GP told me to stop wasting his time - AIBU?

[TimeWastingTeresa]

I had my third trip to my GP today in 3 months.

I feel like absolute rubbish constantly - tired all the time , achy , generally run down .

My hair is awful - dry as a bone and gets greasy at the roots within hours of a wash.

My skin is so dry it flakes . My legs look like a reptiles !

My periods are much heavier than usual - I need to change a super plus tampon after 3 hours . I used to wear regular for the whole duration.

I have gained over a stone in weight in less than a year and I just can't shift it .

My GP ran bloods around a month ago and all vitamin levels were fine.

My thyroid came back as TSH 4.5.

He told me everything was normal and to go back in 6 months .

I went back a month later as I just don't feel well at all.

He ran bloods again and again my TSH came back as normal (4.5).

He told me I'm fine and I'll feel better if I exercise and lose weight .

I can not go on like this so I went back today and he told me that I just need to lose some weight . He told me not to come back before 6 months is up as there's nothing wrong with me .

I left in tears .
I feel so down . I'm so so tired I can't cope with much at all.

I look and feel disgusting . My hair is dull and lifeless and my scalp is so dry .

I don't know what to do

My mum says I should go private but if my TSH comes back as 4.5 again , my GP will still refuse to treat it !

Help please !

Please ignore the posts saying you should get further tests on the thyroid - there are lots of inaccuracies about this on the internet and lots of people trying to make money out of people wanting to feel better - TSH is the correct measure to look at, not t4 and t3. Sorry if you feel your GP didn't listen but don't get hung up on th thyroid. Do consider getting help with your mood via self or GP referral to IAPT or privately if you like. And try to look after your self - exercise, good foods, relaxation etc. Take care

Sigh (well, it made you sound superior ) do keep up with current research before dismissing others out of turn. "The laboratory assays for assessment of thyroid function include thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), FT3, and FT4. The measurement of FT3 and FT4 is the most clinically relevant for the evaluation of thyroid disorders, with total thyroid hormones being affected by variations in binding protein concentrations." www.eje-online.org/content/175/6/R255.long

As for Vit D deficiency being rarely low, "Low serum levels of vitamin D are found in significant numbers of all population groups in the UK: in winter 30-40% of all age groups in the general population are classed as vitamin D deficient. Even towards the end of summer 8% of adults and 13% of adolescents remain deficient." www.bjfm.co.uk/prevention-of-vitamin-d-deficiency.aspx

w12newmum checking TSH only is not the correct method for checking the thyroid.
TSH is a hormone from a gland in the brain. It is produced when the body realises there is not enough T4 in the body. TSH hormone is then released which causes the thyroid to replicate and release T4.
Sometimes is still doesn't produce enough. Hence T4 needs to also be checked alongside TSH as a minimum. Checking T3 as well is also better.

I know this for a fact as I am under the leading endocrinologist after having thyroid cancer.

Yet another new study backing the info from 'quacks' on here...

"A Revised Dialogue

Hypothyroid patients who continue to have symptoms on levothyroxine monotherapy might talk to their physician about trying combination therapy, or a pill that contains both T3 and T4. Trials of combination therapy are supported by the American Thyroid Association, but clinical studies are mixed on whether this approach works, Bianco said. Subjectively, some patients report feeling better and others don't.

Better medications are needed to treat hypothyroidism, Bianco believes. Until that day, he urges physicians to change how they talk about hypothyroidism treatment with patients. "Doctors should be telling their patients, 'I'm going to normalize your TSH, but you're going to be at a higher risk for gaining weight, experiencing depression and fatigue. It is also more likely that your cholesterol will go up.' That's what we should be telling patients, based on our study. This conversation is particularly important for any patient that is considering surgical removal of the thyroid gland."

www.sciencedaily.com/releases/2016/10/161012132038.htm

In thyroidless patients TSH is measured alongside T4 to check and alter dosage of levothyroxine.

Someone mentioned acid reflux - I get this quite often - really painful to the point my mouth fills with warm water - is this a symptom of lowered metabolism ?

Have you been checked for H.Pylori infection??

This can cause this & much more, the gastritis it causes can hamper B12 & possibly other vitamin/mineral absorption.

Have you seen your B12 results or just told it was normal?

Theres a lot of controversy around B12 deficiency/PA as getting an easy diagnosis can at best be a bit of a postcode lottery, at worst, a big fight. Low Folate can have similar symptoms too

I was told my B12 was "normal" it wasnt, it was borderline which should have triggered further testing.

My DD results were well in range & considered normal, but the NHS serum B12 test is recognised by NICE as unreliable - eventually the doctors agreed to treat on symptoms as per guidelines & the effects were amazing. Her TSH corrected itself after B12 injections too.

So perhaps get a copy of your results if you haven't already done so

Could it be early menopause? Regardless your GP is very unprofessional so you should change GPs and I'd report your current one tbh.

I haven't got the information to hand but I am pretty sure some countries class a TSH of 4.5 as not within normal range. These ranges will always have some outliers that get missed. I would contact Thyrpid UK. Your clincial symptoms fit under active thyroid.

