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Very down after seeing GP

(56 Posts)
Salteena Mon 11-Mar-13 10:16:18

I don't often post in health but about a month ago I asked for advice about my increasingly painful, achey arms....Vitamin D deficiency was mentioned as a possible cause.

Well, I put off going to the GP as I usually do (I rarely feel I'm ill enough to 'bother' them), but the arm pain developed into joint pain, hip and leg pain, in fact all-over-body pain, as though my actual bones were aching. Add to that a very stiff neck, which is unusual; disturbed sleep pattern, feeling depressed, increasingly frequent migraine-like headaches and sometimes a really weird tightening feeling in my chest - not pain, but a squeezing sensation.

I know chest problems shouldn't really be ignored so I did make an appt, after a struggle. Had to wait 3 weeks in fact, and even then couldn't get to see my normal GP.

Anyway, I came away feeling as though I could burst into tears, which is not me at all. He sent me for bloods but flatly refused to add a check of my Vitamin D levels. Apparently it's VERY uncommon for people to be deficient, he says - which is not the impression I get from these threads. I asked him twice (politely I might add) and he just said no. He also mentioned that it 'costs money' for that particular test and he'd only start to even consider it if some of the other results indicated there might be a need. Am menopausal btw, but don't have any of the usual troublesome symptoms with that.

Basically he thought I just had 'wear and tear'. Which I know is perfectly likely to be a factor with some of it, but I've been feeling so increasingly wretched that I find it hard to believe there isn't something more happening.

I know it must be infuriating for doctors when patients come in having semi-diagnosed themselves, but I feel, really, pretty much dismissed as a time-waster. He wasn't what you'd call empathetic.

Sorry this is so long but I just wanted to blurt it all out, as there's no-one to talk to about this! AIBU to feel sad?

AnnIonicIsoTronic Mon 11-Mar-13 10:18:43

sad

HumphreyCobbler Mon 11-Mar-13 10:20:00

YWNBU to feel angry

he sounds crap and dismissive

I would go and see another doctor

ThePathanKhansAmnesiac Mon 11-Mar-13 10:22:30

Yy go and seek a second opinion. Hope you feel better soon.

Salteena Mon 11-Mar-13 10:22:49

Thanks both, so maybe I'm not being too over-sensitive. I would have preferred 'my' doctor but it's virtually impossible to get an appointment with her. They seemingly never answer the phone and if you use their automated system, you can't get a slot any earlier than 3-4 weeks hence, it seems angry

georgedawes Mon 11-Mar-13 10:24:45

Not unusual to be vit d deficient, in fact it's incredibly common! Some GPS very reluctant to test or treat it though.

I'd either ask for second opinion or get it tested privately, which is what I did. Google vitamin d test and there is an NHS hospital in Midlands that does it for 25 pounds. I then took results to my go and they then treated me (but refused follow up check to see if worked)

greenfern Mon 11-Mar-13 10:26:54

Thats terrible you had to wait 3 weeks for an appointment.

You know your own body and when there is something wrong.

Try and get an appointment with your own doctor, share your worries with then, be adamant you are not going to be dismissed.

Hopefully you will not have to wait for 3 weeks.

Salteena Mon 11-Mar-13 10:28:50

The ironic thing is that I was talking to a friend about all this and we discussed the Vitamin D thing as neither of us had really been that aware of it until someone suggested it to me on MN.

Friend later emailed to say she'd been for a routine GP appt, was sent for a blood test and just as an afterthought following our conversation asked for them to check Vit D. They didn't bat an eyelid and she then got a call to say her levels were much lower than they should be and could she go and collect a prescription for mega-strength supplements.

After that I was confident there wouldn't be any problem when I went for my appt. How wrong can you be...

Sugarice Mon 11-Mar-13 10:52:40

He sounds like quite a twattish GP!

I was under the impression last summer that due to the lack of sunshine that Vit D defieciency was on the rise, in fact I have a bottle of Vit D pills in a cupboard for my ds's which I bought after hearing that report.

Second opinion required OP, hope you see a more sympathetic Dr.

