How best to approach GP with health concern?

[linesandlines]

For various reasons (years of symptoms, recent research and advice), I think I may have a pituitary tumor. Don't want to drip feed, but am more than happy to explain why if need be.

The thing is, how do you waltz in to an appointment with a GP and suggest such a thing without them immediately writing you off as a hysterical hypochondriac? How do you request tests etc and get them to take you seriously?

After 20 years of appointments trying to get doctors to understand how badly my symptoms (extreme fatigue, major weight gain, cognitive decline) affect me, they generally just say I'm depressed and issue another anti-depressant script. Yes, I have had depression, but am sure it's a symptom not a cause of my physical symptoms, not the other way round as they insist. Right now I'm mentally fine, but still borked physically which supports that.

[maiii]

It's easy. I went to the doctor and said 'I'm lactating and have headaches, can you test my prolactin levels please'. 10 days later I was told they were 5000.
The sooner you know the better!

[linesandlines]

Oh good for you, getting a diagnosis, Maiii.
I'm not even slightly lactating. unsure whether to do happy or sad face here

[Cel982]

GP here, OP. Would you mind elaborating on your symptoms a bit? It's just that if, like the PP, you have galactorrhoea, then a pituitary tumour would be high on the list of potential diagnoses and any GP would be quick to measure your prolactin. If the symptoms are a bit less specific then it might be harder to get the tests you want done.

[Hassled]

My experience is that GPs are pretty sympathetic to patients saying "I've googled and am worried it might be this". And they'll either say no, I don't agree because of X, Y and Z or they'll say well yes, that makes sense. So just tell then what you said in your first para - you've got these symptoms and you've done some research and what do they think? But do trust their judgement - they have the experience and the training. I hope you're wrong, for your sake - good luck :).

[linesandlines]

oh thank you, Cel982! Well, my symptoms, which have steadily worsened over the last 20 years, mirror just about every hypothyroid symptom in the book. Intolerable fatigue (had to give up work, can't be properly involved in family life, too tired for any social life at all), 5 stone weight gain despite very strict diet - 2 LCHF meals per day, no snacks, inability to concentrate at all, loss of body hair, low temperature (usually 35.5) etc etc but TSH tests all come back as within range. I recently had my free T4 and T3 tested which were right at the bottom of the range. Thyroid antibodies were normal, which as far as I can tell indicated no Hashimoto's, but could be central hypothyroidism.
Recently I read something about Cushing's Disease, and sure enough, all my weight is on my trunk, I have a dowager's hump which developed probably early to mid 20's, moon face (presume that means very rounded? It's now round and kind of coarse featured - didn't use to be) and I have pale red lines on my stomach and breasts, which I thought were stretch marks but my youngest is now 8.
So, those two sets of symptoms led me to the pituitary - affecting the thyroid and secreting ACTH. It's just a guess to be honest, but I'm desperate to get this sorted out. I can't face another 20 years of decline.

[linesandlines]

Thanks Hassled I guess previous mental health diagnosis makes me worry they'll just think 'here she is, wanging on about being tired again, try being a junior doctor, petal!'.

[Cel982]

Poor you, that's a lot to be dealing with. It certainly sounds like Cushing's could be a possible diagnosis. You explain it all very clearly; I think the best approach is just to lay it out as you have here.

Try to speak calmly and avoid getting upset (I know things like that shouldn't matter, but some doctors unfortunately may focus on that rather than what you're saying). If he/she dismisses what you're saying, reiterate calmly that you've been dealing with these symptoms for X number of years without improvement, and you feel some further investigation is not unreasonable at this stage.

As the tests for Cushing's aren't that straightforward, you may need to be referred to an Endocrinologist for further investigations - ask for that specifically if your GP doesn't suggest it.

[linesandlines]

Thanks so much Cel982. It's reassuring to hear from both a GP and other patients' point of view that they won't necessarily dismiss it out of hand.