Pity the doctors don't keep up with the changes.

[Moggie]

Hi all,

Just got myself up at 5.45am for a 7.15am. appt with my GP before I go to work (had to walk my little dog beforehand) only to find that the lab has refused to do my TSH levels.

It seems that now, and it doesn't matter who is asking - consultant or GP, they will only do a TSH test every eight weeks so the test wasn't done. I am furious as on the form it clearly stated six weeks and my next appt with the endo is before the eight week TSH deadline. My GP is going to phone the lab and ask them to do it but what I want to know is why waste my time, the nurses time and the GP's time in telling me to have a re-test in six weeks when they have moved the goal posts, and when were these moved anyway. I have always had a six week re-test so when did it change to eight? and why wasn't my endo privy to these new rules, or did he just think it would be good exercise for me to make two unnecessary trips to my local surgery.

To make matters worse I am feeling absolutely dreadful on just 100mcg's of Levo (down from 150mcg's T4 and 20mcg's T3 - which is the equivalent to 230mcg's levo) but needed to stay on this dose consistently for 6 weeks to see how my heart palps adjusted. As soon as they took the bloods on Tuesday I took an extra 25mcg's of T4 and have done so for the last three days due to feeling so ill, so now I have screwed the test up anyway by taking extra if my GP cant talk them into doing my TSH levels with the bloods they already have.

So to sum up - I have run around like a lunatic all week, making phone calls, having blood tests and GP's appts only to find that they whole thing has been a big waste of time as the NHS has moved the goal posts regarding re-testing and my endo either wasn't aware of it or chose to ignore it. Yet another brilliant money saving move by the GP's/Labs that is a total farce. Would love to know how much money has been wasted this week just on my experience alone.

Moggie x

[helvella]

The apparent lack of communication of such changes is really bad.

To be fair to the lab, it is quite possible they put out a notice which said that, but the doctors involved missed it - or it is in their inboxes waiting to be read sometime...

It can be worth looking online and seeing what the lab's policy really is. Try searching for "pathology handbook" for your health area.

To be honest, I don't see how they can maintain that separation (8 weeks) when the recent MHRA Levothyroxine report says dose is normally increased at 3-4 week intervals:

Once diagnosed, patients normally start the estimated full or just below the full replacement dose immediately unless they are over 50, have severe hypothyroidism or have cardiac problems, in which case, the levothyroxine dose is gradually increased from an initial daily dose of 25 - 50 mcg levothyroxine. This is then increased by 25 – 50 mcg/day at 3-4 weekly intervals until a normal metabolic state is attained.

mhra.gov.uk/Safetyinformati...

We cannot have two masters.

I would consider quoting the MHRA report and putting in specific complaint that the lab is failing to follow normal practice and needs to justify their deviation.

Rod

[boo16 in reply to helvella]

Hi Rod,

Would really love to know what a 'normal metabolic state is' - It does state this in PIL in Levo pack - pity GP's don't adhere to these guidelines......................x

[Moggie]

Thanks Rod BUT I am over 50 and I do have cardiac problems so where would that leave me in complaining about the lab as I would love to give it a go.

I think these changes are going to get worse - just little changes that will creep up on us like changing people from Eltroxin and time scales of tests. Its all a cost cutting exercise in my book and the GP's will be cutting more and more now they have full control over everything.

I was speaking to a lady on the phone last night who's GP told her that she could either see a gyna OR an endo but not both "so choose which one you want", how disgusting is that.

Rant over Rod.

Moggie x

[helvella in reply to Moggie]

The difference is a) the starting dose being 25 or 50 rather than near full replacement; b) increasing by only 25 micrograms. The end state should be the same. Unless there are specific additional reasons, the rate should still be 3-4 weeks according to that report.

[Moggie in reply to helvella]

Thanks Rod,

I'll try and digest that but don't need to complain as my GP spoke to the lab yesterday and they agreed to do my TSH after all.

Amazing what a bit of heated discussion can do isn't it.

Moggie x

[Poppy03]

I have had tests at the same hospital and in the beginning I am sure it was 6 weeks. And anyway if a Dr or Endo requests them they sure as hell should do it. And why where you not informed that the test was not done by your GP so you didn't have to attend an appointment? What is it with these people!

[Duchy82]

Thats really odd, ive had 2tsh tests i the space of a week before, i see 2 consultants and the gp and all ask for tsh to be measured the lab doesnt take any notice and will do any blood tests any of them ask for funny how different pct have different policies

[Moggie in reply to Duchy82]

I think my pct are tightening their belt. I have never had this problem either and its obvious that the consultant knew nothing about the eight weeks time frame.

I just think its another way to try and save money and its only going to get worse now the doctors are in full control of the spending.

Moggie x