Re: We Wouldn't normally Treat a TSH Under 10

[Guest guest]

Kit,

Not at all, go back and take in a copy of the pulse magazine article which is in

the files...... it's by endo toft and the doctor may take note....

and take in a copy of the press release from last year by the society for

endocrinology which says a tsh of more than 4 puts you at risk of heart

problems.

http://www.endocrinology.org/press/pressreleases/2010-03-16_Thyroxine.pdf

and ask what 'guidelines' she is using..... there are no NICE guidelines in the

uk and the doctor is free to follow whaetver giudelines she sees fit, even

guidelines from another country.

I know it's horrible having to hassle the docs when you feel rotten, but with a

tsh that high, you need some answers.....

if turns out you have low ferritin, or high antibodies, then the doc will

act.......

You can get a D3 test for £20.... here: http://www.vitamindtest.org.uk/

It does get better but you need meds...

x

>

>

>

> At the beginning of last month I wrote to my GP following a TSH reading of

6.9, following the guidelines that Sheila very kindly laid out for me. These

were to list my signs and symptoms, basal temp, family history, plus requests

for

>

> 1) Further testing for various minerals

> 2) An Endocrinology referral

> 3) A trial of Levothyroxine

> 4) That the letter be answered in 2 weeks and placed in my records.

> >

> Then she said if I'd been getting all these symptoms, I probably had

subclinical hypothyroidism, as my Free T4 was normal. She added that " the

guidelines suggest we wouldn't normally treat a TSH under 10 " .

h.

>

>

> Back to Square One?

>

[Guest guest]

Yes, I got the same thing from a GP at my surgery. She read the guidelines of

the computer and said they were NICE guidelines.

Miriam

> and ask what 'guidelines' she is using..... there are no NICE guidelines in

the uk and the doctor is free to follow whaetver giudelines she sees fit, even

guidelines from another country.

[Guest guest]

Remind this Locum

doctor that only two of the 17 references given to the research and studies given

had been carried out on rats and research and studies done on rats should be

taken very seriously. If she isn't 'inclined' to agree to those tests,

then she should agree to the others, or she should give you references to show

these were not reliable. How damned arrogant - sorry - but you should not see

this Locum, wait and see your own doctor, or at least, one who doesn't make

excuses not to help their patients who are suffering such ill health. Why isn't

she following research - does she know something that we (or the authors of

such research) don't know?

Ask her what

Guidelines she is talking about. There are NO guidelines within the UK, and

even NICE have not published any guidelines. AND, the Government have written

to state that any doctor can use whatever thyroid guidelines they wish, even if

written in another country, so long as they could explain why they had chosen

those particular guidelines to work from.

Recently, Dr Gordon

Skinner was up before the GMC for daring to give a diagnosis and treat outside

of guideline recommendation (those naturally being the RCP/BTA 'guideline'

until it was pointed out to the Panel that what they had published was their

OPINION only, and that they had not authored any guideline. Also, their

recommended TSH reference range was 0.5 to 10.0 when in Europe, their

recommended reference range was 0.3 to 3.0, and that Dr Skinner HAD CHOSEN TO

USE THE EUROPEAN GUIDELINE (sorry for shouting, but I am) and gave good reason

to the GMC as to why, they fully accepted this and he was completely

exonerated.

Perhaps you should

take a copy of the Determination by the GMC Panel on Dr Skinner's hearing that

is in our web site www.tpa-uk.org.uk and

show this locum GP the facts, to bring her knowledge that is so sadly lacking, up

to date with what is really happening in the thyroid world, and me personally, I

would be sorely tempted to tell her to get off her back-side and start to help

her suffering patients by getting the true facts.

Unless we stand up

to such ignorant, arrogant doctors, they will continue to do real harm to their

patients.

Your results show

your TSH is appallingly high by European and US standards. Did you get tested

to find out whether you have antibodies to your thyroid. i.e. TPO and TgAb. Do

you have members of your family with a thyroid or autoimmune disease?

Luv - Sheila.

Out of a request for testing for (please bear with me) iron, ferritin,

transferrin saturation, B12, D3, Magnesium, Folate, Copper and Zinc, she agreed

to test for TFT, thyroid antibodies, FBC and Ferritin. She said some of the

research papers I had listed had been conducted on rats, making her less

inclined to agree to authorise tests on the basis of it. As I was unfamiliar

with the literature myself I felt ill-placed to query this.

Then she said if I'd been getting all these symptoms, I probably had

subclinical hypothyroidism, as my Free T4 was normal. She added that " the

guidelines suggest we wouldn't normally treat a TSH under 10 " .

My results in full so far are:-

TSH - 6.9mu/L (0.3 - 5.5)

Free T4 - 15.7 pmol/L (10.0 - 19.8)

Free T3 - 4.8 pmol/L (3.5 - 6.7)

It was only after I'd left the consultation room I realised I'd come away with

neither a trial of medication nor a referral.

Truth be told, I don't mind things like being overweight or having sinusitis

overmuch, but the prospect of being depressed for the rest of my life leaves me

in great anguish.

_

[Guest guest]

What were the guidelines she was reading off for you Miriam.

There are no thyroid guidelines whatsoever in the UK and all doctors should be

made aware of this. If she was reading the RCP. BTA et all 'Statement on the

diagnosis and management of primary hypothyroidism' she should realise that

this is NOT a GUIDELINE, it is a statement of their opinion only, and nothing

they state has been backed up with references to research or studies.

