blood tests for hypothyroidism

[Guest guest]

Hello All

Thanks Sheila, for sending the list. I am also researching endos locally. Has

anyone ever seen Dr P at Liverpool Womens H.?

[Guest guest]

Hi Chrissie - any chance you can change this doctor from one who

is not so 'busy' and who is unable to keep up to date with the latest research

in order to help his patients as much as he can? You really do need to run a

mile from such a prat!

Before you do however, take this opportunity to write him a

letter and at the bottom, let him see that a copy has been sent to the Head of

Practice and ask for the letter of requests to be placed into your medical

notes.

In this letter, start by saying that you are no longer prepared

to put up with the suffering you have been put through all these last 40 years

and are now determined to get to the bottom of what is happening, and would

like him to help you.

First, list every single one of your symptoms and signs (signs

are what you can see). Check these against those in our web site www.tpa-uk.org.uk

.. It matters not how long the list is. Tell him that he is correct in that the

symptoms of hypothyroidism are non-specific ON THEIR OWN, but a

group of more than 8 of the symptoms can be specific to hypothyroidism and that

this should be taken into account. Tell him that if he still believes your

symptoms are nothing to do with hypothyroidism that he should now investigate

each of your symptoms separately and if he is unable to, then you wish to be

referred to whatever consultant specialises in each of your individual

symptoms.

Tell him that over 40,000 UK endocrinologists decided that their

previous TSH reference range of 0.5 to 5.0 was too wide and that they were

missing many hypothyroid patients so they lowered this range in 2003 to 0.3 to

3.0. Tell him that in Germany, Belgium and Sweden, the endocrinologists found

the American reference range too wide, and lowered theirs to 0.3 to 2.5. Tell

him that research has shown that for patients to feel 'normal' they need their

TSH to be somewhere within the region of 1.0.

Tell him that you believe levothyroxine (which is a mainly

inactive thyroid hormone may not be converting to the active thyroid hormone

triiodothyronine (T3) and you would like a trial of Liothyronine (T3) either in

combination with T4 or T3 alone, or even natural thyroid extract that contains

all the thyroid hormones you need. He may balk at this latter one, but put it

in your letter anyway. Tell him that even though it remains unlicensed in the

UK, the MHRA have stated that NHS doctors can prescribe it. Tell him that

fibromyalgia can be treated very successfully with T3 and ask him to take some

time out and read Dr Lowes research http://www.drlowe.com/france.htm.

Tell him that you would like the following to be tested, even

though he has no time to do the required research to show the connection

between these conditions and the symptoms of hypothyroidism - tell him that you

HAVE done the research and that is why these tests are very important.

Ferritin, vitamin B12, vitamin D3, magnesium, folate, copper and zinc. You need

to remind him once again that if he is not aware of the connection, he MUST

update his knowledge to help you, and other patients who are possibly suffering

in the same way:

Low iron/ferritin: Iron deficiency is shown to

significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block

the thermogenic (metabolism boosting) properties of thyroid hormone (1-4). Thus,

iron deficiency, as indicated by an iron saturation below 25 or a ferritin

below 70, will result in diminished intracellular T3 levels. Additionally, T4

should not be considered adequate thyroid replacement if iron deficiency is

present (1-4)).

1.

Dillman E, Gale C, Green W, et al.

Hypothermia in iron deficiency due to altered triiodithyroidine metabolism.

Regulatory, Integrative and Comparative Physiology 1980;239(5):377-R381.

2.

SM, PE, Lukaski HC. In

vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of

dietary fat. Life Sci 1993;53(8):603-9.

3.

Zimmermann MB, Köhrle J. The Impact of

Iron and Selenium Deficiencies on Iodine and Thyroid Metabolism: Biochemistry

and Relevance to Public Health. Thyroid 2002;12(10): 867-78.

4.

Beard J, tobin B, Green W. Evidence for

Thyroid Hormone Deficiency in Iron-Deficient Anemic Rats. J. Nutr.

1989;119:772-778.

Low

vitamin B12: http://www.ncbi.nlm.nih.gov/pubmed/18655403

Low

vitamin D3: http://www.eje-online.org/cgi/content/abstract/113/3/329

and http://www.goodhormonehealth.com/VitaminD.pdf

Low

magnesium: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292768/pdf/jcinvest00264-0105.pdf

Low

folate: http://www.clinchem.org/cgi/content/full/47/9/1738

and http://www.liebertonline.com/doi/abs/10.1089/thy.1999.9.1163

Low 

copper/zinc:http://www.istanbul.edu.tr/ffdbiyo/current4/07%20Iham%20AM%C4%B0R.pdf

and http://articles.webraydian.com/article1648-Role_of_Zinc_and_Copper_in_Effective_Thyroid_Function.html

Tell

him that your ferritin level needs to be between 70 and 90, that your Vitamin

B12 needs to be at the top of the range, that your vitamin D3 levels need to be

about 50. Magnesium levels need to be at the top of the range. Tell him that

you would like a copy of the results when they come through, together with the

reference range for each of the tests done.

Tell

him that you are NOT prepared to wait yet another three months to be referred

to an endocrinologist of your choice - it will be another 3 months before any

appointment will come through - meaning your continued suffering for another 6

months. Ask for an immediate referral.

