Treatment question - anyone know a good Doctor?

[Guest guest]

Having suffered with almost the full range of symptoms of underactive

thyroid for the past 18 months or so (and very significant), I just

found out that my blood test results are slightly raised TSH (4.88) and

normal free T4 (10.8) and I also learned that my GP isn't prepared to

offer treatment despite my symptoms. I was told to wait and see the

result of a second blood test in a months time - but also told that

unless that test shows a higher TSH or change in T4 then still I am

unlikely to receive treatment. My life has been affected in a big way

over the past 18 months and so I am considering self-treatment if the

NHS is of no help. Already placed an order from one of those 'no

prescription required' websites for Levothyroxine and will start on a

dose of 50 mcg and gradually increase every 3 weeks (will also have

blood tests periodically too). I won't start my self-treatment regime

until I have had the second test and seen my GP. I will also advise my

GP that I will be treating myself.

Does anyone know of a good Doctor or Endocrinolgist that would treat in

light of the above info?

[Guest guest]

Hello, you should be treated based on the symptoms and your tests,

your TSH and your T4 are borderline, your GP is being unreasonable

and could compramise and give you a trial of thyroxine at least. I

would suggest maybe changing to a different doctor, a different

surgery or approaching a private doctor, the best thing is to try to

get somebody's support, going it alone should be an absolute last

choice. You will come across somebody who will support you if you

look hard enough. Are your immediate family/partner supportive of

you? Ruth x

>

> Having suffered with almost the full range of symptoms of

underactive

> thyroid for the past 18 months or so (and very significant), I just

> found out that my blood test results are slightly raised TSH (4.88)

and

> normal free T4 (10.8) and I also learned that my GP isn't prepared

to

> offer treatment despite my symptoms. I was told to wait and see

the

> result of a second blood test in a months time - but also told that

> unless that test shows a higher TSH or change in T4 then still I am

> unlikely to receive treatment. My life has been affected in a big

way

> over the past 18 months and so I am considering self-treatment if

the

> NHS is of no help. Already placed an order from one of those 'no

> prescription required' websites for Levothyroxine and will start on

a

> dose of 50 mcg and gradually increase every 3 weeks (will also have

> blood tests periodically too). I won't start my self-treatment

regime

> until I have had the second test and seen my GP. I will also

advise my

> GP that I will be treating myself.

>

> Does anyone know of a good Doctor or Endocrinolgist that would

treat in

> light of the above info?

>

[Guest guest]

> Having suffered with almost the full range of symptoms of underactive > thyroid for the past 18 months or so (and very significant), I just > found out that my blood test results are slightly raised TSH (4.88) and > normal free T4 (10.8) and I also learned that my GP isn't prepared to > offer treatment despite my symptoms. I was told to wait and see the > result of a second blood test in a months time - but also told that > unless that test shows a higher TSH or change in T4 then still I am > unlikely to receive treatment.

Don't discuss this with your GP - the time has come to put what you feel in writing, so that it can be placed into your medical notes. If it is found that you suffer any ill effects because your GP has refused to take this matter further, i.e. refer you to a specialist in thyroid disease, she will think again, before saying this to anybody else. Make a list of all your symptoms and signs. You can get this from our website www.tpa-uk.org.uk Click on Hypothyroidism and on the drop down Menu, click on Symptoms and Signs. Signs are things you can see. Also take your temperature every morning for 5 days before you get out of bed. Normal temp. is 98.4 degrees F. If yours is 97.8 or less, and it could be much less, list these with your symptoms.

If you lived in the USA, Australia or germany (and probably elsewhere) you would now have been given a diagnosis of hypothyroidism and started on treatment. the TSH reference range in the USA and Aust. is 0.3 to 3.0 - and in Germany it is 0.3 to 2.5 - and they are talking of lowering the upper end of the range even further. The UK seem to be years behind other countries in diagnosing and treating this disease. Put in your letter that you now wish to be referred to an endocrinologist because you are aware your GP does not have the necessary training to be able to diagnose hypothyroidism. She should NOT go by blood tests alone. You should have a thorough physical examination, your thyroid palpated, you should have your achilles tendon tapped to see the reflex reaction (a slow reaction is specific to hypothyroidism). You should be asked about any thyroid illness in your family, or asked whether anybody has an autoimmune problem. You should ask for a FULL thyroid function test which should include TSH, Free T4, Free T3 and a test to see if yhou have antibodies to your thyroid.