Salteena Mon 11-Mar-13 10:57:57

Thanks to all. georgedawes I just rang for one of those home kits so we'll see.....not that I'm wishing a Vitamin D deficiency on myself, but I now really want to see what the result is. Fair enough if it's in the normal range and GP is right, but I'm still reluctant to go back and see him again thanks to his bedside manner, or lack thereof. I'll now need to start the battle to get an appointment with someone else this side of Christmas angry

Yes, after being alerted to the possibility of deficiency I did check it out, and was genuinely surprised to see pretty much all of my symptoms listed.

georgedawes Mon 11-Mar-13 11:03:10

Their reference range is under 50 is deficient, but lots of other trusts say 75+ is normal, so just be aware could still be deficient if not.

If it is low insist on treatment, over the counter remedies are nowhere near enough. My levels were 14 and I could barely walk a few metres when diagnosed.

fuzzpig Mon 11-Mar-13 11:06:31

What an arse. It is not right for a GP to be so dismissive.

When you get your results, find out if calcium was checked, as low calcium is an indicator of low vitD (since the latter aids the absorption of the former)

Hopefully he has tested you for things like ESR (inflammation), thyroid etc, there are loads of illnesses that have your symptoms. Don't be fobbed off, it sounds like more than 'wear and tear' (hmm) to me!

Would change GP practice; its not point in dealing with uncommunicative and or unhelpful GP practices. A three week wait for an appt is completely unacceptable.

Barbie1 Mon 11-Mar-13 11:21:05

Your list of symptoms match mine... I went to the doctors here in France and they ran a complete set of bloods on me. Turns out I'm vit d deficient and have to take a liquid supplant once every three months. Never even considered it would be this, I thought I had a late onset of pnd. I hope you get sorted soon

ELR Mon 11-Mar-13 11:32:32

Could be iron deficiency and under active thyroid. I had all your symptoms and that's what I had. They prescribed yucky iron tablets and monitored thyroid but I take spatone iron supplement instead of the ones they prescribed,thyroid has almost sorted itself out but still very low but gp refuses to medicate me but I don't feel too bad now. It has taken 18 months for iron levels to return to the lowest accepted levels but within a few weeks of taking spatone(2 sachets) the headaches and tiredness had gone.
If all bloods come back ok go to a different gp and request vit d.

timidviper Mon 11-Mar-13 11:54:34

I have a little bit of sympathy for the GP here as many surgeries are swamped by the "worried wel"l at the moment with requests for Vit D levels. I'm not minimising your distress but it is hard for GPs and many of your symptoms are also consistent with menopause, thyroid, etc.

I would wait until you get the blood results back about the obvious things and pursue it with the GP if those are clear. GPs do get regular updates about clinical issues and many areas are in the process of setting protocols so I'm sure he will be aware of this. Don't fall into the trap of valuing Dr Google above a trained medical professional although you could be right and he might be a knob!

georgedawes Mon 11-Mar-13 12:03:07

If it wasn't for Dr google I never would've had my vit d checked, I was having suicidal thoughts by the end as my mobility had been restricted so much it had completely affected my life. I'd seen numerous drs but was completely dismissed because my other blood tests were normal. Yet my symptoms were classic.

Op is not the worried well, she is not feeling well at all. This is purely about cost.

Salteena Mon 11-Mar-13 12:07:54

timidviper I completely get what you're saying but I don't think I'm well ATM (though I am worried!). The fact is that I never expected to get quite such an abrupt brush-off as I assumed from friend's experience and from threads on here that it was a routine thing to test for.

Yes, of course Google is no substitute for a doctor but there are degrees of thoroughness in medical professionals....I'm not going off on a rant here but I pretty much diagnosed myself with endometriosis having been fobbed off by a succession of GPs, one of whom told me I was just constipated. Much later and after paying to see a respected specialist I turned out to have Stage 4 endo after all sad

Salteena Mon 11-Mar-13 12:08:54

Oops x-post with georgedawes

mercibucket Mon 11-Mar-13 12:09:19

its not the worried well, its the worried ill. vit d deficiency has the potential to cost the nhs countless millions, there are now articles in pulse, the gp magazine about the cost to the nhs of treating vit d deficiency. some health authorities have tightened up the criteria for running the test, as if you dont test, you dont have to treat, and so can save money.
it is actually v cheap to self treat, and i would recommend a high dose thro winter in any case, but see what the bloods come back as and do any initisl high dose treatment via the gp

georgedawes Mon 11-Mar-13 12:10:53

It is a routine test, as in easy to do and vit d deficiency is very common, but I think GPS pay extra so dont like to request it. Ridiculous, I had loads of other blood tests that were not relevant, and I only got treatment after going private.

