Re: Should I nag my doctor?

[Guest guest]

Yes, Ian, ALWAYS nag your doctor if you feel you are not getting

the level of service you feel you should be. Doctors are there to work with you,

not against you and you should be both working together to help you regain

normal health.

I would highly recommend that you do the following and tell your

doctor that you are no longer prepared to put up with your symptoms and will do

everything you can to get a proper diagnosis and the treatment that will make

you well.

First, write a letter addressed to your GP and send a copy to

the Head of Practice. In this letter, list every single symptom and sign (check

our web site www.tpa-uk.org.uk and click

on 'Hypothyroidism' and then click on 'Symptoms and Signs' and check all of

yours against those there). Signs are things you can see, and your doctor

should 'see' these too.

Next, take your temperature for 4/5 mornings before you get out

of bed and before drinking anything or doing any activity and write these down

too.

Next, list every member of your family who has a thyroid or autoimmune

condition.

Next, list all the blood tests you would like to be done - a

full thyroid profile that must include TSH, free T4, free T3, TPO and TgAb.

Thyroid antibodies see your thyroid as public enemy number one and set about

it's gradual destruction. As you have members of your family with thyroid

disorders then these tests could be positive and you might be suffering with

Hashimoto's disease, which is a cause of hypothyroidism. You should ask for a

copy of the reference range for the Free T4 test they have done because it

looks to me like your fT4 is below the reference range and you should be asking

for a trial of some form of thyroid hormone replacement.

Next, ask for the following blood tests to be done too, but make

it clear to your GP that you are specifically asking for these tests because it

is well known, that should any of them be low in the reference range, your own

thyroid hormone is unable to be fully utilised at cellular level and whatever

you are low in could be a cause of your awful symptoms. If any are found to be

low, they would need supplementing with immediate effect. These are ferritin,

vitamin B12, vitamin D3, magnesium, folate, copper and zinc. Ask that the

results of all these tests be sent to you, together with the reference range

for each of the tests done. (You can post them here on the forum and we will

help with their interpretation, because it is a fact that many doctors don't

know how to interpret results, believing that if they appear anywhere within

the normal reference range, this means they are normal - NOT SO!)

Next, ask for a referral for a second opinion to a specialist of

your choice. You do NOT have to see an endocrinologist recommended by your GP -

you have a choice, and if necessary, you can be referred outside of your area,

especially if there are no endocrinologists in your area who specialise in

thyroid disease. Most have a speciality in diabetes and some know little or

nothing about the symptoms of hypothyroidism.

Next, ask for your letter of requests to be placed into your

medical notes, send a copy to the Head of Practice and ensure you keep a copy

yourself in case you need to use this at a later date, should your doctor

decline to do his duty, though quite often, doctors pay more attention to the

written word than they do to face to face consultations, which they can deny

ever took place once you have left their surgery door.

Good luck, and let us know the outcome.

Meanwhile, if possible, do get the 24 hour salivary adrenal

profile done so we can see where your cortisol and DHEA lie at four specific

times during the day. this is important. Check out our FILES section accessible

from the Home Page of this forum, and open the FOLDER entitled 'Discounts on

Tests and Supplements' and then open the Genova Diagnostics File and follow the

instruction on ordering there to be able to claim a discount for all TPA

members. Just write (or tell them) when ordering that 'Thyroid Patient

Advocacy' is your practitioner. You will get the results sent to you direct.

Luv - Sheila

I have been to the doctors several times and they have suggested I have a

lingering virus, arthritis and fibromyalgia. They have carried out a number of

blood tests (including one for Thyroid) and could not come up with a definitive

diagnosis.

My mother suffers from Hypothyroidism and suggested I might be suffering from

the same. I asked my doctor for a copy of my blood test results and would like

a second opinion as to their interpretation.

Blood Test Results

Plasma free T4 level = 8.9 pmol/L

Plasma TSH level 1.94 mu/L

[Guest guest]

Hi , the answer is yes, nag him and tell him that the T4 is to low. and the TSH could be a bit lower. the TSH can be anywere in the reference range and the T4 should be in the second half of the range, better still try to get a T3 test. as this is more accurate , also a TPOab test to look for auto-antibodies.. Angel.

[Guest guest]

Hello Ian,

We've found that some doctors have a way of simply not listening, or playing

dumb.

