Re: Visit to the GP after blood tests

[Guest guest]

Hi Chrissie

Thank you for letting me know about Lisinopril - I am on it too but after reading what you have written about it, I am making an appointment to change it now!!!! Do you mind me asking what alternative you are going to take as it will save me ajob trying to sort out something. Terrible brain fog at the moment so I never seem to get anything sorted.

Fingers crossed for you that your GP will refer you to who you want. I have given up at the moment witg GP and just starting to self-medicate.

What a shame we cant insist - how can they price differently for a local endo as opposed to out of area. All under the NHS in the long run surely?

Regards

Colleen

From: chrissierob12 <christine@...>thyroid treatment Sent: Wednesday, 14 September 2011, 17:28Subject: Visit to the GP after blood tests

Hi everyoneAnother long session with the GP today I went with a long list of points to make and two new blood test interpretations for him to read. he actually asked me .

[Guest guest]

Chrissie,

Send him the copy of the pulse magazine article . it's in the files.... not in

any folder, jus on it's own... scroll down 'till you see

it....thyroid treatment/files/

x

> If I do get prescribed NDT or T3 in any form, he is very confused about dosage

and monitoring on T3. I tried to explain but the old fears of low,suppressed or

absent TSH frighten him silly- such a shame,it`s still one step too far for him.

I said I will find a relevant document to explain it to him

> All comments welcome

>

> Chrissie

>

[Guest guest]

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1341585 & blobtype=pdf

We consider that

biochemical tests of thyroid function are of little, if any, value clinically

in patients receiving thyroxine replacement. Most patients are rendered

euthyroid by a daily dose of 100 or 150 ,tg of thyroxine. Further adjustments to

the dose should be made according to the patient's clinical response. In our laboratory

36% of all thyroid function tests are performed to monitor thyroxine

replacement. To stop doing these tests in such patients would cause considerable

saving in the costs of reagents in laboratories using commercial kits.

Our findings

emphasise the need for laboratories to make their users aware that the

reference ranges for serum thyroxine, free thyroxine, and thyroid stimulating

hormone concentrations in patients receiving thyroxine replacement are considerably

different from the conventional ranges; they should also point out the limitations

of these ranges. This is especially important for general practitioners and

non-specialists, who generally rely on the biochemical findings more than specialist

endocrinologists do in managing these patients. The conclusions in this paper

also have major implications for schemes such as the ish Automated

Follow-Up Registry,2 " which relies on results of thyroid function tests in

assessing patients treated by radioiodine or thyroid surgery.

Also:

http://f1.grp.fs.com/v1/sPlwTngpgRu7QtRsnxyhSNo-ZYNg7zusJw3V1LAfB0B2sA-Gnsz7GShLEVKtcp6mfofa0tJ7Lt48sg5rRWCyBw/TSH%20~%20What%20affects%20the%20level%20of%20TSH/Media%20Release.%20Lower%20TSH%20OK.pdf

ABSTRACT

Is it safe for patients taking thyroxine to have a low but not suppressed serum

TSH concentration? Graham

Leese & Flynn University of Dundee, Tayside, UK. For patients

taking thyroxine replacement guidelines generally recommend aiming for a target

TSH within the laboratory reference range. The evidence for this guidance is

generally based on an extrapolation of data from patients with endogenous

subclinical thyroid disease. We aimed to examine the safety of having a TSH

which was either suppressed (˜0.03 mU/l), low (0.04–0.4 mU/l),

‘normal’ (0.4–4.0 mU/l) or raised (>4.0 mU/l) in a

population-based cohort of patients all of whom were treated with thyroxine. We

used a population-based thyroid register (TEARS) linked to outcomes data from

hospitalisation records, death certification data and other datasets between

1993 and 2001. The endpoints of cardiovascular disease, dysrhythmias and

fractures were assessed. Patients were categorised, using a time weighted mean

of all TSH recordings. There were a total of 16 426 patients on thyroxine

replacement (86% female, mean age 60 years) with a total follow-up of 74 586

years. Cardiovascular disease, dysrhythmias and fractures were increased in

patients with a high TSH (adjusted hazards ratio 1.95 (1.73–2.21), 1.80

(1.33–2.44) and 1.83 (1.41–2.37) respectively), and patients with a

suppressed TSH (1.37 (1.17–1.6), 1.6 (1.1–2.33) and 2.02

(1.55–2.62) respectively), when compared to patients with a TSH in the

laboratory reference range. Patients with a low TSH did not have an increased

risk of any of these outcomes (HR: 1.1 (0.99–1.123), 1.13

(0.88–1.47) and 1.13 (0.92–1.39) respectively. People on long-term

thyroxine with a high or suppressed TSH are at increased risk of cardiovascular

disease, dysrhythmias and fractures. People with a low but not suppressed TSH

did not have an increased risk of these outcomes in this study. It may be safe

for patients treated with thyroxine to have a low but not suppressed serum TSH

concentration.

Sheila

Send him the copy of the pulse magazine article . it's in the files.... not in

any folder, jus on it's own... scroll down 'till you see it....thyroid treatment/files/

x

> If I do get prescribed NDT or T3 in any form, he is very confused about

dosage and monitoring on T3. I tried to explain but the old fears of

low,suppressed or absent TSH frighten him silly- such a shame,it`s still one

step too far for him. I said I will find a relevant document to explain it to

him

> All comments welcome

>

> Chrissie

>

[Guest guest]

Did you know that Lisinipril was made from snake venom?

[Guest guest]

Colleen

Yes it was something I read in the Daily Mail health pages a couple of months

back. GP has put me onto bendroflumethiazide which apparently will help with

fluid retention.I am on a month`s trial.

Chrissie

>

> Hi Chrissie

> Thank you for letting me know about Lisinopril - I am on it too but after

reading what you have written about it, I am making an appointment to change it

now!!!!    Do you mind me asking what alternative you are going to take as it

will save me ajob trying to sort out something. 

[Guest guest]

Thanks Chrissie. Will have a word with my GP now. Bad enough with illnesses without meds causing more problems!Sent from my BlackBerry® smartphone on O2From: "chrissierob12" <christine@...>Sender: thyroid treatment Date: Wed, 14 Sep 2011 21:18:27 -0000<thyroid treatment >Reply thyroid treatment Subject: Re: Visit to the GP after blood tests ColleenYes it was something I read in the Daily Mail health pages a couple of months back. GP has put me onto bendroflumethiazide which apparently will help with fluid retention.I am on a month`s trial.Chrissie >> Hi Chrissie> Thank you for letting me know about Lisinopril - I am on it too but after reading what you have written about it, I am making an appointment to change it now!!!!    Do you mind me asking what alternative you are going to take as it will save me ajob trying to sort out something.