Advice needed - GP thinks symptoms are down to stressful job rather than thyroid

[oakqueen]

Hi everyone - I found out in Aug 2012 after having blood tests for something else my T4 was 12.9 & TSH - 5.30. She advised testing every 6 mths. Since then i've had 2 further tests with my T4 now 14.4 &TSH 5.1. I have other symptoms along with tiredness. At our last meeting, my GP said she wouldnt consider meds as my stressful job is the cause. Im not sure where to go from here, someone has said to get the antibody test bu I feel like my GP is just going to think I'm over reacting - any advice would be great x

[helvella Administrator Thyroid UK]

Make sure that you have any future blood draws as early as possible - I aim for 08:00. For that is when TSH is usually highest.

It would be good to have the reference ranges, especially for FT4, as that varies widely from lab to lab.

I agree an antibody test is appropriate.

The inter-relation of stress and thyroid is itself complex and poorly understood. That there is a relationship seems clear - but not that reducing stress would, in and of itself, reduce TSH and increase FT4.

You do have a problem with an unwilling GP. Any chance seeing a different GP? A locum when she is on holiday or another doctor in the practice?

Continuing to have elevated TSH and low-ish FT4 is not good. My take is that it can be sensible to do repeat tests to ensure that things do not resolve after a virus or other transient issues, but when it is like that repeatedly, there is something which needs treatment.

As always, also try to get the following checked:

vitamin B12

folates

iron/ferritin

vitamin D

(Though you might have an uphill struggle to persuade your GP.)

Rod

[oakqueen in reply to helvella]

Thanks for the reply - I'm going to push for the antibody test and see someone else. It's a shame as she has been brilliant for other things, but doesnt want to budge on this. I know my iron levels are ok as that was tested in August too. I have spoken to several people who have been boarderline like me and have really benefited from a small dose of medication but they have also had to fight for it. My stressful job can't explain all my symptoms and i have told her that but no I just need to be re tested in 3-6mths

[helvella Administrator Thyroid UK in reply to oakqueen]

In my book, your FT4 is too low, your TSH is too high, you are on too low a dose and all of that would make you less able to cope with stress.

You need more than you are getting.

I was diagnosed on a TSH and FT4 level quite close to where to currently are stuck - and am now on 100 mcg with TSH somewhere nearer 1.

[oakqueen in reply to helvella]

I'm not on meds, just being monitored at the moment - but i will request an antibody test and see what that says.

Hopefully another GP will be willing to give me a trial of meds - fed up of feeling like crap

[nursey]

I do so feel for you as I am struggling with a gp who thinks I am sepressed and suffeting s.a.d. syndrome. I am no way an expert byt having avidly read this forum I am trying to build a case in writing as I suffer terrible brain fog when sat in front of the gp. Quote the evidence, uae tge thyroid uk symptom checker, I am waiting for dr toft book and hope to get some good quotes. Put the case to them, show them you know what you aee talking about. I work wth gp's and they dont like being told what to do but a letter giving facts and suggesting how yiu xan solve it may be more favourably received. As I aaid I am not an expert just someone fighting to be well again. Good luck. X

[oakqueen in reply to nursey]

Thanks nursey - i'm also trying to research as much as i can now for my next visit. This site has been great and it's nice to have some support from people going through the same as me.

Hope your next visit is a successful one x

[nostoneunturned in reply to oakqueen]

Buy the book "Understanding thyroid disorders" by Dr Anthony Toft, past president of the British Thyroid Association. From chemists/Amazon, £5. Show your GP Page 44 (my edition) where he says:

"The most common finding is the combination of a "normal" TSH but raised TSH level, known among doctors as subclinical hypothyroidism. It is known around 5-20% of these people will develop more obvious hypothyroidism in each following year.

For this reason it is now common practice to "nip things in the bud" when the abnormality has been found on more than one occasion."

I gather you have so far had two repeat tests showing just this abnormality. further , you have symptoms, whereas "sub-clinical" means by definition there are NO symptoms.

The main site, thyroiduk.org has a lot of info to bolster your researches.

[oakqueen in reply to nostoneunturned]

Thanks, i'm going to get this book. Yes i've had 3 tests in all and they have all showed a T4 level in the normal range but raised TSH and i have other symptoms, not that my GP wanted to listen about those, easier to blame my job !

[merissa in reply to nursey]

Hey, I agree, present a case study, me to and being backed by diagnoses and blood results and of course research. nearly finished my a4 note book to submit lol.

x

[merissa]

had to reply, get the antibody test done, its a must, I am in the process as my antibodies have trebled in a year, even though G>P insists not related, my last appointment I made reference to this and she is going to look into it for me.

I was trialed on 25mcg Thyroxine for 2 months, looking back I think I should of not been on them to long on such a small dose. now gp feels the meds have caused me to be hyperthyroid, arrrrrrrrrr until, I pointed out my antibodies( thyroglobulin are rising, even with very supressded T S H.

What really gets to me is this, when i go for blood test and they are abnormal, GP wants to continue bloods test weeks after weeks after weeks until she can say your normal now. I always say, but my smptoms havent changed.

good luck and order the test, even if you dont get treatment, you will have a better idea whats going on.

xx

[onhereagain]

Change your Dr the best thing I have done walked in last week explained a diabetes issue and at same time asked for vitamin D test she without asking put down vit B ferro etc got blood test tomorrow so will see

[oakqueen]

Book has been ordered and I'm feeling more positive - thanks for the advice guys x

[Hashi_since_age9-1988]

don't be scared to make a fuss. Its worth it to get better, push to get treatment. Your blood tests and symptoms suggest you are hypothyroid

[skyfall]

Late to the party of this post but PLEASE get your adrenals checked (cortisol and DHEA). If your GP thinks it's stress then those tests can confirm whether your adrenals say it is...your cortisol would be flat throughout the day; not peak in the morning then tail off as the day progresses. If your adrenals are reacting to stress then treat them first as the symptoms of adrenal stress mimic those of hypothyroidism - see this link drlam.com/articles/adrenalf...

also and importantly adding T4 to an already stressed body can cause adrenals to work even harder.

Just worth checking...and it plays to your doc's assertion. If they're wrong the tests will show it.