If

you feel you will be stone-walled again, perhaps you should remind him of The

Duties of a Doctor Registered with the General Medical Council http://www.gmc-uk.org/guidance/good_medical_practice/duties_of_a_doctor.asp

Sadly,

patients have to fight more and more to get their doctor to listen to them, but

we have to keep on, and on, and on, until they do.

Remember

to ask last that your letter of requests be placed into your medical notes.

Doctors pay more attention to the written word.

Good

luck Chrissie.

I quoted Dr P on mucopolysaccherides and muscle pain and asked my GP if he had

read the book which I took with me. He replied he had no time for reading,he

was working all the time. How do they keep up with medical developments then ??

On a positive note, he agreed to raise my dosage to 75mcg and to retest TFT and

B12 in three months,but not the other tests suggested. he saw no link. I

offered him the relevant links but I fear he wouldn`t read them. I am taking a

good multi vitamin though. He will refer me to an endo of my choice in three

months,if there is no improvement. Any comments would be most welcome

Chrissie

[Guest guest]

Thanks for your suggestions,some of which I had already employed anyway.the GP

already has had a letter from me with symptoms/signs as per the website> He told

me at the next appointment he had not read them,only the letter-not time! So I

had to explain everything from scratch then the appointment time ran out. Very

annoying!. Some of my symptoms have been individually investigated over the

years, tests done and deemed inconclusive, or `nothing can be done`.No real

explanations. I was told by my previous GP(now retired) that I should live with

the muscle pain-he was an endo`s clinical assistant. I am sending a second

letter using your model and asking for letters etc to go on my records and

copying to the Head of Practice as suggested.Unfortunately, my GP obviously does

not read much so this could be a long and tortuous education process.

Chrissie

>

>I`m angry with myself for being so clueless on many occasions in the past.

> I quoted Dr P on mucopolysaccherides and muscle pain and asked my GP if he had

read the book which I took with me. He replied he had no time for reading,he was

working all the time. How do they keep up with medical developments then ?? On a

positive note, he agreed to raise my dosage to 75mcg and to retest TFT and B12

in three months,but not the other tests suggested. he saw no link. I offered him

the relevant links but I fear he wouldn`t read them. I am taking a good multi

vitamin though. He will refer me to an endo of my choice in three months,if

there is no improvement. Any comments would be most welcome

> Chrissie

>

[Guest guest]

>>>>. He replied he had no time for reading,he was working all the time. How do they keep up with medical developments then ??<<<<

What he means is that he doesn't get paid for it.Lilian 

[Guest guest]

Chrissie, when you write the letter to your GP (sending a copy

to the Head of Practice), don't allow this to become a long, tortuous education

process. Get in there first with a reminder about " The duties of a doctor

registered with the General Medical Council " http://www.gmc-uk.org/guidance/good_medical_practice/duties_of_a_doctor.asp

.. You can simply tell him that you need a doctor who follows the GMC

recommendations and who you can trust to do whatever is necessary to help you

regain your optimal health. Below is the list straight from the GMC web site.

" Patients

must be able to trust doctors with their lives and health. To justify that

trust you must show respect for human life and you must:

·

Make the care of your patient your first

concern

·

Protect and promote the health of

patients and the public

·

Provide a good standard of practice and

care

o

Keep your professional knowledge and

skills up to date

o

Recognise and work within the limits of

your competence

o

Work with colleagues in the ways that

best serve patients' interests

·

Treat patients as individuals and respect

their dignity

o

Treat patients politely and considerately

o

Respect patients' right to

confidentiality

·

Work in partnership with patients

o

Listen to patients and respond to their

concerns and preferences

o

Give patients the information they want

or need in a way they can understand

o

Respect patients' right to reach

decisions with you about their treatment and care

o

Support patients in caring for themselves

to improve and maintain their health

·

Be honest and open and act with integrity

o

Act without delay if you have good reason

to believe that you or a colleague may be putting patients at risk

o

Never discriminate unfairly against

patients or colleagues

o

Never abuse your patients' trust in you

or the public's trust in the profession.

You

are personally accountable for your professional practice and must always be

prepared to justify your decisions and actions. "

In

your letter, ask your GP for a Double Appointment Time so that you can both

discuss your problems in more detail, but do emphasize that a doctor should not

be diagnosing by the results of blood tests alone, but that symptoms and signs

are VERY important in diagnosing any disease, that a good clinical examination

is needed, that your previous medical history should be taken into account

including your family history if any members have a thyroid or autoimmune

disease. You are entitled to be treated exactly as the GMC expect doctors to

treat their patients and if he does not treat you in that way, you need to find

another doctor as soon as possible.

You

take control of how you want to be treated Chrissie.

Luv -

Sheila

Thanks for your suggestions,some of which I had already

employed anyway.the GP already has had a letter from me with symptoms/signs as

per the website> He told me at the next appointment he had not read them,only

the letter-not time! So I had to explain everything from scratch then the

appointment time ran out. Very annoying!. Some of my symptoms have been

individually investigated over the years, tests done and deemed inconclusive,

or `nothing can be done`.No real explanations. I was told by my previous GP(now

retired) that I should live with the muscle pain-he was an endo`s clinical

assistant. I am sending a second letter using your model and asking for letters

etc to go on my records and copying to the Head of Practice as

suggested.Unfortunately, my GP obviously does not read much so this could be a

long and tortuous education process.

Chrissie

_,_._,___