Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Meeka on November 15, 2016, 02:34:51 PM
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I see Prof Studd once a year just to check everything is ok. He always wants blood tests and in the past I have written a short letter to my GP requesting them and he has always done these for me to take to Prof Studd. My GP has now merged with another practice and this time I have asked for the blood tests and they have been refused. The receptionist says that the GP has said they will not be accurate because I take HRT and so the reading will not be a true reading??
I explained to the receptionist that my Gyne needs to check I am on the correct dose of oestrogen but she says I must book to see the a GP and discuss it further with them. Does anyone else have this problem with a GP? I will have to pay extra for the blood tests if Prof Studd does them......I think its quite expensive.
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If the GP won't do it , there is a very good company on line where it can be arranged £89.00 for a HRT test , plus £20.00 to have blood taken from a local private hospital in your area , or via finger prick then it's the £89.00.
If GP refuses maybe cheaper than Prof Studd ?
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Ring Prof Studd and check that it is required :-\ ? :-\
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Meeka, that sounds like pretty poor service, I would have thought it was blindingly obvious that you need blood tests from time to time to ensure that your HRT regime is working properly and that you are getting the right amount of hormones into your system. Doesn't this surgery offer this service to their patients on HRT?
You could complain to the Practice Manager stating your case or perhaps try the place that Maryjane recommended because it is probably cheaper than Professor Studd's tests. Alternatively, as CLKD said, you could ring Professor Studd's office and double check what is needed and tell his secretary that your GP has refused the blood tests. I wonder if he/his secretary might phone your surgery? It has to be worth a try.
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I'm also with Prof Studd, my GP wouldn't do all of the tests, too expensive, but he has done most of the important ones, give them a call and find out what the most important ones are.
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Meeka, that sounds like pretty poor service, I would have thought it was blindingly obvious that you need blood tests from time to time to ensure that your HRT regime is working properly and that you are getting the right amount of hormones into your system. Doesn't this surgery offer this service to their patients on HRT?
You could complain to the Practice Manager stating your case or perhaps try the place that Maryjane recommended because it is probably cheaper than Professor Studd's tests. Alternatively, as CLKD said, you could ring Professor Studd's office and double check what is needed and tell his secretary that your GP has refused the blood tests. I wonder if he/his secretary might phone your surgery? It has to be worth a try.
I've never been given a blood test to check my hormone levels while on HRT. I didn't realise that this was supposed to happen :-\
Taz x
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I've been on hrt since I was 32 and only had hormone bloods done since peri at 45, it helps to know where you're at and showed when I became post meno as I had no periods to go by
X
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Me neither Taz.
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Hi Taz - you're right - it's not supposed to happen! Me neither. They are not necessary! Docs should go on symptoms usually. I think according to Dr Currie (can't remember where I read this) they can be useful for women who have had hysterectomy with ovary removal and for women who have had implants but otherwise - not needed. If you are not on ADs then the first indication that levels are low would be a return of flushes and sweats and perhaps anxiety. If symptoms return then the option is to increase oestrogen. However a private gynae may well want to look into everything at greater depth and of course charge for all of this too ::)
I can see the point of doing them if you are on a very high dose of oestrogen to check whether your levels are too high - that would be the only reason to do them once.
Meeka if you are feeling OK then you are on the correct dose. If your dose and symptoms haven't changed since last review - then should be OK :)
Hurdity x
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The blood tests are a very good way of finding out how well your are absorbing your HRT and it is useful to know what level of oestrogen you need to reach in order to fire on all cylinders. It is also good to know how oestrogen interacts with other things like thyroid function and cholesterol. For example, when I was using oral HRT/patches, I didn't feel anything like as good as I should and looking back at my blood test results, I can see that my oestrogen levels were way too low and my thyroid function (all of them) and cholesterol levels were not as good as they are now on a higher level of oestrogen.
If you are using testosterone, again, it is good to know that you are taking the right amount and seeing how well you absorb it.
I guess this is why Professor Studd wants his patients to have them.
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I guess it is down to cost with the NHS.
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What did you decide to do? :-\
I don't think that GPs are required to do any tests if a Patient has decided to go privately.
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I've only had one lot of hormone blood tests done and that was about 6 years ago. My doctor has no interest in testing them again, and just says "it's not going to show us anything we don't already know". Most doctors seem to adopt that approach and just go by symptoms to work out if the hrt dose is right. This is probably why your GP isn't interested in doing them. If you're feeling fine on your current routine, and nothing has drastically changed for you, or you don't have any other health issues he needs to check on, I don't really understand why Prof Studd would need them.
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Hi Meeka - I'm the same as you, studd patient and not absorbing gel well so I asked for blood test at GP. Also wanted thyroid tested as some symptoms were similar to low E. GP refused as I didn't have enough symptoms. I've since had a phone consult with Studd and he's sent a letter requesting bloods so hopefully I'll get them done now.
