I've Seen Dr P

I saw Dr P yesterday. As I said in my previous blog post, I've improved from where I was at last October when I literally couldn't function. I was overwhelmed with depression and so weak and shaky that I could barely stand. I was in bed for 3 months.

My TSH was 5.6 so a GP in my surgery put me on 50mg of thyroxine to shut me up. On 50mg I didn't really feel any better but several things changed. I could breathe properly, my atral fibrillation stopped and I could talk properly. In Jan my TSH was 2.5 and I increased to 75mg. Within days I finally noticed an improvement in how I was feeling.

Slowly but steadily I've improved and have added in various supplements - detailed on my last blog post.

Fast forward. I asked for a repeat blood test a week ago. My TSH was 0,2 and my FreeT4 and T3 were in range but right at the top.

Dr P said, what I'd come to suspect, that my main problem isn't thyroid but adrenals. I was taking 1 tablet a day of nutri-thyroid and nutri-adrenal.

He says I should stop taking the thyroxine as I'm now toxic (!) and instead increase the Nutri Adrenal from one a day steadily up to the equivalent of 8 a day. I say equivalent because he suggested NA Extra as it is stronger and has lots of other "goodies" in it too.

Then he says to adjust the Nutri thyroid as necessary.

I am going to keep a daily diary - and I'm tempted to head today's "today is the first day of the rest of my life". I do so hope that it is.

I know it will be 2 steps forward and one step back. I have just had the mother and father of all colds, which dragged me down. However - one thing I have noticed (and I should be typing this with my fingers crossed, but I'd type the wrong letters!) is that for the first time in years I seem to have come out of the cold without going downhill and being ill for weeks afterwards.

I have an appointment to see my GP on Monday. That will be interesting. I know he's going to tell me my TSH/T3/T3 are wrong - cos the lab have printed it on my test results. It's not hard for GPs to interpret test results I now know, cos the lab print on them when it is time to see the patient! They have also flagged up my serum C reactive protein level as sky high (56 instead of it's usual 4/5). But this is because I was in the throes of the mother and father of all colds.

I suspect when I tell him that and tell him I've stopped taking thyroxine his jaw will hit the floor of his consulting room. Let's see what he says!

21 Replies

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  • I thought TSH less than 1 was good and T3 and T4 at the top of range was desirable??

  • I think it probably is, but he said that I am becoming thyrotoxic on a low dose of T4 as my body isn't able to utilise it properly.

  • that makes sense :)

    I'm dreading my next blood test results, I just want to be straight forward lol

  • Im interested in why you felt you needed to see Dr P. From what I can see, Id be happy with your test results.

    To have your TSH where it is and the T4 and T3 top of the range indicates to me that you have achieved all that we're trying to achieve here?

    I too have seen Dr P but I was definitely toxic because I felt so ill and already on 200mcg of T4 with worsening leg pains and actually feeling toxic. You however say that youre gradually improving in how you feel.

    Are you missing something out in your explanation ie some other symptoms that just werent right that gave you the need to see Dr P?

  • For me Thyroid has always only been part of the problem. In the adrenal quizzes I always score poorly and for most of the time I've been ill my thyroid doesn't seem to have been a problem at all. Thyroid was the clue I needed, not the whole answer. I think it only became part of the problem 6 years ago when I had the menopause.

    As to why I saw Dr P. Long story very short. His Malvern consultations take place in a clinic run by a hypnotherapist who is one of my computer clients. Back in October when I was too ill to function at all, but not yet diagnosed with thyroid problems, she phoned me about her computer. When I told her I was too ill to come, she said "you must come and see Dr Peatfield, he's coming to my clinic in April". I had no idea who he was, but she gave me his phone number. Over the years many people have told me they know, or think they know, what treatment I need, so just to keep her happy I rang his number. His secretary phoned me to make the appointment on the day my Dr told me I had thyroid problems. Some coincidence, eh?

    As soon as my Dr told me I had thyroid problems I felt as if a light had been turned on in my head. I hit the internet and it became clear very quickly that thyroid was just one part of the problem. It was the clue, not the whole answer. I believe my whole endocrine system doesn't work correctly and never has. Dr P says the adrenals are what underpins the whole system.

  • If you felt better on thyroxine, it may be wise not to tell your GP that you are no longer on it and taking NAX. The reason: He will remove from your records that you are hypothyroid (which you are) and will stop giving you thyroxine so if you should ever need to take it (or any other thyroid hormone) again, he will refuse to prescribe it for you. He also most probably won't like to hear that you are on NAX. Just because you are getting a prescription for for thyroxine, doesn't mean you need to take it!

    If you are a positive you will never need any thyroid hormone EVER, then by all means tell your GP. The thing is, one cannot predict this so, personally, I would keep quiet and see how you get on with the NAX first before shooting myself in the foot. ;-)

    If you battled getting a diagnosis of hypothyroidism this time, you can be sure you will battle even harder next time and they may not treat you until your TSH has gone over 10!

    Silky x

  • Now there's a thought. I'll think about that.

  • Yes I totally agree iwth Silky - you need to stay in the system as hypothyroid. I didn't tell my GP that I was taking NAX and Nutri thyroid and had reduced my thyroxine. I am a firm believer that NT contains thyroxine and T3 anyway. xx

  • I've just re-read the notes he wrote me. He starts by saying stop thyroxine for 10 days but not NT. Further down he says build up on the NT again. I think I will tell my GP I'm stopping for 10 days - then I can show him Dr P's notes. I want to try to keep my GP on side for the time being.

  • Sorry, just trying to be helpful but is it wise to bring Dr P into it with your consultation?

