How to talk to GP about potential thyroid issue when results are "normal"?

[elementofsurprise]

Following on from this thread: www.mumsnet.com/Talk/general_health/2443625-Constantly-exhausted-blood-tests-fine-UTI-help but no real need to read it!

I'm getting more convinced it's a thyroid issue, due to other symptoms eg. feeling cold/sleepy, especially after eating. This on top of general exhausted feeling.

Over the last couple of weeks I've also had worse bloating, flatulence, and really painful trapped wind (I think?) type stabbing pains from under my ribs to right down in my abdomen. This tends to be in the evening and I feel a bit constipated too, whilst in the morning to midday it's the opposite, very sudden urges to defecate and it's soft and stinks (this part has been going on for months).

Anyway wondering if I might have a thyroid problem. I know a lot of people have symptoms but a blood test result in the supposedly "normal" range - how do I know if this is the case for me? What specifically do I need to ask my GP? And what if it is thyroid but their silly system says it's not - how do I get treatment? If it's borderline, how do I convince him to take me seriously? He's a nod/pat on the head type. Can't change GP and he's the best in the surgery, but I kind of have to spell it out to him who I need referring to to get him to do it!

Also - is a random glucose test any good for showing up diabetes, or should I ask specifically?

Was also tested for vitamin deficiencies, and maybe a few other things - is there anything specific I should have been tested for?

Am going to get re-tested for UTIs.

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Also wondering...
I've had some horrendously diffuclt times in my life than have involved prolongued, all-encompassing stress - feeling like I'm in "fight or flight mode" for days/weeks/months on end, and not exactly stable or safe between that. (circumstances causing MH issues, which cause worse circumstances etc... am now seeing therapist, not on meds).

I'm wondering about the effect on adrenal glands? I have all the symptoms listed on this page: www.stopthethyroidmadness.com/adrenal-info/ Could I now have some kind of adrenal or other hormonal issue causing these symptoms, that GPs wouldn't look for unless I'd been in a warzone or something? (I know this sounds far fetched but doctors never seem to have grasped the terror and stress I lived in day-to-day.) It's just I've always noticed the effect on my body, when going through stresses, that it makes me feel physically ill and I find myself thinking "it can't be good for me to feel his wrenching pain inside/be so on edge all the time". I cant go into it here but I have fared very bady in MH services so had to somehow survive through a lot without any support. Just writing it is setting me off crying so better stop.

Anyway, adrenal fatigue isn't recognised by the NHS either! Feel really crap, its bad enough them dismissing my emotional pain/making it worse, but if that's had an effect on my body then it's a double whammy of disbelief from them :(

Any ideas? Is there a cortisol or adrenal test I could try to convince my GP to do?

If you're going to talk to your GP about this, you need to be on top of your subject.

Do you have your actual results, the figures with the reference ranges? You might want to get these and post them somewhere like the ThyroidUK forum on www.healthunlocked.com.

You'll get lots of good, non woo advice there and they should be able to point you in the direction of the right questions to ask and the challenges to make.

However, be aware that if you do have thyroid/adrenal problems, it can be a long road to diagnosis and treatment and you may have to go private, or self-treat in the end.

On the NHS it's a nightmare. The best thing would be to get a copy of your thyroid results with the ranges and see where your results sit in the range. List all your symptoms. Ideally get vitamin b12, D, ferritin and folate tested too. Deficiencies in those mean that the thyroid hormone doesn't work like it should, finally thyroid antibodies to see if there's a problem there.

I should tell you at this stage I gave up with my GP although he was happy to diagnose or refer me for diagnosis with carpal tunnel syndrome, monorraghia, tennis elbow and I could have gone on, but refused to accept there was anything wrong with my thyroid despite the results not being as normal as they ought to be. I was reading too much rubbish on the internet according to him. In the end I found a private Dr thanks to thyroid UK keeping a list, got diagnosed and started taking medication. I was lucky I was able to go down that route. It's made a huge difference and it's fun being articulate enough thanks to the medication to be capable of disagreeing with my GP again. Different GP I might add, again thanks to revived mental and physical energy from taking the pills the NHS said I didn't need.

Thanks. I will ask for specific results of everything I was tested for.

Is there a specific adrenal test that would show anything? I might be able to convince GP to refer me (he'd think he was doing it to prove there's nothing wrong!

How much do you think it would cost to go private? It's almost certainly going to be too expensive but thought I'd ask!

I know exactly what you mean about the adrenal stress thing, as well as feeling hypothyroid with normal levels, and in fact I could have written most of your post over again about myself. While a lot of what I am doing is a work in progress, there are some things that definitely do help.

I use kelp as a natural supplement for iodine - I know this isn't recommended but it works for me. I have to keep an eye on the frequency - if I take it every day I am a bit manic, but it does help some of my symptoms, esp very dry skin. I also take massive vitamin B12 supplements too.

For the adrenal fatigue I used this which I think helped - it certainly stopped me waking up at 4am.

In the end, I concluded that I was having a lot of these problems because I wasn't absorbing stuff properly in the first case, so have been going to an acupuncturist to rebalance the whole system (I also developed IBS after a food bug, and some of your symptoms sound like that too, the gas etc). This is definitely helping a lot, but it's still ongoing.

The received wisdom is that you should be very careful about taking kelp if you may have a thyroid problem, especially if that thyroid problem may be auto immune in origin, as most of them seem to be.

Have you also been tested for Coeliacs?

Don't think I've been tested for Coeliacs, however symptoms don't seem to coincide with eating gluten. GP appt today so ready to state my case. I know he'll say IBS aka "something's up can't be more specific" but might be able to have more tests.

Do GP's in the NHS ever prescribe thyroid treatment whilst in the "normal" range? Is it possible to convince them to at least try it, on symptoms alone?

ps. very terrible, I know, but I'm a smoker and apparently that can interfere with TSH results...

I would definitely ask for the Coeliacs test, and as you eat Gluten it should give a clear result.
Coeliacs and Thyroid can be linked.

Righty ho. Been to GP and have another appointment next week. Unfortunately due to something else I was in a bad way mentally today so couldn't get through everything.

However... apparently I have an iron deficiency. For some reason when I phoned for blood test results (was assuming a deficiency and wanted to start sorting it before next available GP appt!) they told me everything was fine. I assume they must have meant nothing urgent.

Going to have fasting blood test for diabetes, will ask about coeliac test. Did have to really ram home the fact that I get so thirsty and pee all the time, but this may be UTI still there so need to take in sample too.

Feel like I'm getting somewhere.

Thank you for all the advice