To add, this is a great book about the problems with and how the thyroid ranges were set. www.amazon.co.uk/Tears-Behind-Closed-Doors-Condition/dp/0954310608

If you have the money, I would consider seeing an endocrinologist privately.

Ps forgive typos above!

I would definitely keep an eye on your thyroid. I was TSH 4.5 at the age of 37 - sent away, told it was borderline but normal - then spent the next two years feeling low, gaining weight, loosing hair, feeling sloth like, eyebrows falling out, heavy period. When i test again I was up to 8. In the US they would have treated me at 4.5 - as their optimum range is 1.-2.5. I remember taking the thyroxine and feeling as I had five years earlier. I work best now at around 2 - any higher and I slow down considerably. turned out I had hashimotos, which is an autoimmune disease. Worth checking to see if you have this?

"Sigh" yes it does have an air of superiority doesn't it?
I find the internet can usually provide you with whatever answer you are looking for, including the opinion of at least one medical expert to back up one's point of view.
So in that spirit, I found the document below (see link) It provides a useful and fairly recent summary of how the current evidence has been reviewed in a systematic manner rather than simply relying of the opinion of one or two experts who have treated a handful of patients.

www.prescqipp.info/-liothyronine/send/225-liothyronine/2836-prescqipp-response-to-thyroid-patient-advocacy-submission

This is a good article on the controversy over TSH ranges. www.verywell.com/tsh-thyroid-stimulating-hormone-reference-range-wars-3232912

perfumelife - thanks for that. I've had brain fog for so long now, and exhaustion and also very high cholesterol. doctors pay zero attention as my TSH is in the normal range. (even though my T3 is still in the low range).

I must mention to my endocrine consultant ( who is a doctor and has a PhD ) who is the clinical lead for endocrinology in a busy and well reknowned department that his regular testing of my t4 and t3 levels is "quackery".

This NHS lab uses a TSH range of between 0.2 - 4 as normal. www.pathology.leedsth.nhs.uk/pathology/ClinicalInfo/Biochemistry/EndocrinologyampDiabetes/ThyroidFunctionTests.aspx

Have you considered seeing a naturopath, I was diagnosed with Hashimotos a couple of years ago after failing to conceive baby no 2.

Similar symptoms although not quite so bad.

Do some research on this and look at your diet, there is a lot of evidence that cutting sugar out will reduce the levels significantly, I did and I had to halve my meds as a result!

I second seeing another GP and keep searching for the answers, your health is the most important thing you have and yes diet and exercise are absolutely crucial but you may need help and direction with these things too.

Also try drinking 3 litres of water a day, it takes the pressure off the organ functions and you will have more energy.

I live in Australia, with that TSH you would be treated for being hypothyroid (if you had other symptoms, which it sounds like you do). Not sure what to advise due to not knowing about NHS - can you find an endocrinologist to talk to? The thyroid is a funny thing, my endo has accepted that at anything over 2 I feel like death and we need to aim lower.
Good luck with sorting it out.

MiMiMaguire I was put on metformin to tackle insulin resistance caused by the PCOS and to encourage ovulation.

sleepyowl I think a lot of other countries have an upper TSH limit of 2.5-3.2. In the UK, it's 10, but I've read that doctors are supposed to consider treatment/do further investigations if a patient has the symptoms of hypothyroidism and a reading above 2.5.

Sorry I wasn't implying t4 and t3 are never useful but the results of every test need to be interpreted in the clinical conxtext of the patients symptoms and why you are doing test (looking for hypothyroidism, monitoring thyroxine replacement, monitoring thyroid cancer). This thread would confuse anyone and individual papers do not mean they are accepted practice, relevant to this situation or clinical guidelines. If you are still concerned about the thyroid then do of course see a different GP who can go through the results with you and hopefully can also discuss other potential solutions to your current problems. keep an open mind if you can and good luck 😀

Each lab has heir own reference range most U.K. Labs work on a reference tsh range between 0.3 to 5.0. This is only based on an average of the local population and not necessarily your normal range. Ask to be referred to an endocrinologist if you're still sure it's your thyroid.

corabell I'll need to do the same with my specialist, he is practicing 'quackery' as well !
Despite being a professor of endocrinology and has written many papers and lecturing the subject at universities as well as leading research trials.

so happy I found a good quack to treat mine. Mine's so quacky he says T1 and T2 must be also playing a supportive role in thyroid function too. I shall tell him he needs his head tested. But not the the 5 doctors I saw who all insisted I was fine even after showing them my thinning patchy hair, getting them to feel my freezing hands in the middle of July, (was told by one not to go climbing mountains anytime soon, just poor circulation) high cholesterol, and nine day long periods. No the blood test was king. The range was god. Everything else was just in my mind.

Yep. Give me the quack every time

8Bloopbleep* et al measurements and tests are one thing interpreting them with all the other observations of the patient and history make the diagnoses.

Then of course its how you treat it;)

Lets hope the OP puts her foot down and gets the doctors and specialists she needs. Now doubt in my mind shes ill!

Just an example - I dug out some tests of mine, last time when I got tested I felt like I was hypo again. TSH 2,6. So if only that was tested, doc would have declared everything perfect. But luckily she also checked my T3 that was below normal, and was happy to increase my dose based on that, and my symptoms.