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Physician recommendation on Hashimoto
Hello - I'm new to this forum. I am desperately seeking help/advice. I am having bad luck with getting any of my current physicians to listen to my symptoms.
Quick history on me - I quit smoking about 2 1/2 years ago. Of course I gained about 10 lbs. immediately following. For several years (starting even before I quit smoking), I was very tired; just feeling not right - sluggish, no interest in anything. This has been getting progressively getting worse - has now gotten to the point (for the past 1+ years) that I am exhausted (sleeping 12+ hours a day - waking completely unrested), continuously gaining weight - up 40 lbs so far.
Finally, in June I went to my physician's assistant - she took extensive bloodwork. I was then diagnosed with Hashi, but was told that "it's not bad enough yet - wait". My T3 and T4 were normal. I waited 3 months, then begged her to refer me to an Endo - who, looked at my original results and told me to come back in January -"You may by Hypothyroid by then". At that point, my T3 = 32, my T4 = 5.6, TSH = 1.138, T3 Uptake = 32. But, my Thyroid Peroxidase antibodies were 193 (normal 0-34?)
I am desperate to find someone who may listen to me - I am extremely frusterated. Have actually considered going back to smoking (I feel like I felt better before I quit) I would love to find a doctor in Baltimore/Harford County, MD area who will listed and help. Any help would be greatly appreciated.! Thanks in advance.
Quick history on me - I quit smoking about 2 1/2 years ago. Of course I gained about 10 lbs. immediately following. For several years (starting even before I quit smoking), I was very tired; just feeling not right - sluggish, no interest in anything. This has been getting progressively getting worse - has now gotten to the point (for the past 1+ years) that I am exhausted (sleeping 12+ hours a day - waking completely unrested), continuously gaining weight - up 40 lbs so far.
Finally, in June I went to my physician's assistant - she took extensive bloodwork. I was then diagnosed with Hashi, but was told that "it's not bad enough yet - wait". My T3 and T4 were normal. I waited 3 months, then begged her to refer me to an Endo - who, looked at my original results and told me to come back in January -"You may by Hypothyroid by then". At that point, my T3 = 32, my T4 = 5.6, TSH = 1.138, T3 Uptake = 32. But, my Thyroid Peroxidase antibodies were 193 (normal 0-34?)
I am desperate to find someone who may listen to me - I am extremely frusterated. Have actually considered going back to smoking (I feel like I felt better before I quit) I would love to find a doctor in Baltimore/Harford County, MD area who will listed and help. Any help would be greatly appreciated.! Thanks in advance.
Ahh, so as im Peri-menopausal this would be why my doctor has said start to taking Calcium and Vitamin D and K i think..Ok now im with you on this..lol thanks for that..Now i will re-read many times before i believe anything that is written..Dawn
Yes by re-reading i see where your coming from, you are right by what i have re- read ..Dawn.
This is a direct quote that was one of the bases for my post. It was taken from this link. http://www.hormonerestoration.com/Thyroid.html
"Increased bone loss with higher thyroid levels occurs only in persons who
are already in a bone-losing state, because thyroid hormones increase all metabolic activities inthe body. So if you're losing bone you will lose it faster when your thyroid levels are raised. Such is the case with postmenopausal women who are not on estrogen (Appetecchia 2005). Bone loss with TSH-suppressive thyroid therapy is not seen in most men or in younger premenopausal women because they are not losing bone to start with. The problem of bone less should be addressed by restoring the sex hormones and Vit. D, not with keeping someone's thyroid hormone levels low!"
To me this just clarifies the conditions under which excessive thyroid medication can contribute to bone loss. Anyone taking excessive thyroid meds will have a host of other, more immediate problems such as anxiety, fast heart beat, etc. I was just concerned that your statement that "I think the main concern..again only reading is it can lead to osteoporosis if you have normal levels and are on thyroid meds" could be misunderstood and create some confusion with our members, about taking thyroid meds. I think that any mention of bone loss and thyroid meds together needs to be carefully discussed in order to avoid this possible misunderstanding. FWIW
"Increased bone loss with higher thyroid levels occurs only in persons who
are already in a bone-losing state, because thyroid hormones increase all metabolic activities inthe body. So if you're losing bone you will lose it faster when your thyroid levels are raised. Such is the case with postmenopausal women who are not on estrogen (Appetecchia 2005). Bone loss with TSH-suppressive thyroid therapy is not seen in most men or in younger premenopausal women because they are not losing bone to start with. The problem of bone less should be addressed by restoring the sex hormones and Vit. D, not with keeping someone's thyroid hormone levels low!"