He did well getting a test for T4 and Tsh, many docs just do tsh and guess the

rest. A normal TSH is 1, so yours is raised, allbeit not by much..... The T4

looks low to me, but you don't give the reference range for the free t4.... if

you have the range it would be useful. Usually it's somewhere between 9 and

22. If your t4 is low then the t3, which is made from t4 will be low....

The fibromyalgia is a bucket diagnosis, for when they just don't know what they

are doing..... Dr Lowe believes it is linked to a lack of thyroid hormone T3.

he has a website at www.drlowe.com

I think it would be well worth you asking your doctor for the reference range

and for a test to see whether you have antibodies to your thyroid (Hashimotos),

if your mother suffers it is very likely that you will too.... I would also

list your symptoms (check list in the files section) and ask for a trial of

Levothyroxine and/ or a referral to a specialist of your choice... Your

doctor is a General Practitioner, not an expert. We do have a list of both

NHS and private endos who may be of use, depending on where you live...

Yes, thinking about it, get in there and nag him to do something for you....

bear in mind that you shouldn't have to nag as the doctor should be doing his

job properly, and his job is to consider your signs and symptoms and treat you,

using the blood tests as a secondary back up.

>

> Hi,

>

> I have been suffering from fatigue, aches and pains all over for many months,

I find it extremely hard to wake up in the mornings regardless of how much sleep

I get. My morning body temperature (using a digital thermometer under my tongue)

averages at 97.5 F. My resting pulse is usually between 58 and 60 bpm and I am

no athlete. I go to the Gym 1-3 times a week and have been on a calorie

controlled diet of around 1,800 calories per day and yet I seem to be unable to

lose any weight.

>

> I have been to the doctors several times and they have suggested I have a

lingering virus, arthritis and fibromyalgia. They have carried out a number of

blood tests (including one for Thyroid) and could not come up with a definitive

diagnosis.

>

> My mother suffers from Hypothyroidism and suggested I might be suffering from

the same. I asked my doctor for a copy of my blood test results and would like a

second opinion as to their interpretation.

>

> Unfortunately, the test were only for TSH and T4. I would like to know if the

results from these would be reason for me to ask for a T3 or other thyroid

tests.

>

> I am male, 53 and weigh 16st.

>

> Blood Test Results

>

> Plasma free T4 level = 8.9 pmol/L

>

> Plasma TSH level 1.94 mu/L

>

> There was another result with the word High within it so I have included it in

case it has any bearing.

>

> Plasma creatine kinase level = 206 iu/L High Original result:206 iu/L (37C)

(<171)

>

> I hope this is a appropriate post for this forum.

>

> Thank you.

>

> Ian

>

[Guest guest]

Thank you. I will start nagging my doctor! :-)

>

> Hi , the answer is yes, nag him and tell him that the T4 is to low. and the

TSH

> could be a bit lower. the TSH can be anywere in the reference range and the T4

> should be in the second half of the range, better still try to get a T3 test.

as

> this is more accurate , also a TPOab test to look for auto-antibodies.. Angel.

>

[Guest guest]

Hi Sheila

Thank you for your detailed and comprehensive reply to my query.

I will contact my doctor tomorrow and ask for the ranges. I will also book an

appointment for a weeks time to enable me to produce a proper record of my

moring body temperatures etc. I will also send a letter as per your suggestion

to arrive well before my appointment as I hope it will have the desired effect.

I was not aware that I was entitled to see a specialist of my choice. How would

I go about finding an endocrinologist specialising in thyroid conditions in my

area?

Can I insist on having these blood tests or seeing a specialist or is it down to

the docter (and dare I suggest her budget)?

I forgot to mention in my original posting that I am diabetic (controlled by

diet) and I wonder if that would affect any of the results.

Many thanks.

Ian

>

> Yes, Ian, ALWAYS nag your doctor if you feel you are not getting the level

> of service you feel you should be. Doctors are there to work with

[sNIP]

> instruction on ordering there to be able to claim a discount for all TPA

> members. Just write (or tell them) when ordering that 'Thyroid Patient

> Advocacy' is your practitioner. You will get the results sent to you direct.

>

> Luv - Sheila

[Guest guest]

I have responded direct and sent you our list of recommended

doctors privately Ian.

Luv - Sheila

Hi Sheila

Thank you for your detailed and comprehensive reply to my query.

I will contact my doctor tomorrow and ask for the ranges. I will also book an

appointment for a weeks time to enable me to produce a proper record of my

moring body temperatures etc. I will also send a letter as per your suggestion

to arrive well before my appointment as I hope it will have the desired effect.

I was not aware that I was entitled to see a specialist of my choice. How would

I go about finding an endocrinologist specialising in thyroid conditions in my

area?

Can I insist on having these blood tests or seeing a specialist or is it down

to the docter (and dare I suggest her budget)?

I forgot to mention in my original posting that I am diabetic (controlled by

diet) and I wonder if that would affect any of the results.

Many thanks.

Ian