# Need to write a strong letter to doctor



## Piers (Jul 16, 2010)

Hello,

I have made a previous thread and thank you for the very useful answers. I have now taken your advice and think the best action is to construct a letter to take with my to my GP asking for the exact tests that need doing, not just the T4 (think thats what its called).

Would someone here mind helping me write this letter? Or even better if there is a doctor on these forums?

This may sound slightly patronising but I do realise that many American doctors seem to be worried about law suits, this letter would 1) Be for a UK GP and 2) Not have your name or anything else on there. Its just for the correct technical and medical lingo that I really need the help with.

Thanks,

Piers


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## Lovlkn (Dec 20, 2009)

Piers said:


> Hello,
> 
> I have made a previous thread and thank you for the very useful answers. I have now taken your advice and think the best action is to construct a letter to take with my to my GP asking for the exact tests that need doing, not just the T4 (think thats what its called).
> 
> ...


Piers,

Go find another doctor and use this guy as a back up - no "letter" needed.

I have to switch doctors when they quit running the tests I need to monitor my doses and dispense enough medication to keep me feeling my best.

Lovlkn


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## Piers (Jul 16, 2010)

Thanks for the reply. I have seen 3 doctors all my doctors surgery including the head of my surgery. I am not sure what do do now


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## Lovlkn (Dec 20, 2009)

Piers said:


> Thanks for the reply. I have seen 3 doctors all my doctors surgery including the head of my surgery. I am not sure what do do now


If all you are looking for is lab testing - Free T-4 and Free T-3 you can pay for that privately and save yourself alot of frustration. I looked back at one of your other posts and I think you are from the UK.


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## AngieG (Jul 5, 2010)

Lovlkn said:


> Piers,
> 
> Go find another doctor and use this guy as a back up - no "letter" needed.
> 
> ...


I wish there were a "like" button for this post!


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## AngieG (Jul 5, 2010)

Here is a copy of the letter I recently wrote to my OBGYN (we are 8 weeks pregnant). Even after giving his this letter in person at my latest appointment, it was still neccessary to verbally persuade him and then I only got TSI in the deal. I assured him that getting at least that one would ease my concerns greatly, and that it what tipped the scales. He was very cautious about appearing to step on another Doctor's toes. My OB is a very nice Dr, but perhaps a little too nice.

Dear Dr S_______,

I appreciate everything you (and Brook!) have done for ______ and I up until now, you are showing yourself to be a compassionate professional who has a positive outlook on life, and I couldn't have found a better person than you!

I hope that you can help uncover the mystery that is enshrouding my confusing thyroid results and symptomology with a few very simple blood tests.

Now having been on 4 different thyroid medications, and having all four result in near identically poor side effects which rather point to HYPERthyroidism, I am interested in finding out more about the state of my thyroid.

I suspect there may an underlying condition affecting my thyroid, such as Graves Disease of possibly Hashimoto's, both of which involve antibodies which harm the thyroid.

_Here's the significant point_: Graves Disease, from what I've only recently learned, can produce a situation where the TSH is artificially elevated because a thyroid antibody binds, or mimics, TSH, but the patient is in reality hyperthyroid, not hypothyroid. This conditions consistently shows elevated levels of TSH on the blood test, but without testing for antibodies and TSI, Graves Disease can easily be missed. Testing for TSI, and the other antibody tests, will point towards proving or disproving the thyroid-autoimmune conditions I mentioned above.

I would kindly like to ask you to approve the following blood tests, based on the above information and my need to have a full and proper diagnosis:

Antibody segment: 
a.	TSI (thyroid stimulating immunoglobulin)
b.	TPO Ab (thyroid proxidase antibodies)
c.	TG Ab (thyroglobulin antibodies)

Adrenal segment (correlates somehow with immunity)
a.	ACTH
b.	Serum Cortisol

Full Thyroid Panel (must be done all at same time): 
a.	TSH
b.	FREE T3
c.	FREE T4
d.	Total T3
e.	Total T4

I do hope you will approve these tests, and let us do them today. This pregnancy is too important to me to be on the wrong medication! 
Dr. S____, if I do these tests, it will put my mind at ease, I will better at accepting a Hypo diagnosis and will continue to seek therapy for my anxiety problems, and I will continue to do my very conscientious best for this baby.

If I do these tests, I can take the results to my visit to see a thyroid specialist in Raleigh, NC on July 26th, where diet, hormones, adrenals, weight, and several other issues are taken into consideration (Dr. Beverly Goode). This Doctor's PA was previously in OB practice, which I am hopeful will help all three of us communicate easier together. Since this Doctor does not take insurance, I will be reimbursed by my insurance for her services. I hope this indicates to you how incredibly important this is to me.

Being already 8 weeks along, I am very concerned about the quality of this pregnancy. I hope it's not too late.

We will know more after this morning's ultrasound, too!

Concerned and Sincere, 
Your Patient,

____________________


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## CA-Lynn (Apr 29, 2010)

If I may make a point:

The doctors in the UK are overworked and the less they have to read, the better. Therefore, just write down the test names on a sheet of paper and hand it over. Don't make them have to read the entire letter because I can almost guarantee you they won't. Just a list.


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## AngieG (Jul 5, 2010)

Mm, good point. Sorry I overlooked that. I used to live in Germany and it was much the same. I had written a letter that long because I wasn't sure I could make it to the actual appt time, and wanted to make a stronger case in my absence.

On that note, nagging might also be the way to go - lol! Squeaky wheel gets the oil? If things don't go well? If they don't have time, they might do the test just to get us to shut our pie holes!


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