To me this just clarifies the conditions under which excessive thyroid medication can contribute to bone loss. Anyone taking excessive thyroid meds will have a host of other, more immediate problems such as anxiety, fast heart beat, etc. I was just concerned that your statement that "I think the main concern..again only reading is it can lead to osteoporosis if you have normal levels and are on thyroid meds" could be misunderstood and create some confusion with our members, about taking thyroid meds. I think that any mention of bone loss and thyroid meds together needs to be carefully discussed in order to avoid this possible misunderstanding. FWIW
Ok ill just put in what i read.....How does thyroid disease affect bone health?
Too much thyroid hormone increases bone loss and increases the risk for osteoporosis. There are different conditions that result in excess thyroid hormone:
* Hyperthyroidism- Bone loss is seen in patients with a naturally occurring excess of thyroid hormone, a condition called overactive thyroid disease, hyperthyroidism or Graves disease.
* Hypothyroidism treated with excess thyroid medication- Hypothyroidism is a condition in which there is too little natural thyroid hormone. People with hypothyroidism commonly take thyroid medication to replace what their own glands are not making. Loss of bone occurs in patients with hypothyroidism who take more than the needed amount of thyroid replacement medication. In contrast, the correct amount of thyroid medication will not produce any adverse effects on bone.
* High doses of thyroid medication-. Some patients are treated with high doses of thyroid medication to stop the growth of small benign tumors called nodules. It is important to have nodules checked and the dose of medication reassessed by a doctor every six months. In rare cases of thyroid cancer, large doses of thyroid medication may also be necessary to prevent stimulation of the thyroid tissue. High doses of thyroid medication increase the risk for bone loss and osteoporosis.
Too much thyroid hormone increases bone loss and increases the risk for osteoporosis. There are different conditions that result in excess thyroid hormone:
* Hyperthyroidism- Bone loss is seen in patients with a naturally occurring excess of thyroid hormone, a condition called overactive thyroid disease, hyperthyroidism or Graves disease.
* Hypothyroidism treated with excess thyroid medication- Hypothyroidism is a condition in which there is too little natural thyroid hormone. People with hypothyroidism commonly take thyroid medication to replace what their own glands are not making. Loss of bone occurs in patients with hypothyroidism who take more than the needed amount of thyroid replacement medication. In contrast, the correct amount of thyroid medication will not produce any adverse effects on bone.
* High doses of thyroid medication-. Some patients are treated with high doses of thyroid medication to stop the growth of small benign tumors called nodules. It is important to have nodules checked and the dose of medication reassessed by a doctor every six months. In rare cases of thyroid cancer, large doses of thyroid medication may also be necessary to prevent stimulation of the thyroid tissue. High doses of thyroid medication increase the risk for bone loss and osteoporosis.
Your statement about any thyroid effect on osteoporosis needs to be modified, just to avoid confusing people. Thyroid meds don't lead to bone loss. From what I have read about this subject, the only way osteoporosis can be affected is if you already have conditions causing bone loss, then taking thyroid meds enough to increase metabolism can have the effect of speeding up the bone loss. The best way to approach this problem is to eliminate the conditions for osteoporosis, not avoiding thyroid meds.
Im not sure, by what i read doctors dont like to treat Hashi with thyroid hormones if your levels are ok..For some reason they like to just keep an eye on it and then when the levels go hay wire they treat you..I think the main concern..again only reading is it can lead to osteoporosis if you have normal levels and are on thyroid meds..Confusing i know..Dawn
If your Hashi antibodies are elevated, why wouldn't he be totally sure it's thyroid?
Maybe you have more than just thyroid. He is testing some other things, which is good, but Hashi people should be treated with thyroid hormone replacement.
I have been extremely tired before. So far, I have just Hashi. I've had the other bloodwork. I have felt close to passing out. I've never passed out on the floor, but I came close a few times.
He gets kudos for running many tests, but major boos from me for not taking your Hashi antibodies seriously. Maybe after the FT3/FT4 and other thyroid tests, he will give you some thryoid hormones.
:) Tamra
Maybe you have more than just thyroid. He is testing some other things, which is good, but Hashi people should be treated with thyroid hormone replacement.