Obviously cost implications but I think some GPs are also fed up with Meno women but quite happy to prescribe and do blood tests for other patients who have 'a cold'!
You could ask Studd's secretary to send an email requesting bloods. His are very expensive.
Good luck.
Dxx
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Thanks for all the replies......It helped me to decide what I was going to say to the GP and a plan if she wasn't willing to help.
It was a young woman GP and she listened while I explained why I was asking for the bloods.
I explained that my gynea likes to have blood tests as he likes to monitor how well I am absorbing the gels and that he likes the level of oestrogen to be around 800-1000 range. I explained that on my last visit to him a year ago my oestrogen level was around 300 and when the Dexa scan was done it showed that my right hip had moved from osteopenic to osteoporosis range. I explained that Mr Studd said I needed to get my oestrogen levels up higher to stop the osteoporosis from progressing.
The GP agreed to do the bloods for oestrogen and testosterone . I didn't need the other blood tests as I had them around 5 months ago for something else so she just did me a print off of those so I could take them to show prof studd.
When I saw Prof Studd 12 months ago my oestrogen level was 300.....I felt fine and was having no symptoms like flushing or sweats. Prof Studd said that although the level of 300 was preventing these symptoms it was not enough to protect my bones so he wanted me to up the dose to 3-4 pumps daily. He also said testosterone for the bones.
Thanks again for the help and suggestions.
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My gynae won't do hormone blood tests as they alter continually throughout 24 hours. He 'goes' on symptoms.
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My gynae won't do hormone blood tests as they alter continually throughout 24 hours. He 'goes' on symptoms.
Yes ive heard that mentioned on here before. Prof Studd may think although they fluctuate 'some indication is better than nothing'. When I have taken a higher dose of Oestrogen in the past it has shown in the blood test so maybe it does show a good indication. I was only taking 1 and a half pumps when the reading was 300 and I am now doing 3 pumps so I hope it has risen to nearer the 800 mark. Studd says I need that for my bones. I felt fine on 1 and a half pumps but it wasn't doing much for my bones. Everyone is different . I am quite slim so not much body fat . Body fat can make some oestrogen I believe.
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If the GP won't do it , there is a very good company on line where it can be arranged £89.00 for a HRT test , plus £20.00 to have blood taken from a local private hospital in your area , or via finger prick then it's the £89.00.
If GP refuses maybe cheaper than Prof Studd ?
Thank you for this info. I was going to use them if the GP had said no. I believe Prof Studd charges £200 for full bloods.
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That is really interesting Meeka.
Firstly the fact that you have a medical reason to request the tests because your specialist has said you need certain levels for osteoporosis protection which you are already at risk from - that is a different matter than just seeing how you feel.
Also I am interested in the fact that Prof Studd has stated a particular absolute (very high) level to build your bone as this is way higher than most of us attain and much higher than I imagine the average oestrogen level to be on the doses of oestrogen licensed for osteoporosis protection and I presume again this is because you are already at risk and he wants to make sure you do actually build bone at the right amount?
I haven't time to read about this now but I'd love to find out more about this.
I do hope that your bone density improves under this treatment....
Hurdity x
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Thanks for all the replies......It helped me to decide what I was going to say to the GP and a plan if she wasn't willing to help.
It was a young woman GP and she listened while I explained why I was asking for the bloods.
I explained that my gynea likes to have blood tests as he likes to monitor how well I am absorbing the gels and that he likes the level of oestrogen to be around 800-1000 range. I explained that on my last visit to him a year ago my oestrogen level was around 300 and when the Dexa scan was done it showed that my right hip had moved from osteopenic to osteoporosis range. I explained that Mr Studd said I needed to get my oestrogen levels up higher to stop the osteoporosis from progressing.
The GP agreed to do the bloods for oestrogen and testosterone . I didn't need the other blood tests as I had them around 5 months ago for something else so she just did me a print off of those so I could take them to show prof studd.
When I saw Prof Studd 12 months ago my oestrogen level was 300.....I felt fine and was having no symptoms like flushing or sweats. Prof Studd said that although the level of 300 was preventing these symptoms it was not enough to protect my bones so he wanted me to up the dose to 3-4 pumps daily. He also said testosterone for the bones.
Thanks again for the help and suggestions.
Maybe you've gotten to the point where you need more than just estrogen for your bones. I'm on HRT, but it wasn't doing much for my osteopenia. I didn't need nor want to take more estrogen, so I now take Fosamax once a week and it's made the world of difference. You will have to watch how high your estrogen levels go because the side effects of too much estrogen can be just as bad as too little.
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Thanks for all the replies......It helped me to decide what I was going to say to the GP and a plan if she wasn't willing to help.
It was a young woman GP and she listened while I explained why I was asking for the bloods.