Antibodies see your thyroid tissue as the enemy, and set about its destruction and gradually, the whole thyroid is destroyed and it is unable to put out the thyroid hormones your body requires. Your TSH is at the TOP of the reference range, and your Free T4 is at the bottom - both showing that you are hypothyroid.

Write in your letter that you are no longer prepared to wait (after waiting 18 months) for her to decide whether you are deserving of thyroid hormone replacement or not. Make it very clear that you are VERY aware that some common and often undiagnosed symptoms and dangerous consequences of low thyroid include: serious mental problems, seizures, heart disease, diabetes including misdiagnosis and complications, constipation resulting in colon cancer, all female problems (due to high amounts of dangerous forms of oestrogen), including: tumours, fibroids, ovarian cysts, PMS, endometriosis, breast cancer, miscarriage, heavy periods and cramps, bladder problems leading to infections, and others....and that you do not wish to put yourself at risk of getting any of these, if thyroid hormone replacement can stop them, simply because she refuses to send you to a specialist. Keep a copy of this letter yourself. Ask your GP to respond to you in writing and doln't accept a phone call from her. That way, at a later date, if it is not written down, they can deny whatever it was they said....if you know what I mean.

Give her 10 days to respond to you. If she doesn't, you can then pass your complaint on to the Primary Care Trust, or other organisations, but we will talk about that if, and when this arises.

My life has been affected in a big way > over the past 18 months and so I am considering self-treatment if the > NHS is of no help. Already placed an order from one of those 'no > prescription required' websites for Levothyroxine and will start on a > dose of 50 mcg and gradually increase every 3 weeks (will also have > blood tests periodically too). I won't start my self-treatment regime > until I have had the second test and seen my GP. I will also advise my > GP that I will be treating myself.

If you are determined to start treatment yourself, please be assured that you understand about thyroid hormones and the role they actually play. It can be very dangerous to do this without some knowledge. Levothyroxine, for a start, is an inactive hormone. It has to convert through the liver to the active hormone T3. T3 needs to get into every cell in your body and brain to make them function. Tool little can be dangerous, too much can be dangerous, and if you are one of the large minority of sufferers who are unable to convert for some reason, you will remain ill. We usually recommend using natural thyroid extract (Armour Thyroid, USP as it contains all the thyroid hormones your body needs.

You should start for the first time with only 25 mcgs levothyroxine (not 50) to make sure that you do not have a bad reaction to it. If you have a heart problem, you should not start this on your own at all - again, this can be dangerous. Neither should you increase your levothyroxine every 3 weeks. It takes up to 6 weeks for the thyroxine to be absorbed by your body, and doing it the way you suggest would cause over-dosing very quickly. You should have your blood tested every 6 to 8 weeks when first starting to see whether it is working as it should.

You may also have low adrenal reserve which you sould need to treat as such a condition would stop any thyroid hormone replacement from working. There is a lot to treating hypothyroidism, and there are many conditions that will stop it from working. Look at our website again, click on 'Hypothyroidism' and then click on 'Associated Conditions' and be sure you understand everything. Any questions, just shoult very loud, and somebody will come along to help you.

Tell us where about ion the UK you live and we will see whether we have a good doctor in your area. Are you prepared to travel.

Lastly, please be patient - I know personally how frustrating it can be when our doctors refuse to help us. Especially as we know they are mainly refusing to help us because they haven't been taught - and they are often putting off the 'evil day' when they must do something.

Let us know the outcome of your letter. Remember, your letter has to stay on your medical notes, and writing is often a way of getting a doctor to change their mind and passing you on to a consultant who will take the responsibility.

Good luck.

Luv - Sheila> > Does anyone know of a good Doctor or Endocrinolgist that would treat in > light of the above info?>