Is this GP a bit over zealous?

[FloofyBird]

I had some bloods done a year ago due to being tired all the time but they all came back normal so I just left it thinking if there was anything wrong it would show up in the bloods.

I've been back to the GP again today as still tired and fed up now. GP thinks I might have chronic fatigue syndrome and I'm a bit shocked. It seems quite a jump?

They're sending me for more bloods (a nice 2 week wait and 30 mile round trip for that joy thanks to the current state of the nhs) but the GP said they didn't think they would show anything.

I suppose I should be grateful they're taking it seriously and not fobbing me off. I think it's just taken me by surprise.

They sound just zealous enough.

If they’re planning on a referral to the CFS clinic then you have to have a load of routine bloods done before the referral can be made. I wouldn’t worry, it’s just normal NHS procedure.

A lot can change in a year but it sounds unusual that they suggested that as my experience is that they withhold diagnosis and reluctant to diagnose with chronic fatigue syndrome. Either way just try and distract yourself until then.

You're concerned enough to go back to the GP, and you're worried they're taking your concerns seriously?

I think this may be a MN first!

Also despite them feeling the GP’s actions are over-zealous they’re sarcastic about a 2-wk wait for a routine phlebotomy appt? 🙈

Such is my life working in the NHS - we’re dammed or sued if we don’t or we’re bitched about if we do. Nothing is good enough for anyone. Everyone knows best. Anything we do is questioned and posted about.

Count yourself lucky.

If it is chronic fatigue syndrome it's not like it's going to run away in the 2 weeks period or like a tumor, it's still gonna be there a decade later.

You're exhausted and your first set of blood tests apparently don't show any obvious cause, so why would it be over-zealous to consider CFS?!

The GP is doing exactly the right thing. Jeez.

Jeez, you can't please some people. GPs are damned if they do and damned if they don't. Talk about ungrateful.

I don't know what bloods you've already had but just to flag I had similar years ago and they did lots of routine tests including serum iron, but hadn't done ferritin (iron stores) and that was the issue for me even though I was never clinically anemic or low in serum iron. Once iron tablets got my ferritin levels back up all the symptoms went the other one that is commonly missed is Viramin B12.

What were you expecting to be diagnosed with that this seems like a jump?

If you have a reasonable enough lifestyle, no underlying causes, no problems that can be detected, and presumably you're taking supplements for vitamins, energy etc. then surely it makes sense?

Proof some mumsnetters will find anything to complain about.

Did he actually say "I think you might have CFS" or was it more "we'll get further blood test done to get a better picture and rule out CFS".

Your name rings a bell...weren't you asking about blood test results last week or so?

You went back what did you expect them to do. Your bloods are fine so the gp had 2 choices tell you there's nothing wrong with you and to stop coming which obviously they can't do or diagnose you with a questionable condition to shut you up.

Yep. This is a large part of why I burnt out and had to leave. I won’t be going back to GP work.

on the other hand OP does acknowledge she isn’t being fobbed off. I am sorry that you feel (understandably) worried OP and I hope you can find some answers and resolution to your symptoms.

This exactly - and the best most people have is the ability to use Google, they would rather ignore the several years training the healthcare professionals have to do to be able to qualify and practice because Google must be right !

All of this!

CFS can’t be ruled out by a blood test. If you’ve got chronic fatigue, they’ll do a load of blood tests to rule out the usual suspects like anaemia, under active thyroid etc. Once they’re ruled out, they’ll give a diagnosis of CFS. It sounds to me like the GP does think it’s CFS, but if someone has been knackered for 12 months with no obvious other cause, that’s not going to come as a shock.

Ok well to give a bit more context I have a family member with CFS and they had lots of appts and several lots of blood tests before CFS was even remotely hinted at. I've also had issues in the past with being tired and heavy periods and wasn't taken seriously at all (ended up with a 6 pint blood transfusion) . So this experience is very different for me- actually being listened to and taken seriously straight away. I suppose this is how it SHOULD be, but that hasn't been my experience in the past so this is a bit novel!

I wasn't intending to be a dick and I was being 'sarcastic' about the blood tests as having to do a 30 mile round trip for them because they no longer do them at our GP surgery is ridiculous imo.

Yes I did post recently about bloods. I read some posts about low ferritin and there seems to be a train of thought that anything under 30 is iron deficient and around 125 is the ideal. I looked at my bloods from last year and my ferritin was 19 so I asked about it. But the GP didn't see a problem with it although commented today it was on the low side. Presumably the GP knows more than google and mumsnet though 😛

You can get iron tablets from boots it's worth a try as low ferritin can make you feel crappy

I understand what you mean OP as similar has happened to me.

I had a routine GP appointment about something else, mentioned I was constantly exhausted and had pain, particularly in my legs. One lot of blood tests, discovered my VitD was very low but all else apparently normal. Was given a VitD loading dose then maintenance dose but symptoms of tiredness and pain didn't improve. GP referred me to CFS clinic, who diagnosed me after a half hour chat.

I struggle to believe I have CFS, the diagnosis seemed too quick and neither GP or CFS clinic investigated other possible causes of exhaustion and pain. I feel the GP just wanted rid of me.

However, the care from the CFS over the past six months has been good and taking on board all their advice has actually helped my tiredness. (though there's been no help for the pain).

They've even arranged for me to see the CFS clinic's psychologist - apparently to help me accept my diagnosis! Getting free access to a psychologist seems like a privilege so I'm grateful for that 🤷🏻‍♀️

Women can get anaemia like symptoms (which includes fatigue) from ferritin under 50. I would want this sorted before they thought about a CFS diagnosis. CFS is a diagnosis of exclusion so everything else should be ruled out first.

Oh right, thank you for correcting me. I guess I just put 2 and 2 together from the OP: GP thinks it's CFS - he's sending me for blood tests.
Lucky I'm not an actual doctor!

Highly recommend getting copies of your test results and looking at the properly. I was fobbed off with "your thyroid is normal" for a long time - turns out it was borderline normal, it was actually underactive and I had off the charts antibodies for Hashimoto's disease, but they didn't check that one! They rarely do.

Also a lot of surgeries only check TSH, which can't actually tell you if your thyroid is fine.

Same for ferritin, b12, vitamin D etc

Just worth making sure everything is actually fine, because once you've got a CFS diagnosis, you won't get taken seriously again, they'll just blame everything on that.

Also don't fall for the "GP knows more than Mumsnet" - my GP admitted to not knowing much about thyroid issues, and was visibly relieved when I told him I was seeing a private specialist from now on. My specialist rolled her eyes when I told her some of the things I'd been told by NHS GPs!!