why do I have to wait to become more ill before treatment?

[ndtplease]

I had a total thyroidectomy 10 years ago, and regardless of TSH levels have felt hypo, and free t4 and free T3 have indicated this. After being on 250mcg of T4 and being told I should accept atrial fibrillation as there was nothing else that could be done, I finally got prescribed T3 as well. I lowered my T4 dose and introduced the T3 slowly. Finally the weight came off, the depression disappeared, and other symptoms improved......but not for long. I went back to the GP with racing heart, sweats, severe fatigue, and feeling low again. I didn't seem to be tolerating the T3. It turned out my iron levels are just a few points above being anaemic. We know that ferritin levels need to be good for the absorption of T3 to be succesful. My TSH was again 'ok' but free T3 and free T4 still low. However I cannot have iron until My bloodwork says I am no longer in the 'normal range', so I basically have to become anaemic before I can have the iron that will enable my thyroid meds to work properly. How can this possibly be right?? It is bad enough that I have had to wait 10 years for T3 and suffer the awful symptoms that I have had. Why do doctors treat numbers rather than patients? The TSH test is clearly not a reliable indicator of a persons health and wellbeing, yet we also have to fight to get free t3 and free t4 tests done. Adrenals are overlooked as are ferritin and B12 levels. In my opinion (and many others) thyroid sufferers are being failed by the medical profession who on the whole give defensive responses based on faulty tests. We are patronised on a regular basis and lied to about the potential benefits of natural dessicated thyroid. It is time for the whole treatment system of thyroid disease to be reviewed and renewed, patients need to be heard and appropriate treatment given to avoid continued misdiagnosis(M.E, depression...the list goes on) Thousands of people are being kept ill by Thyroxine only treatment.

[Dr Petros Perros]

The T3 / T4 combination seems to have affected you and your heart negatively and this is one of the reasons why many doctors are reluctant to prescribe it.

If the ferritin levels are low, this is indicative of iron deficiency and this is a cause of feeling unwell and tired. If there is no obvious explanation for teh low ferritin, t may need to be investigated. Iron supplements often improve symptoms. There is no reason why iron supplements shoud not be taken if you are pon thyroid hormone medication, as long as yu don't take it at the same time (iron taken with thyroxine can interfere with the absorption of thyroxine).

People with autoimmune hypothyroidism are a little more likely to develo B12 deficiency that the background population. B12 deficiency shows in the blood count (the red cells become larger), so that if you are not anaemic and the red cell size is normal (this is information that is provided with a full blood count test), then B12 deficiency is exceptionally unlikely and there is no need to measure specifically teh B12 levels.