mercibucket Mon 11-Mar-13 12:11:31

oh yeah, my gp was the same, twat, but did agree to test after 20 min when i pretty much refused to leave. oh imagine the apologies when i was v v v deficient. yes, imagine them, cos i never heard any

georgedawes Mon 11-Mar-13 12:15:18

Completely agree with merci. Evidence is clear levels of at least 70+ are healthy yet many trusts now saying 50 is healthy. Purely so don't have to treat.

It's short sighted as causes long term health problems, but doesn't affect short term budget so that's ok.

I found it very interesting that my gp had had his own levels checked, which were low, and he had had treatment. I had classic symptoms but was denied even a simple blood test.

timidviper Mon 11-Mar-13 12:15:59

I agree the OP isn't well George and I'm not implying she is worried well but GPs are often swamped in those who are.

It is all very well saying it is just a cost issue but where would you suggest the money to pay for all these tests comes from if the budget is squeezed to squeaking point already? Each test costs over £15 and some areas estimate the cost of testing on request would run into millions. Which group of patients would you cut something from to cover this? Children, terminally ill, who?

Just as a couple of final points, levels are always lower in winter/spring with about 50% of people having insufficiency at this time of year and, if you pay for prescriptions, many Vit D supplements are cheaper to buy.

georgedawes Mon 11-Mar-13 12:17:27

Same here merci. He actually had a massive rant at me about wasting NHS time til he stopped and read my results that I'd brought with me. His mouth was opening and closing like a goldfish.

timidviper Mon 11-Mar-13 12:20:38

Sorry OP. I took so long typing my last post I have x-posted with loads of you!

I do agree with a lot of what people are saying btw but there simply isn't money to test and treat for everything. I would love to run a health service which looked at keeping people healthy rather than waiting till they are sick but nobody wants to pay for that

FWIW I take a Vit D supplement over the colder, darker months. I buy it at the health food shop in spray form, one squirt into the mouth each day and it is available in a range of strengths at a reasonable price. Takes around 12 weeks to raise levels I believe

georgedawes Mon 11-Mar-13 12:20:49

I find that a spurious argument. The facts are she has symptoms that easily identify with vit d deficiency. Many of the blood tests on the full blood count are hugely unlikely to be relevant, but because they don't cost extra they'll test them.

Just because it's common doesn't mean it can't be treated. It's disingenuous to say over the counter remedies are the answer too..the highest ones are 1000 iii daily which will not raise anyones levels

Salteena Mon 11-Mar-13 12:24:19

My friend who was tested on the off-chance was prescribed a huge dose, about 3 times the over-the-counter high-strength 'maximum' dose...she'd also thought her aches and pains were 'wear and tear'

timidviper Mon 11-Mar-13 12:27:26

I would agree OP should press for a Vit D test if this lot of tests come back normal but would let the GP run his normal stuff first as it could also be thyroid, anaemia, etc.

OP, please don't think I am minimising your symptoms or suggesting your GP is faultless, I just think it is prudent to choose your battles.

georgedawes Mon 11-Mar-13 12:29:48

And even if you feel ok with low levels, the long term health risks are huge

Highest strength tablets on high street are 1000 iui. My treatment was 40000 iui daily for 10 days, then 20000 per week. That only just got me in normal range after 8 months..

Not suggesting others do that without medical supervision, but it shows how self treatment is unlikely to work

ppeatfruit Mon 11-Mar-13 12:34:18

Salteena another thing to look at would be your omega 3 levels, esp. for aches and pains you can buy starflower or Evening primrose oil and take it regularly. If you have a high acid diet,(e.g. vinegar, tea, coffee and alcohol etc.) it can cause aches and pains too.

digerd Mon 11-Mar-13 13:40:54

I find it rather unfair that when you get old, the NHS are paying for all sorts of things to keep you alive until 100 < indirectly>, but young people are being ignored.
My GP tested my calcium as being a woman and predisposed to osteoporosis, when it came back too low, gave me calcium and Vit. D, although the latter was not tested . Not that I am ungrateful.
But my aches and pains, I have to put with, which I do with groans and sighs, < and accasional curse words> as is only arthritis and normal ageing process.

georgedawes Mon 11-Mar-13 13:52:42

It's probably your vit d levels digerd - what strength were you given? 1000 iui unlikely to do anything. Honestly, it is a national epidemic that isn't being faced purely because of short term cost.

