GP refusing treatment and I feel like an imbecile. What should I do?

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I went to my GP a few months ago prepared to finally inform her of all the things I felt were going on/wrong with me. I let her know that I felt that I had IBS-D (she agreed), PCOS (she stated it "didn't really matter"wink, major depression and generalized anxiety (she agreed). I am currently 23, and I brought up PCOS because it runs in my family and I had mentioned to my mom that my hair was falling out quite a bit. She told me to ask about PCOS, and given my painful periods and an incident where we think a cyst may have burst, I decided to ask. My GP felt it didn't really matter whether I had it or not unless I was planning on children, so that was the end of that. I did not discuss any symptoms there.

Due to my mentioning my depression, she stated that although I was too young for her to want to normally run blood tests, she would do it just to make sure my thyroid was working, while also starting me on an anti-depressant. I thought nothing else of it, as I've never read up on thyroid disease or issues and had attributed many of my symptoms to depression and anxiety. I have a mental health background, so it made sense to me that my severe fatigue and other symptoms would be related to this.

When my blood tests came back, I had a TSH level of 5.1 and a Free T4 of .69. She stated that this meant my thryoid function was "borderline" and that she would want to retest in a year. However, I went in for a follow up on my anti-depressant about a month after this and decided that I would ask if we could try a trial treatment. After reading up on the symptoms, I realized that these felt very much like me. I have been incredibly depressed, have gained nearly 50 pounds in only a handful of years, and have been so fatigued that I struggle to get out of bed and do things in a very literal sense beyond my low motivation caused by depression. I have thin hair that falls out frequently and very brittle nails. After reading up, I felt that a trial might be worth it.

My GP did not feel the same. She stated that she would retest my blood today, but that she wanted to wait on treatment, because it could contribute to osteoporosis or make my anxiety worse. When my results came back, my TSH was 8.2 and my Free T4 was .72. At this point, she stated that "most likely" my thyroid would fail "over time" and that I would then need thyroid treatment and that she wanted to retest in six months. 

At this point, I was feeling incredibly - stupid? but also upset about this. I didn't want to question her knowledge on the subject, but I felt like my concerns were being dismissed. So, I responded and informed her that I was still seriously struggling, in particular with my fatigue, and that I did not know how to deal with the symptoms until she decided treatment was appropriate. She decided to up my anti-depressant dose, but essentially repeated her earlier comments about osteoporosis and dismissed me with, "It is not appropriate to use thyroid hormone when it is not indicated as it can cause other problems." At this point, I felt even worse. While I know that some of the symptoms I communicated to her were definintely me needing to up my anti-depressant dosage (something that I did tell her in my message), even when my earlier dosage was working, it did not treat some of my core concerns (particularly the fatigue/exhaustion). Her responses have made me feel ignorant and pushy, and while I am not a fan of self-diagnosis or trying to use the internet to determine what's going on, I feel like it cannot seriously be this worthy of dismissal?

From what I have read, I am clearly symptomatic and my blood tests indicate at least subclinical hypothyroidism. I also have no idea why my thyroid is "probably" failing or if there is a reason behind it? I feel lost here. My best friend has recommended I get a second opinion, but I struggle so much with going to the doctor in the first place and given my doctor's response to my questions, I'm concerned with how a request for a second opinion would even be received. I'm really sorry to go on so much, but no one other than my best friend really knows what's going on, and I have no idea what to do or how to feel about my results. I feel like I am somehow lying or making this all up and that my symptoms are just my being lazy, but at the same time I know that in reality that's not the case. I just don't know what to do here.

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37 Replies

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  • Posted

    Ask for a printout of your latest results. It should flag the out-of-range TSH. Then ask your doctor why she ignores it. If you can, take a supportive relative or friend along to back you up.
    • Posted

      Dave I readthat drs doo not take any notice unless the tsh is 10 !!
    • Posted

      Jane, well, here in Canada the top of normal range is 4 and if you are over that they will prescribe Thyroid medication.
    • Posted

      Just google "what is normal TSH". What you will find is that between 3 and 4 is "at risk", and that below 2.5 is ideal for most. Your doctor's attitude is truly worrisome and that is being polite. You need to get a second opinion and/or another doctor.