I have been extremely tired before. So far, I have just Hashi. I've had the other bloodwork. I have felt close to passing out. I've never passed out on the floor, but I came close a few times.
He gets kudos for running many tests, but major boos from me for not taking your Hashi antibodies seriously. Maybe after the FT3/FT4 and other thyroid tests, he will give you some thryoid hormones.
:) Tamra
OK, so I went to the new Endo today. Now, I'm extremely confused. The first thing that I did was look around the office for literature on Thyroid...found some; looked like a good sign. I ended up spending 2 hours talking to this doctor about my symptoms - He actually did an exam, too. My first endo didn't do that.
Anyhow, after hearing everything (including my discussing a diagnosis of hypoglycemia), he decided that he is not entirely sure that this is a thyroid problem. Because of what happens to me when I do not eat every 2-3 hours (trying to control the hypoglycemia), and because of the severity of my fatigue, he said that there is a possibility that my symptoms could be insulinoma or possibly a neurological problem. (I should say that it's not only how tired I get - it's the way and the time that I go out -- recently, I took a bite of a cookie and laid down. I woke up over an hour later with the cookie in my mouth! Didn't have time to swallow - that story concerned him.)
I am scheduled to go back into the office on Thursday to do the blood tests that are required to rule out the insulinoma. It won't be pleasant - I have to wait until my glucose drops to 40-50 before he can take the blood. He did, however, inform me that he will be doing a full thyroid workup - including the free T3 and free T4. But, I asked about preventative treatment for Hypothyroid - he said that he does not treat for that because it can cause other issues. My plan is to see how the blood test goes - then take it from there. Why is it that now, I feel like I am a hypochondriac? I went from "wait and see" to this could be some kind of insulinoma or neurological problem in one visit. I guess I should be happy that he's being thorough?
Anyhow, after hearing everything (including my discussing a diagnosis of hypoglycemia), he decided that he is not entirely sure that this is a thyroid problem. Because of what happens to me when I do not eat every 2-3 hours (trying to control the hypoglycemia), and because of the severity of my fatigue, he said that there is a possibility that my symptoms could be insulinoma or possibly a neurological problem. (I should say that it's not only how tired I get - it's the way and the time that I go out -- recently, I took a bite of a cookie and laid down. I woke up over an hour later with the cookie in my mouth! Didn't have time to swallow - that story concerned him.)
I am scheduled to go back into the office on Thursday to do the blood tests that are required to rule out the insulinoma. It won't be pleasant - I have to wait until my glucose drops to 40-50 before he can take the blood. He did, however, inform me that he will be doing a full thyroid workup - including the free T3 and free T4. But, I asked about preventative treatment for Hypothyroid - he said that he does not treat for that because it can cause other issues. My plan is to see how the blood test goes - then take it from there. Why is it that now, I feel like I am a hypochondriac? I went from "wait and see" to this could be some kind of insulinoma or neurological problem in one visit. I guess I should be happy that he's being thorough?
Thanks, all - I can't wait to get in there tomorrow. Hopefully, this will work out - I am completely frusterated and am getting really depressed. I went out last month and bought a couple of pair of pants (because I outgrew everything). I went to put those on this week, and I couldn't. - now, they don't fit.....they still have the tags on them! This is making me crazy. What's worse is that I eat very healthy foods and excercise, but, I keep gaining. Between that and the sleeping, I'm not sure how much more I can take.
Gimel - I've taken note of your questions. I really hope that this new doctor is willing to help me.
I'll keep you posted. Thanks again!
Gimel - I've taken note of your questions. I really hope that this new doctor is willing to help me.
I'll keep you posted. Thanks again!
Three questions you should be prepared to ask the new doctor. First, does the doc use TSH alone as a diagnostic to determine thyroid status and dosage of medication? If no, then the second question should be does the doc regularly test for the biologically active thyroid hormones , FT3 and FT4? If yes, then the third question should be is the doc willing to treat a patient clinically, by which I mean listen to symptoms and test and adjust FT3 and FT4 with meds as required to alleviate those symptoms?
Be aware that if you get the wrong answers to any of these three questions, then you may still be looking for the type of thyroid doctor you really want. JMHO
Be aware that if you get the wrong answers to any of these three questions, then you may still be looking for the type of thyroid doctor you really want. JMHO
COMMUNITY LEADER
I've been treating my Hashi for almost a year and my antibodies have not "reversed" at all. Once they are there, they aren't going to go away. They will keep "eating" at the thyroid until they "kill it off' and then they will go into remission, but they will still be there.