I explained that my gynea likes to have blood tests as he likes to monitor how well I am absorbing the gels and that he likes the level of oestrogen to be around 800-1000 range. I explained that on my last visit to him a year ago my oestrogen level was around 300 and when the Dexa scan was done it showed that my right hip had moved from osteopenic to osteoporosis range. I explained that Mr Studd said I needed to get my oestrogen levels up higher to stop the osteoporosis from progressing.
The GP agreed to do the bloods for oestrogen and testosterone . I didn't need the other blood tests as I had them around 5 months ago for something else so she just did me a print off of those so I could take them to show prof studd.
When I saw Prof Studd 12 months ago my oestrogen level was 300.....I felt fine and was having no symptoms like flushing or sweats. Prof Studd said that although the level of 300 was preventing these symptoms it was not enough to protect my bones so he wanted me to up the dose to 3-4 pumps daily. He also said testosterone for the bones.
Thanks again for the help and suggestions.
Maybe you've gotten to the point where you need more than just estrogen for your bones. I'm on HRT, but it wasn't doing much for my osteopenia. I didn't need nor want to take more estrogen, so I now take Fosamax once a week and it's made the world of difference. You will have to watch how high your estrogen levels go because the side effects of too much estrogen can be just as bad as too little.
I worry about the stuff I read about Fosamax
https://www.drugwatch.com/fosamax/
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The problems related to fosamax are mainly for those who take it every day, or don't take it as directed. If you start treatment early enough it is only one tablet a week so I can't see how it can be that risky.
I'm proof that it definitely helps. I was diagnosed with osteopenia probably about 8 years ago and I started taking fosamax. I didn't need hrt then, and my bone density improved. About two years later I was scared off it by a naturopath, and for the next four years my density gradually got worse even though I was now using hrt. I've been back on fosamax for the last two years and there has been a big improvement.
My attitude is that if you read enough stuff on the internet you would scare yourself off all medications. Just take hrt as an example. People pull up a lot of "studies" to prove their particular POV.
I watched my father battle osteoporosis, a broken hip and a very painful final six months. I'll take my chances with fosamax.
*edit* I'll just quickly add that Dr Elizabeth Vliet recommends the use of Fosamax in her book "Screaming to be Heard", so I'll take her opinion over what you read on the internet. My own GP is also very happy to prescribe it. There may come a point where I might be able to stop taking it for a while, if the density has improved enough, but I will be reluctant to stop it long term because it will just decline again, and I don't want that to happen.
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Hi Meeka,
I'm in the same boat as you with osteoporosis, I also started on three pumps of oestrogel, I just had my blood results and mine is sky high after three months, I'll see what Studd says about that. I also want to give HRT a go for a few years, I hope I won't need any osteo drugs until I'm in my 70's, could be wishful thinking but that's the plan.
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Do you mean Professor Studd :-\
Exercise - 10 mins. brisk walking daily can help stave off osteoporosis. However …….. we have a tread mill which I look at every day :sigh:
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Yes, Prof Studd. I've worked out since my 30's, I was really surprised by the diagnosis, lifestyle wise there isn't much I can change, my Vit D levels were high. Fingers crossed that the HRT will stabilise me, though Dana's post was quiet the eye opener.
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It really is Trial and Error ain't it :sigh:
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Hi CLKD, yep ::)
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My husband was diagnosed with osteoporosis aged 47. He was changed from Strontium Ranelate to Alendronic Acid (Fosamax) weekly tablet and he is also doing very well. It is one of the older biphosphonates and is generally well tolerated if taken correctly.
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That is young babyjane, did they have any idea of the why and wherefore? Did it run in his family?
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Hello Charlotte, yes. His mother was terribly disabled with it. Both his brothers have it and so does our eldest son. Our other son has been refused a scan on the NHS so my husband's consultant has writted to son's GP otherwise he will pay for it.
My husband was intially refused a scan as he was a 47 year old male so he paid for one privately which showed he was already osteoporotic. this is why his consultant advised our sons to be scanned once they reached the age of 30.
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My Dad was on a 'trial' with regards osteo porosis in men … from the mid-1990s until he died.
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Oh that's terrible babyjane, I'd snap up the medication too if I were him.
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IMO it can be a big mistake to just assume that hrt, diet and exercise is all you need to do to ward off osteopenia or osteoporosis. For a lot of women this will be true, but a lot of us will have a genetic predisposition to it, and it may not always be through a female link. Men are also prone to it, as my father was. He had no idea he had it until he suffered a broken hip, and from there it was a steady and painful decline until he died 3 years later. My GP told me that once an elderly person breaks a hip 3 years is about the limit.
When my bone density kept declining even though I was on hrt, exercising, taking calcium, vitamin d etc, I expressed my disappointment to my GP, and she said it was probably helping and things could have been worse without it, but it obviously wasn't enough.
So don't make assumptions ladies. Make sure you get yourself tested, because there are no symptoms - until you break something.
There is more to fear from osteoporosis than there is from a once a week fosamax tablet, because it is a medication that definitely works, and is best taken in the early osteopenia stage.