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Visiting Your GP

This is an extract from Dr. Rowan Hillson’s book Thyroid Disorders:-

“Myxoedema can damage the heart in three ways:

By encouraging furring-up of the arteries supplying oxygen and nutrients to the heart (coronary atherosclerosis).
By weakening the heart muscle generally.
By causing accumulation of fluid (effusions) in the bag which surrounds the heart (pericardium). This is called Pericardial effusion.

The most common heart problem found in people with myxoedema is coronary atherosclerosis and its consequences. This occurs because of the increase in cholesterol circulating in the bloodstream associated with thyroid underactivity. It can cause angina and, rarely, a heart attack or coronary thrombosis."

Your GP may tell you that if he gives you thyroxine you could have a heart attack due to overactivity. He probably won’t tell you that you could have a heart attack (see above quote) if you are not getting enough thyroxine.

Presumably, you have already seen your doctor because you have been unwell. If you have not had a thyroid blood test yet, make an appointment to see your doctor and request one. If you have already had blood tests done in the past and they have come back “normal” or “borderline” make an appointment with your doctor to discuss these results. Either way:-

Find out as much as you can about the thyroid before your appointment so that he can see you are well informed. Copy articles from this website, or from books in the book list and highlight them, so that you can show these to your doctor.
Tick off all the symptoms you have on the symptoms form. Add any other problems you may be having at the bottom and take it with you.

Do the Basal (Barnes) Temperature Test. (See Barnes Temperature Test)

Take someone along with you if you can, not only for support but also so that they can remember what has been said.

Don’t ask for the results of your blood test over the telephone. The receptionist is not a doctor. If you have had a blood test (or two or three!) already, then you are allowed to know the results under the 'Data Protection Act'. To be told they are “normal” or “borderline” is not enough. You need to ask for your exact results in figures. Also ask for the reference ranges. The blood tests are sent to different laboratories, depending on where you live, so the ranges are different. You can then see where you are in the range. Your FT4 may be in the lower end of the normal range but if you have many symptoms of underactivity, you may still be underactive, even though you are in the normal range. You may need to point out to your doctor that you did not have a blood test done when you were well, so how does he know where abouts in the range you normally are? Your normal may be at the top end of the range.

If your doctor refuses to do this, tell him that under 'The Data Protection Act' you have the right to:

Have access to your health records, and to know that everyone working for the NHS is under a legal duty to keep your records confidential.

Comprehensive guidance on the Data Protection Act and the Freedom of Information Act can be found at www.informationcommissioner.gov.uk

If he still refuses to let you have the results, contact the Patients Advisory and Liaison Service http://www.pals.nhs.uk who will tell you what you can do about this. There should be a poster in your Doctor’s surgery, or ask the receptionist for their telephone number.

Discuss with your doctor the possibility of a trial of a small amount of thyroxine i.e. 25mcg for three months. If he flatly refuses, we recommend that you see one of the doctors from our list. If he agrees, take the thyroxine as directed. Always discuss with your GP any increase or decrease in medication you wish to make.

NB: Although this has not been confirmed, it has been suggested that if you have your blood tests done later in the day, the levels will be lower. This could make all the difference to borderline blood tests and just take you outside of the range, enabling your doctor to give you treatment!

DON'T FORGET - IF YOUR DOCTOR AGREES TO PUT YOU ON A TRIAL OF THYROXINE, PLEASE LET ME HAVE HIS NAME AND ADDRESS. I AM MAKING A LIST OF DOCTORS WHO ARE HELPFUL SO THAT OTHERS IN YOUR AREA CAN BE HELPED TOO.