Is this a reasonable way of approaching my GP?

[KatyMac]

I'm seeing my 'good' GP this afternoon; is this a reasonable approach?

I have:
Chronic Fatigue Syndrome
Fibromyalgia
IBS – currently on an exclusion diet (FODMAPs) I have had quite a few investigations for bowel issues.

I get the following fairly often/regularly:
Otitis Externa
Cystitis
Thrush
Mouth Ulcers (occasionally salivary stones)

I had my tonsils out in 1989.

The only medication I take regularly is prescription co-codamol for back/joint pain.

I’m tired all the time.
I have joint/muscle/bone pain all the time.
I have concentration problems sometimes.

I’m fairly sure I’m not depressed; but I am fed up

Possibilities?
Non-coeliac gluten sensitivity
Oral Allergy Syndrome
Something Auto-immune

Do you want to be tested for those possibilities? How would one be tested for them to rule them in or out?

I guess an autoimmune specialist could look at my immune system, an allergy specialist would look at oral allergy syndrome - but the non-coeliac gluten sensitivity would be (yet another) exclusion diet

How much of that could you try at home to see what works?

I'm not allowed to exclude anything from my diet without medical
supervision - so nothing really

Maybe I shouldn't suggest possibilities?

What is the current problem you would like your GP to investigate and/or treat?

I’m tired all the time.
I have joint/muscle/bone pain all the time.
I have concentration problems sometimes.
This appears the classic definition of CFS & Fibromyalgia.

I get the following fairly often/regularly:
Otitis Externa
Cystitis
Thrush
Mouth Ulcers (occasionally salivary stones)
Are you suffering from any of these problems today?

How is the FODMAPs going? I've read that this can sort a whole host of problems related to the IBS/allergy/immune stuff...

I find that I get the best out of a visit to my GP when I know what precisely I'm after and state that up front when I go in, along the lines of " This is my problem, and this is what I am hoping you can help me with..." I carry this written down on a piece of paper - not in case I forget (although it's good for that also) - but to signal to the GP that I have come with something concrete and I want to leave with something concrete...it works sometimes:)

Good luck

I think all of my symptoms are being treated separately and I think they are connected

Every time a new symptom comes along it gets a new diagnosis when I think they are connected.

Auto-immune would deal with bowels/joints/ulcers
OAS would deal with bowels/joints/thrush/ulcers
Non-coeliac gluten sensitivity would deal with bowels/joints/ulcers

Anything that affects bowels & joint pain would help with tiredness (i'd have thought)

Look at mixed connective tissue disease and Sjögren's syndrome. Your GP can run the initial blood tests ANA, rheumatoid factor, ESR are amount them. If these suggest these diseases a rheumatologist is the way to go.

I guess I am concerned about offering possible diagnoses in case I offend

Very often CFS and Fibromyalgia diagnoses are just an excuse not to check your thyroid function and act on any discrepancies. I was diagnosed with CFS on three occasions when I actually had vitamin and mineral deficiencies and an underactive thyroid. I am now completely well.

It would be very much worth your while to ask your GP for a full thyroid screen (TSH, FT4, FT3 and antibodies), together with a coeliac test and vitamin B12, folate, ferritin and vitamin D. I doubt very much if any of those are at optimum levels and fixing those alone should make you feel appreciably better.

Go in with your ideas, why not? He or she can discuss with you all of the things you are worried about, or book a double a appointment for you in case time is short.

Good luck OP.

Non-coeliac gluten sensitivity & blood work with the results deciding whether we go gastro or rheum

So nice & listening and no suggestion of depression!

& he also suggested that some of my diagnoses were nearly 20 years old & things have changed since then

If it is something autoimmune, more often than not, it will show up in bloods. You say you have joint pain; do you have swelling? any stiffness?

heard a report on You & yours this morning about under diagnosis of Coelic. they were describing many of the symptoms you mention. Interestingly one of the problems they said with diagnosis is that the test only works if you're on a standard diet - if your on a exclusion it doesn't work. I can't give you a link as it's not on iplayer yet - might be worth a listen

Very occasional swelling - usually on my hand or my foot (a memorable one was the bit on my jaw by my ear )

Constant stiffness, sore joints, sore bones & sore muscles - it starts bad in the morning then eases off - returning mid to late afternoon & bad again by the evening

My brother has RA & his CRP is relatively normal as is his rheumatoid factor; his anti CCP is about 1600 tho'

I hope you can get to the bottom of it Katy. It sounds like you had a good consultation today.

Very, very good - which surprises me as I have a certain amount of medical anxiety.

I accidentally exposed myself to milk on Thursday - so I imagine my inflammation markers will be up a bit for the blood test - not sure if that is a good thing. DH jokingly said I should eat everything I'm not allowed so my bowel is in melt down for the test but I'm not sure I could cope with the pain

Very, very good - which surprises me as I have a certain amount of medical anxiety.

I accidentally exposed myself to milk on Thursday - so I imagine my inflammation markers will be up a bit for the blood test - not sure if that is a good thing. DH jokingly said I should eat everything I'm not allowed so my bowel is in melt down for the test but I'm not sure I could cope with the pain