My DH had what he thought was a 'dodgy' knee, which he put down to getting older. Turns out his vit d levels were through the floor too, and after high dose treatment his knees are actually fine.

I find it really quite depressing how the evidence is being ignored purely on a cost basis. I appreciate that the nhs does not have a bottomless pit of money, but the evidence is overwhelming that treating vit d deficiencies save so many health problems in later life.

And the OP's GP was either ignorant or lying when he said vit d deficiency was very rare - it's completely endemic in this country as I'm sure he knows. You can't get vit d in this country from the sun between Oct-Mar, and it's impossible to get much from your diet. Stores only last 3 months..

Either way that is not a GP I'd want to see again.

Salteena Mon 11-Mar-13 14:09:27

Well, he was absolutely definite about it being 'very' uncommon and insisted that if my diet was OK and I saw the sun occasionally I wouldn't have a problem! I didn't take issue with this but since discovering that deficiency can be an issue, from what I've read it actually IS very common.

After the winter we've had I feel as though I've barely seen the sun for months on end....

georgedawes Mon 11-Mar-13 14:11:44

He's either scarily ignorant or blatantly lying then.

As I said, the sun isn't high enough in the sky in the UK to get any vit d over the winter. Very few foods have vit d in it, m

georgedawes Mon 11-Mar-13 14:15:13

Posted too soon. Margarine, fish and eggs have a v small amount. Your body stores it for around 3 months, hence why so many people in UK get deficient.

My bet is he does know all this but fobbing you off based on cost. Pct don't like vit d blood tests..look at digerds gp above - still didn't test despite classic symptoms and clinical indicator - low calcium (incidentally lots of people don't have this, I didn't).

It's pretty scandalous I think.

mercibucket Mon 11-Mar-13 14:40:44

I buy 10 000 iu off amazon (solgar) for about 15 quid, then take a couple a week thro winter. It is not our fault that the nhs is incapable of ordering off amazon suppliers and instead spends 150 quid on the same thing.

mercibucket Mon 11-Mar-13 14:40:45

I buy 10 000 iu off amazon (solgar) for about 15 quid, then take a couple a week thro winter. It is not our fault that the nhs is incapable of ordering off amazon suppliers and instead spends 150 quid on the same thing.

georgedawes Mon 11-Mar-13 14:48:17

I'll look at that now merci.

It's not even the paying for it that bothers me so much as the ridiculous advice to take a supplement of 1000 iui a day. They must know that is just shit advice.

DumSpiroSpero Mon 11-Mar-13 14:51:43

I find it rather unfair that when you get old, the NHS are paying for all sorts of things to keep you alive until 100...

I wish I lived near you! My poor dad is 75 and has been suffering for 3 years from insomia, severe headaches, intermittent collapses (he remains conscious but loses all strength/sensation from the waist down) and ear problems.

None of our GP's appear to give a toss, in spite of the fact he has virtually no quality of life as a result of his symptoms.

Anyway OP - if you go for the tests this doc has suggested but make an appt for your regular GP asap, hopefully you can see them for the results and assuming nothing turns up, raise your thoughts about Vit D deficiency with them.

DystopianReality Mon 11-Mar-13 15:21:46

Whilst sympathising with OP, and agreeing that you were treated dismissively, I do also agree with timidviper. So often, what is lacking is not nec 'money or funding' but time to explain and communicate so that people don't leave feeling dismissed and not listened to. The other tests the OP will be having are essential to making a diagnosis. In this situation, Vit D deficiency should not be at the top of the GP's list of possible diagnoses; he is thinking he needs to exclude other, more likely causes for her pain first.
It would be bad medicine to jump to that conclusion first.
But it sounds miserable OP, and I do hope you get it sorted out soon.

georgedawes Mon 11-Mar-13 15:28:44

Completely disagree.

