be diagnosed by an NHS consultant otherwise I risk loosing my job as workplace does not recognise private doctors reports/letters.

[nobodysdriving]

Ocean, you say you have 'normal' results, but you don't right? you have high antibodies.....

there is research/medical papers out there which say that those with thyroid function in range but with high antibodies and symptoms should be treated.

Anyway, I don't remember what your TSH/fT4/fT3 was, do you mind rewriting it for us?

they may not be that normal.....and together with antibodies you do have a case.

My endo in London is good, he does listen, however I do not know at all if he diagnoses with bloods more in range. I would like to think that if I presented an argument that I had high antibodies and I am very symptomatic then he would listen and diagnose, however I don't know as that is not my situation. I went to see him 'after' diagnosis to obtain T3 on the NHS.

[Ocean2 in reply to nobodysdriving]

nobodysdriving, thank you for your reply.

Below are my results 6 months ago from Genova Diagnostic. However, GPs TSH result was around 3.98 just a week apart from Genova's one, and his upper range was 5 but they don't treat/diagnose unless it is above 10.

However, GP is doing some tests (iron, ferittin, B12, D3 etc) and he threw in TSH and T4 which I will go to draw blood for tomorrow. I have been supplementing with Nutri Thyroid (8 tablets a day) and Nutri Adrenals for about 5 months now and I am pretty sure my TSH will now be even further in the range which GP will say 'oh look it's all normal, it's gone down, nothing wrong with thyroid etc etc'...

Dr P has now suggested I try T3 only and will start with this next week.

My Thyroid Blood test results from Genova back in July 2012:

TSH - 6.14 (high) - (reference range 0.4 - 4.0)

FT4 - 11.7 (low) - (reference range 10 - 22)

FT3 - 6.31 (high) - (reference range 2.8 - 6.5)

FT4 : FT3 Ratio - 1.9 (low) - (reference range 2.0 - 4.5)

Reverse T3 - 0.33 (optimal) - (reference range 0.14 - 0.54)

Thyroglobulin (TG) - 207 (high) - (reference range 0 - 40)

Peroxidase (TPO) - 166 (high) - (reference range 0 - 35)

Thyroid 24 hours Urine Test:

T3 - 507 pmol - low (reference range 592 - 1850)

T4 - 736 pmol (reference range 347 - 1994)

T3 : T4 Ratio - 0.7 (reference range 0.50 - 2.00)

I will need to see an endo/consultant who diagnoses with bloods more in range and high antibodies, otherwise I will be flogging a dead horse!

Would you by any chance be able to point me to some medical papers which say those with thyroid function in range but with high antibodies and symptoms should be treated. I'd like to print that out and take it with me to occupational health meeting.

Many many thanks!

xxx

[nobodysdriving in reply to Ocean2]

HI Ocean,

I would have to search just like you to find those papers where they say you should be treated if high antibodies and I am at work all day. when is your meeting?

if you search on google am sure you will find something as I did last year.

However I will try and help, just hope your meeting is not tomorrow or very soon as with me working long hours I can't help too quickly x

[nobodysdriving in reply to nobodysdriving]

also you could bring your genova results to the endo, you don't have to take your GP results

[Ocean2 in reply to nobodysdriving]

Hi nobodysdriving,

No I don't know when I am meeting but I think sometime next week. I will at least try to postpone it if it is this week to prepare myself.

I will of course also try and search.

thank you!

[CarolineAnne]

It is extremely frustrating that some people are not diagnosed as they are said to be in range when there are doctors working for the Nhs that know that the range is too wide.

My gp is of the opinion that I do not have hypothyroidism but my Endo is foreign and he has told me that the range is too wide and in his country he would treat at around 2.5 with symptoms. He has told me that a TSH of 4.2, 4.9 and 7.69 is too high for a woman of my age (43). He says that he has to work within UK guidelines but with symptoms, elevated cholesterol (7.2) and positive antibodies he has some leeway to treat me.

I also had an ultrasound and in his letter to my gp he says that I am to be treated with thyroxine as the patient shows clinical symptoms of hypo, although biochemically borderline. After having an ultrasound he writes that I have mild beginning thyroid under function due to atrophic thyroiditis. (how does your GP know what state your thyroid is in unless you have had a scan!) He also mentions that my L thyroxine levels (t4) levels are at the lower side of normal. Basically at the bottom of the range.

So there are NHS Endos out there that realise that the range is too wide and will treat if you are in the normal range, I think that they just have to be able to justify their decision.

I don't know of any in London, mine is in the Midlands but i just wanted to let you know that you can get a diagnosis even if in range. There are some out there who know what is going on.

So you could use the same terminology at your occ health meeting and say that you are under investigation for thyroid problems. You don't have to have a diagnosis to be covered by the DDA - just the symptoms,which you have.

Wishing you luck at your meeting, wish I could help more!

Carolineanne x

[Ocean2 in reply to CarolineAnne]

Carolineanne,

Thank you for your reply, very useful! I didn't know that you don't have to have a diagnosis to be cover by the DDA.

I am trying to get names of NHS consultants/endos who doesn't just treat with reference ranges and will ask GP to refer me.

thanks

xx