    • Posted

      Dave I wish that I live in Canada!!

      Got any spare rooms to rent out LOL!!!!

    • Posted

      Dave.. I'm in the US and the TSH range from my lab is 4 also.  Anything over that, and if your symptomatic, then they prescribe thyroid meds also.  Jane.. I'm not sure where you are from, but your doctor not treating patients unless they are over 10 is unacceptable.   Perhaps you should talk to a second doctor to just get a second opinion and hear what he has to say?  Just trying to help...

    • Posted

      Thanks I am in the UK and most drs are the same.

      GP will not even take any notice of the private endo.

    • Posted

      So Jane, do you have the option at this point of going direct to an Endo and paying? Can your doctor prevent that? 

      When did you last discuss this with your doc? Did she point blank refuse to refer you to an Endo? It sounds to me like you may want to speak with the College of Physicians or whatever the name of the professional body is, because you could have grounds for a complaint. The possibility of that could change her attitude. 

      Or you may just have to have it out with her and refuse to leave until she gives you a cogent explanation of why she won't medicate you when your TSH is 10 and top of range is 4. Take a strong-minded friend or relative.

      Good luck. Let us know how it goes!

    • Posted

      DAVE The GP cannot prevent me seeing someone privately for a second opinion. Pts can self rerfer to some drs otheers demand a letter of referral.

      The GP refused to send me for an USS of the thyroid to exclude cncer despite knowing I have a multi nodular goitre. I nearly had a nervous breakdown becausee of the worry of possible cancer.

      I paid to have the scaan done plus consultation  plus bloods.

      At least I was able to get some of my life back afterwards instead of being fobbed off by the failing NHS.

      TSH is low so hyper however endo says I have fluctuating thyroiditis so do not know where I fit in, am I hypo or hyper.

      In this country drs are ruled by the Clinical Commissioning GROUPS   and hospitals etc.

       

    • Posted

      Yes Jane, same in the US. GRaves disease will often show very high TSH, but Hashimoto's often does not show very high. I have advanced Hashimoto's, undiagnosed for decades, with a very large compound thyroid nodule. If your TSH is not super elevated, you can get a diagnoses based on high antibodies, high rT3, or ultrasound showing thyroid nodules.  But for those types of diagnoses, you usually have to go to a good endocrinologist.

  • Posted

    I like your friends advice,  some doctors just do the basic tsh test, don't really look at you let alone listen.  You know your body better then she does.  I am not a big fan of Ssri when they are not needed.

    to me she just gave them to you you to shut you up.  You can fire your dr you know you pay them remember that.  Also a lot of dr go by the old thyroid chart.  You can ask to be refured to a specialist or use your friends advice.  Also ask yourself is this the kind of dr you want to treat you when you get older.  

  • Posted

    Currently still waiting on a reply as to when I'll be able to get a referral. The closest endocrinologist to me is not accepting new patients and the next closes (nearly thirty minutes away) only accepts clients based on a referral. If I don't get a response tomorrow when I call again, I'll be calling the endocrinologist and informing them that my GP is refusing to give me a referral. 

    My GP definitely only seemed inclined to treat if my TSH reached a 10 or higher. I have an online copy of all my lab results. The reference range ends at 4.5 for TSH. For my Free T4 it begins at .60, resulting in me being "normal" while only at a .69/.72.

     

  • Posted

    It's obvious your thyroid is under Active! Honestly these GP's but that's the problem they are only general practitioners. Either change doctors or insist you see an Endocrinologist. Your TSH should be around 1. The first thing some GP's jump for are antidepressants which can make you worse, mentally. You should be checked for Vitamin D deficiency and B12, they make a huge difference.

    Hope you get someone to listen to you soon, get help now please.

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