Luv - Sheila

Yes, I got the same thing from a GP at my

surgery. She read the guidelines of the computer and said they were NICE guidelines.

Miriam

---

_._,___

[Guest guest]

> " Ask her what Guidelines she is talking about. There are NO guidelines within

> the UK, and even NICE have not published any guidelines. AND, the Government

> have written to state that any doctor can use whatever thyroid guidelines

> they wish, even if written in another country, so long as they could explain

> why they had chosen those particular guidelines to work from. "

I didn't know that. Sheila, is the government statement available on net link

and if so could you point me in the right direction? I have searched for both it

and the Toft Pulse article Galathea has mentioned on the TPA site under

the headings " Thyroid Patient Advocacy News " and " Further Information " , but I

can't find either under these headings.

" Recently, Dr Gordon Skinner was up before the GMC for daring to give a

> diagnosis and treat outside of guideline recommendation (those naturally

> being the RCP/BTA 'guideline' until it was pointed out to the Panel that

> what they had published was their OPINION only, and that they had not

> authored any guideline. Also, their recommended TSH reference range was 0.5

> to 10.0 when in Europe, their recommended reference range was 0.3 to 3.0,

> and that Dr Skinner HAD CHOSEN TO USE THE EUROPEAN GUIDELINE (sorry for

> shouting, but I am) and gave good reason to the GMC as to why, they fully

> accepted this and he was completely exonerated.

>

> Perhaps you should take a copy of the Determination by the GMC Panel on Dr

> Skinner's hearing that is in our web site www.tpa-uk.org.uk and show this " .

Oh fantastic! Exonerated and free of restrictions! Good for him. Thanks, I will

print that out.

" > Did you get tested to find out whether you have antibodies to your thyroid.

> i.e. TPO and TgAb. Do you have members of your family with a thyroid or

> autoimmune disease? "

Yes, the Locum agreed to an antibodies test, (although I don't have the results

yet) and yes, I have a family history of it.

Many thanks for all replies x

[Guest guest]

Kit, you are looking in the wrong place. The Pulse article is in the files of the forum and not on the tpa website.Here is the link to the forum, (you may have to sign in to your account) click on Files on the left hand column and then scroll down untill you see Pulse article 2003.doc.thyroid treatment If you can't find it, post again and I'll mail you a copy if you don't mind getting emails...... ( We're supposed to ask if this is ok before sending private emails to each other.... - if anyone wants to email me direct, I have NO problem with it ) xx>"> > I didn't know that. Sheila, is the government statement available on net link and if so could you point me in the right direction? I have searched for both it and the Toft Pulse article Galathea has mentioned on the TPA site under the headings "Thyroid Patient Advocacy News" and "Further Information", but I can't find either under these headings. > >

[Guest guest]

Hi Kit - this information is in our FILES SECTION under the

folder entitled 'Information for Patients' and then under 'Guidelines. You

would be surprised just how much information TPA has that you can give to your

doctor. Copy this out for your GP.

>I didn't know that. Sheila, is the government statement available on net

link and if so could you point me in the right direction? I have searched for

both it and the Toft Pulse article Galathea has mentioned on the TPA

site under the headings " Thyroid Patient Advocacy News " and

" Further Information " , but I can't find either under these headings.

GUIDELINES – FROM ANN KEEN MP

" Doctors do NOT have to work with the guidelines they have

been given. According to Ann Keen MP (Parliamentary Under Secretary of State)

written on 16th April 2009

" Doctors are encouraged not to reply too heavily on the

results of blood tests, but to use their clinical knowledge and an assessment

of the symptoms experienced by individual patients in making a diagnosis for

thyroid treatment. Doctors are free to use whatever

guidance they feel is appropriate when making a diagnosis. This includes

guidance published in other countries”

Also " Under their terms of service, GP's are allowed to

prescribe any product, including any unlicensed product or product not licensed

for a particular indication, that they consider to be a medicine necessary for

the treatment of their patients under the NHS, subject to two provisos. These

are that:

·

the product is not included in Schedules

1 or 2 of the NHS General Medical Services Contracts (Prescription of Drugs

etc) Regulations 2004, otherwise known as the Selected List Scheme; and

·

GP's are prepared to justify any

challenges to their prescribing by their Primary Care Trust.

It is the responsibility of health professionals to decide on

the most appropriate treatment for their patients,. If a person has any

concerns over their treatment or the drugs they are prescribed, they need to

raise these concerns with their GP or consultant " .

Luv - Sheila

[Guest guest]

Shouldn't the word be 'rely'.

GUIDELINES – FROM ANN KEEN MP

" Doctors do NOT have to work with the guidelines they have

been given. According to Ann Keen MP (Parliamentary Under Secretary of State)

written on 16th April 2009

" Doctors are encouraged not to reply too heavily on the

results of blood tests, but to use their clinical 

[Guest guest]

Oh yes, so sorry Lilian, it should have been written 'rely'.

Luv - Sheila

Shouldn't the word be 'rely'.

GUIDELINES

– FROM ANN KEEN MP

" Doctors

do NOT have to work with the guidelines they have been given. According to Ann

Keen MP (Parliamentary Under Secretary of State) written on 16th April 2009

" Doctors are encouraged not to reply too heavily on the

results of blood tests, but to use their clinical