The gp said vit d deficiency is very rare. That is not true, and it would be perfectly reasonable to test vit d, in my opinion, at this stage. Many of the fbc bloods are much less likely to be appropriate.

The conclusion I reach is that certain sections of the NHS do not want to test and or treat this problem purely because of cost.

DystopianReality Mon 11-Mar-13 16:35:16

george A full blood count is most certainly not 'inappropriate'. I would be most unhappy if I or someone I knew, presenting with the OP's symptoms were not tested for this. As for Vit D, test by all means but not the first test you should be thinking about

HardlyEverHoovers Mon 11-Mar-13 16:40:50

You can buy vitamin D testing kits online You send them a drop of blood on a bit of paper, and then they email you the results. We were both ridiculously deficient, took them to the docs who put us on a very high dose. My husbands alopecia has cleared up since. This alerted them to test my 2 year old, who was also very deficient and is having treatment.

georgedawes Mon 11-Mar-13 16:47:33

I wasn't saying a fbc was inappropriate, just that many of the tests were less likely to be low than vit d.

Why do you say it's jumping to conclusions to test for it? It's a reasonable test given the ops symptoms in my opinion. Testing iron levels is not jumping to conclusions, yet vit d is? Even though probably the majority of the population is deficient?

Why do you say vit d should not be at the top of the list? It's just as plausible as say anaemia and more likely on a population basis than say thyroid problems.

Eurostar Mon 11-Mar-13 17:07:11

I guess I am lucky, my GP discovered that she was Vit D deficient herself and felt better for supplementing so she was happy to test me, but I did fall into a high risk category (BME), I don't think the PCT allows them to routinely test.

It it not true that you cannot raise level with over the counter, I have done so as PCT would only fund one mega dose, my blood tests show my levels slowly, steadily rising on use of the right OTC brand. I buy expensive oil based preparation though and not cheap pills (some of which are D2 and not D3). Do not supplement longterm without vitamin K2 unless it is contraindicated for you. Take it together with oily food.

NHS are short sighted to not test, there would be big cost savings for the future given how many nasty, costly to treat, diseases are now being linked with it. Not to mention pain killing prescriptions being saved on.

All GPs have been briefed on Vit D deficiency, many people have been labelled as making up symptoms for years. You should change GPs!!!!...and put in a complaint based on their ignorance of DoH briefing
www.dh.gov.uk/health/2012/02/vitamin-d/

Having said that, it is cheap to get a private VitD test and at least your other bloods will be tested too.

Eurostar Mon 11-Mar-13 17:11:16

I mean, are being tested by GP, not that the private vitD test looks for other things! Though of course you can get any blood test privately that you wish if you can afford to.

DystopianReality Mon 11-Mar-13 17:11:45

I didn't say it was 'jumping to conclusions'. I said, test by all means, but exclude more common causes of the OP's symptoms first. I'm not going to sacremonger here, but there are far more common causes of her symptoms than Vit D deficiency.

There is a huge number of people that 'polarise' in on the Vit D deficiency, before excluding other more common problems. The biggest problem we have is that low Vit D levels do not necessarily mean symptoms. I'm not saying it does not exist but biochemistry results and clinical symptoms do not always mean the same thing. That is why there is such widespread uncertainty about what the 'thereapeutic' (ie, the does that treats symptoms) is.

I would be horrified if a GP was so polarised by one thingthat he/she did not consider and therefore test for all the other common causes. It's easyto get swept away by things that are in the news and, indeed are being investigated with trials and studies. But we do still need to remember that there are finite funds and as timid said upthread, where do we take from?

Poppyhat Mon 11-Mar-13 17:47:29

Salteena ,your symptoms could also be from a neurological problem,the stiff (Is it painful also?)neck could be a sign that something is going there ,and that can cause the rest of your problems.
If something is pressing on a nerve in your neck it can affect anything from the neck down.( a disc perhaps)
Please ask your go for a referral to a neurologist,an MRI would tell if there is going on .

Salteena Mon 11-Mar-13 18:07:38

Poppy, yes it is stiff and distinctly painful.

