RE: Newbie...not sure why to go from here?

[Guest guest]

It was reported at a GMC Hearing that doctors must not prescribe

for a patient unless they have seen the patient and given them an examination.

I guess you could report this endocrinologist to the GMC if you have a mind to

do so, but instead, I would first write him a letter explaining that you are

unhappy with his decision and would like to discuss this face to face and that

you would like all of your symptoms and signs to be taken into consideration

(signs cannot be seen unless he sees you face to face).

Tell him that you are very unhappy with his decision and the way

this was reached and that you will do everything you can to regain your normal

health again. Therefore, you are writing to ask him to read your take account

of your letter and requests made in that letter and to give you an early

appointment so that these matters can be discussed.

First, list all of your symptoms and signs you are suffering

right now. Check these against those in our web site www.tpa-uk.org.uk under 'Hypothyroidism'

and then in the drop down Menu 'Signs and Symptoms'.

Take your basal temperature before getting out of bed for 4 or 5

mornings and list these if they are less than 97.8 degrees F (36.6 degrees C) -

or less.

Tell the endocrinologist that you are aware that for people who

are not taking any thyroid hormone replacement, their free T4 is expected to be

just above the middle of the reference range (around 17/18) and for those who

are on thyroid hormone replacement, their expected free T4 should be in the

upper third of the reference range, as it was when you were taking 150mcgs T4. Therefore,

now that your free T4 has dropped to 13.6, this is very low, and also tell him

that you wish to know where your free T3 level lies, and whether this too has

dropped. It is the active thyroid hormone T3 our body and brain need to make

them function. Therefore, ask for a free T3 test as a matter of urgency. TSH is

always suppressed when a patient is taking thyroid hormone replacement if the

T4 is converting to the active thyroid hormone T3.

Many patients do well on synthetic T4, and this can be the case

for years, but then suddenly, for many sufferers, the T4 stops converting to

the active T3 - and these patients need some form of T3, either in combination

with their T4 or T3 alone.

Also, ask your endocrinologist to test specific mineral and

vitamin levels to see whether any of these are low in the reference range.

These are ferritin, vitamin B12, vitamin D3, magnesium, folate, copper and

zinc. In case he tries to tell you there is no association between low levels

of any of these and symptoms of hypothyroidism, then copy out the attached

document and put in with your letter to show just some of the references to the

science to show that there is.

I have also attached another document you should read showing

some of the reasons why thyroid hormone replacement might stop working.

When you get the results of these blood tests, ask for the actual

numbers and the reference range for each of the tests done and post them here

on the forum, so we can help you with the interpretation, because if they

appear within the range, most doctors will tell you that you don't have a

problem. We need to know whether they are at the bottom, the middle or the top

of the range.

Ask for an early appointment with this endocrinologist to

discuss matters further and to look into the possibility of a trial of a T4/T3

combination therapy and ask also for your letter of requests to be placed into

your medical notes. Keep a copy of this letter yourself in case you need to use

it at some time in the future.

let us know the outcome, and good luck.

Don't forget - you don't have to continue seeing this

endocrinologist, you can ask for a referral to one of our recommended doctors

by our members, even if the doctor you wish to see is outside of your area.

Luv - Sheila

TSH - 0.21 (Range 0.4 to 5.5)

T4 - 13.6 (Range 10.3 to 24.5)

He told me to keep on lower dose but I felt so bad that I upped my dose back to

the original 150mcg.

I have been on this dose for about 6/7wks now but not much has changed. I feel

like I've put myself back years by listening to him. I just dont know what else

to do. I know that my gp just follows the blood work not how I feel and it

seems the Endo did too - he couldnt even be bothered to give me a face to face

appointment.

What do you do when you feel bad but doctors tell you your results are 'normal'

and your symptoms are not thyroid related?

2 of 2 File(s)

LOW MINERALS AND VITAMINS AND THE THYROID CONNECTION.doc

Why thyroid hormone stops working (2).doc

[Guest guest]

Personally, I would increase my dose until I feel well again.....and when you go back say exactly what you have done and what you just said to us that your not listening to me your high on blood results....I felt well your advice made me feel ill, I have increased again and now I feel well again....please listen to what I say otherwise i will have to put everything in writing to you. Sally xx

I was referred to an Endo at my insistance in the hope that I would get better treatment. He sent me for bloods and I was assured Id see him in flesh after. I never did he simply wrote telling me to lower my dose to 125/150 alternate days. My results at the time were:free T4 - 22.0 (range 10.3- 24.5) TSH - 0.03 (range 0.4 - 5.5) Free T3 - 5.1 (range 3.5 - 6.5) I did as I was told but felt rubbish. My hair started to fall out heavily, the weight piled on and I was getting bleeding problems again. He requested another blood test, results: TSH - 0.21 (Range 0.4 to 5.5)T4 - 13.6 (Range 10.3 to 24.5)He told me to keep on lower dose but I felt so bad that I upped my dose back to the original 150mcg. I have been on this dose for about 6/7wks now but not much has changed. I feel like I've put myself back years by listening to him. I just dont know what else to do. I know that my gp just follows the

blood work not how I feel and it seems the Endo did too - he couldnt even be bothered to give me a face to face appointment.What do you do when you feel bad but doctors tell you your results are 'normal' and your symptoms are not thyroid related?