I would like to compile the things that UK GPs tell patients when patients have hypothyroid symptoms but the GP doesnt want to diagnose hypothyroidism. I think that I have answers for most things that GPs say but I havent found a similar thing on the internet. All the information is around on the internet but I cant see it put in one place. Mary Shomon has something similar on her site but not in the format that I think is useful for UK NHS patients. The idea is to have a patient friendly rebuttal manual for patients (and GPs for that matter) to refer to.
For example my GP has said
1. you are not hypothyroid because your TSH is within range
Response to be expanded with evidence is: a reference range is for a sample of a population not an individual , indviduals have narrow set points within that range, many experts suggest treating on symptoms, DoH do not want GPs to rely on lab tests
2. the lab will not test for T4
Response to be expanded with evidence is: Even BTA suggest TSH and free T4 initially, Welsh lab group recommend TSH & T4, Drs Skinner, Durrant -Peatfield, Myhill, Starr, Arhem, Rind, Kharrazian (any others?) recommend TSH, free T4, free T3 as a minimum
3. there is guidance in hypothyroidism that I have to follow
Response to be expanded with evidence is: the oonly guidance docotrs have to have regard to is NICE guidance, NICE do not have any guidance on hypothyroidism, Nice states that that NICE guidance does not override the individual responsibility of health professionals to make appropriate decisions according to the circumstances of the individual patient in consultation with the patient and/or their guardian/carer, there are numerous pieces of case law that states that guidance is only guidance, a docotor is free to use any guidance that is the patients best interests,
4. I cant/wont refer you to Dr Skinner
Any other examples?