My main beef is with the dismissiveness really. I know GPs are massively pressured and he was probably thinking 'Oh God, not another bloody middle-aged woman with generalised aches and pains', but after I'd shown I could touch my toes and swing my arms without collapsing in screams of agony, that seemed to be it. The fact that I was concerned about being in unusual pain and didn't feel like 'me' any more - because this all seems to have come on relatively quickly and I've always thought of myself as a pretty healthy person - was ignored. A kindly word wouldn't have gone amiss. But maybe he was having a bad day I guess.

And I genuinely didn't realise that testing for vitamin D was expensive and not included in a general blood test, because I've heard other people say they got it as a matter of course. I might not have risked asking for it and getting slapped down then hmm

I do realise there are other, scarier things that could cause all this...

nanatothree Mon 11-Mar-13 21:42:57

I was diagnosed vit.D deficient after a thyroid op, felt ok first then suddenly very painful hips and legs (pain seemed to be in bones themselves if that makes sense). No strength hardly to walk 100 yards -never felt so bad in my life. Phoned hospital and consultant said maybe low on vit d and he would test for it. GP said it was just because of surgery etc and basically wouldn't entertain the idea. Anyway hospital phoned with result to say rather low at 16. After doing my own research on internet- there is lots of info - even nhs recomend high dose for about 8 weeks and then retest, GP apologised and said he didn't know much about it!! Anyway all he could say is buy your own so I did. Bought from UK company and took high dose for 8 weeks and GP retested and at optimum level and boy did I feel better. Had more strength, wasn't feeling at the point of collapse, could sleep better I just knew thats what it was.
GP said he would retest in six months so didn't take any more and couldn't wait to get test done as started to feel awful again but very curious to see result. And guess what I phoned for results and doc said they didn't send as was expensive test!!! Going to go private and pay for my own in future but believe me most people will not know how a lack of vit d will make you feel. By the way what they sell in chemists is way too low!!

nanatothree Mon 11-Mar-13 22:01:24

I should mention the lack of vit d had nothing to do with the thyroid op it was just lucky my consultant said it could be a lack of vit d from my symptoms. After the fiasco with my GP I have his agreement to treat myself "as it makes you feel better". He should have given me a pat on the head as well!!!!
I am the biggest convert to supplementing with vit d3 going.
By the way its D3 to take and not D2

smee Tue 12-Mar-13 11:12:13

Nanatothree, no I am the biggest convert! grin

Haven't read the whole thread, but I've had lots of aches. Not too surprising as went through early menopause due to Breast Cancer treatment. I thought aches were just down to that, but someone on the Tamoxifen thread told me to take D3 and omg what a difference. I haven't bothered with GP, just researched it and bought myself to try - been on them for about 6 weeks now. Seriously though just do it. I feel so much better. smile

I think sometimes it's difficult for GP's to appreciate the impact the inability to do something or the pain of doing something has on you. My mum who was felled by a major stroke aged 70 5 years ago and had previously been very active - walking, riding, etc was effectively told that she was lucky to be alive, just about walking and get on with it. She was well aware that of all of that, but her efforts to try and improve her mobility to somewhere near her original levels were completely dismissed.

I have terrible back pain, permanent bursitis in both hips and shoulder pain after an accident for which I have to take pain relief regularly - if I request a different treatment or stronger pain relief I'm often greeted with disbelief - fgs woman, you're upright and mobile, what more do you want - is the feeling I get from them. It's very disheartening. Best of luck getting it resolved, def demand to see a different doctor too.

Oblomov Tue 12-Mar-13 11:58:52

GP sound very dissmissive. You must go back and see a different GP.

ParsingFancy Fri 05-Apr-13 16:03:31

So, having lurked on this thread, I've finally paid to have my Vit D levels tested.

They've come back as 27.0 nmol/L, or just into Deficiency rather than Insufficiency.

Can I ask those who've had doctors take their deficiency seriously, or who saw big improvements, whether that sounds outrageously low, or just a bit low?

I also have a GP who looks me straight in the eye and says M.E. is a sign of attention seeking and Munchausens, and I haven't really debilitatingly ill for nearly a decade. So I'm not really thinking of going there for help.

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