    One GP I saw suggested that Dr P was a charlatan! Remember that he's no longer registered with the GMC.

  • I do agree with SilkyJ - keep quiet about what you're taking and who you're seeing. You don't want to run the risk of GP not treating or testing you.

  • See my reply to Clarebear above.

  • You have to box clever in this world......Dont give them a stick (however wellmeaning) to beat you.....because most of them will .....just stockpile the levo for leaner times and if you're fine without it then great.....it's a question of survival really!!!!!

  • I've also been on Nutri Thyroid prescribed by Dr Peatfield and I told my GP about it and he said it was fine by him if it suited me. However, he retired and I went back on Levothyroxine as my blood results changed and I couldn't contact Dr Peatfield - it was during the time he moved house. Later I went to see the GP I was seeing after the one who retired. I took a pot of Nutri along to show him and to say I'd like to go back on it. He would not even take the pot in his hand when I offered it to him so that he could see what the ingredients were. All I could get out of him was " I don't know what's in it". I said it was completely natural and the answer I got was "So's nightshade and it can kill you." He then went on to say what would the BMA think of him agreeing to me taking something like that! I have now moved to another surgery. The doctor I was seeing there has just retired and I think she would have been OK about it because there was no problem when I told her I'd gone on to herbal medicine for raised blood pressure. I have now got another new doctor. I don't yet know what she's going to be like. Open minded I hope!

    Alitom

  • I agree with people saying don't tell your GP yet.

    Thyroid probs are such a misinformed area of GP medicine, and the last thing you want to do is make things more difficult for yourself if things don't go to plan with cutting out the T4. If it says in your notes 'patient is stopping thyroxine', that could easily be used in all kinds of ways in the future. Eg doctors saying you didn't find it helpful & using it for their own ends. Things get lost in translation and the mists of time v easily in med notes. I'd try the new treatment as a self-experiment, and only tell the GP if and when you know it's better for you.

    When my father died suddenly in front of me, I was referred to counselling at my own request - imagine my horror when that referral in my notes was cited back to me by another GP to say my doc thought the ME was psychologically based. Some docs are real opportunists.

    Unless the GP is involved either for his opinion or prescription/referral services, then keeping mum until later when you're sure what works and what doesn't might be a better option.

  • I saw Dr. P. last year with the same issues. I failed all clinical assessments for adrenals. I had then began having skipped heartbeats for which my endo sent me for cardiac assessment, all of which were clear. Dr. P. told me I was t4 toxic (had been on 125mcg daily since TT in 2005) and to drop the dose. I spoke with the endo and told him this was what I was going to do and guess what? skipped heartbeat issue resolved. So I was surprised when I saw my endo last Monday and he suggested upping my t4???! I politely refused.

  • I find this surprising and a little odd. If you were genuinely toxic on the levo, then wouldn't you be having some unpleasant symptoms? Admittedly, I've only read your short post above, so I'm aware that I won't have the full picture, but you didn't give the impression that levo disagreed with you. To my way of thinking a nearly suppressed TSH with upper range normal hormone levels means that you're on the optimal dose... the medication is supplying everything you need, so your body doesn't signal for more to be made.

    Dr P's plan will mean that you come off levo, which is free and easily obtainable on prescription, onto Nutri Thyroid, which you will have to buy yourself for the rest of your life. You are unlikely to be supported by your GP in this plan. Yes, some people do this, but only because they feel that they have no other choice, when they are absolutely sure that levo is not working for them... (and whether adrenals come into the picture or not). But is that true for you?

    Also, I think it's a bad idea to take Nutri Adrenal without first checking what your cortisol levels are. I don't think a questionnaire is necessarily going to give you the whole story as there are some symptoms that are shared by high and low cortisol. Glandulars like Nutri Adrenal tend to boost cortisol levels. If cortisol goes too high then it will make you feel pretty unwell, give you sleepless nights, and in the medium to longer term will lead to osteoporosis.

    Sorry, I realise this won't sound very supportive. It's just my opinion, and I'm not a medical person, so feel free to ignore everything I say. I wish you well in whatever you decide to do.

  • Hi Point. I might well decide to go back on the levo, as I wasn't having any adverse effects. I'll see in time. I had the Genova saliva cortisol test done before Xmas, so we know my cortisol levels are wrong. Low mid range on waking and then flatlined to well below normal for the rest of the day. And no - I wouldn't ignore everything you, or anyone else, says. It's a learning curve and I feel Dr P has given me the next piece of the puzzle. Ultimately I have to find what works best for me.

  • Dr P suggested I stop my thyroxine 75/50mcg for a week and start Nutri Thyroid and Nutri Adrenal, then restart thyroxine at 50mcg. I did this and felt better, but then started to feel worse and blood tests showed I was over-medicated. I found Nutri Thyroid to be quite strong :D I had to tell my endo, who I expected to be shocked and horrified, but in fact he just suggested reducing the dose of Nutri Thyroid.

    Good luck with what ever you decide to do. xx

  • This has been a very interesting thread. Right now I'm thinking that after 10 days I might go back on 25mg of thyroxine - just to keep the point that I am hypothyroid - but also to maintain my entitlement to free prescriptions. We'll see.............

  • Would someone please be kind enough to state what the main signs/symptoms are for hypothyroidism. Have been on T4 - disaster, new endo trialling T3, a little better (won't bore you all with history) but intolerance to exercise has increased -- it is a side effect of T3 AND one of the main signs of adrenal fatigue, laboured breathing a lot worse (this started with T4) and am now, with other patients, being referred to Addenbrooks Hospital Cambridge for this problem. My brain, though foggy a good deal of the time, is trying to work what really is the problem for me. Thanks very much.

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