Requesting certain blood tests from GP - refused

[Wing Commander]

Hi all,

My OH has been diagnosed with hypothyroidism (sp?) approximately 1 year ago and is currently on the synthetic thyroid drug Levothyroxine which is a T4 drug. Her symptoms have got better than they were, admittedly, but she is certainly not all back to what we would consider normal (). She still currently experiences numerous symptoms which are serious enough for us to both take note of and want to sort. We wanted to give the Levo drug time to kick in and work, hence the delay.

When she was last at the Doctors, I suggested she asked for a full blood test work up, to include T4, T3 and TSH levels. From my understanding, the TSH level and T4 level are linked quite tightly, but T3 not so.

Having done lots of research, it would appear to my cynical mind that T3 drugs (such as Armour) are approximately 25x more expensive than T4 drugs like Levothyroxine. If a T3 test isn't done, then you can't be low or high on T3 levels, right?! [/cynic off]

Basically, I think her T3 levels are going to be out from the norm, however the doctor is saying that they will not issue a T3 test unless there is a specific reason. I haven't been with the OH to the doctors to apply a little more persuasive power yet, but am happy to join her and ask questions.

So, to my point, can anyone go to the doctor and essentially override their decision? My alternative is to get her tested privately, but they this won't appear on her records.

So, PH, what do you think? I may well have missed some info out, so just ask if anything else is needed.

Thanks

[apotek]

L-thyroxine is as you say synthetic thyroid hormone but is identical to the natural stuff your wife is not producing.It can be dosed accurately and consistently as opposed to the old fashioned stuff which was always difficult to make consistent IIRC.
I have seen many patient on thyroxine who are perfectly fine,she probably needs just to get her dosage correct and also be consistent taking it in the morning NOT at night.In 35 years of pharmacy I have never seen Armour used once.

[knk]

You may pay for the tests you want privately, but there is no need for them.

TSH is a good marker for adequate replacement. It is very common for women to want to be over-replaced as the feel tired-all-the-time. That is usually life rather than pathological.

[Dublte]

I believe, though could be incorrect, you can request from the GP to be referred to a specialist which they are obliged to do. I had thyroid issues about eighteen months ago and had the full array of tests done. Not sure if I was treated differently as the referral came from another specialist trying to ascertain what was up...

[996c2]

Wing said:

So, to my point, can anyone go to the doctor and essentially override their decision? My alternative is to get her tested privately, but they this won't appear on her records.

No you can't force your doctor to do what s/he thinks is bad for you or would waste NHS resource.

You can have the test done privately and give it to your GP to put in your record.

However, the best thing to do would be to tell your GP what your ideas, concerns and expectations are and hopefully s/he will be able to address them for you. If s/he can't answers your questions immediately s/he can either find the answers for you or refer you to a specialist.

Edited by 996c2 on Thursday 22 December 09:13

[-Pete-]

I agreed, I'd try talking through your concerns/ideas with your doctor, and if they don't want to order the tests (which can't be too expensive) then get them done privately. It will set your mind at rest, and if there are any anomalies he/she might be more willing to help.