Actually, if I'm not mistaken, the thyroid will not "go to sleep" just because you supplement with hormones. Even with med, the thyroid will continue to put out hormone as long as it can - it just might not be enough. Or it may not produce anything for a while, then "spurt" - this might happen once or many times over a period of years. That's why some people have so much trouble regulating their levels until the thyroid has been killed off.
I'm so glad that you were able to find an endo, whom you could get in to see so quickly. Wishing you all the best of luck.
Actually, if I'm not mistaken, the thyroid will not "go to sleep" just because you supplement with hormones. Even with med, the thyroid will continue to put out hormone as long as it can - it just might not be enough. Or it may not produce anything for a while, then "spurt" - this might happen once or many times over a period of years. That's why some people have so much trouble regulating their levels until the thyroid has been killed off.
I'm so glad that you were able to find an endo, whom you could get in to see so quickly. Wishing you all the best of luck.
First just let me say - congratulations on quitting smoking!! That's huge and you should be very proud of yourself! I myself haven't had a smoke for 2 days, so I can sympathize.
As for the Hashi's - I, like you, have elevated antibodies, but fairly normal TSH and FT4, but the nurse prac agreed to put me on a low does of synthroid (25 mcg) b/c I am so symptomatic. That was about 2 months ago, and I'm not sure if I can tell a difference - I know it takes a while. Well, 2 things I have noticed - my toes aren't frigid 100% of the time, and my skin is now more normal instead of incredibly dry. Whether it's from the synthroid or not??
I understand when you say you feel like the doctors think you are exagerrating. How many different ways can we say "I'm tired, I'm exhausted, I'm fatigued, I feel like @$^#@!!", before they take us seriously? Good luck with your new Dr! Let us know how that goes. I'm considering looking for a new doc myself, b/c, among other things, my current one will not test for FT3 - they say it's too unstable, but gimel (a member of this forum) says that is outdated information.
Good Luck!
As for the Hashi's - I, like you, have elevated antibodies, but fairly normal TSH and FT4, but the nurse prac agreed to put me on a low does of synthroid (25 mcg) b/c I am so symptomatic. That was about 2 months ago, and I'm not sure if I can tell a difference - I know it takes a while. Well, 2 things I have noticed - my toes aren't frigid 100% of the time, and my skin is now more normal instead of incredibly dry. Whether it's from the synthroid or not??
I understand when you say you feel like the doctors think you are exagerrating. How many different ways can we say "I'm tired, I'm exhausted, I'm fatigued, I feel like @$^#@!!", before they take us seriously? Good luck with your new Dr! Let us know how that goes. I'm considering looking for a new doc myself, b/c, among other things, my current one will not test for FT3 - they say it's too unstable, but gimel (a member of this forum) says that is outdated information.
Good Luck!
Thank you all for your help. I was wondering if I was making a mistake by hunting for a new doctor. So far, I've been feeling like my doctors think that I have been exaggerating about how bad I feel. Today, I came home from work - laid on the floor to play with the cat for a second. I woke up an hour later with my face in the carpet! Then, I had to force myself to wake back up. I did, however, find another Endo - luckily, they were able to fit me in for next Tuesday. I can't wait. Thanks again - I will post again when I hear more.
Following is a link to a site that lists top thyroid doctors, by state and city/town. I have used this site successfully a number of times. You can look through the listings and see if any are close enough for you. I also recommend that you read through the patient feedback. I found that to be very revealing as well.
http://www.thyroid-info.com/topdrs/maryland.htm
http://www.thyroid-info.com/topdrs/maryland.htm
This is the article that you NEED to show your doctor.
:) Tamra
http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm
:) Tamra
http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm
The 'Wait and See' approach for treating Hashi is WRONG!!!
Find a new doctor. Why isn't the current doc testing FT3/FT4? The free Ts are more accurate? Why wait to treat Hashi!!!
Treating Hashi in its early stages has clinically proven to reverse the antibodies. The key is to trick the thyroid into going to sleep by giving your body enough thryoid hormone now. Once the pituitary realizes you've got enough hormone in your body, it will tell your thyroid to go to sleep, then the antibodies will have nothing more to attack. Will your doctor wait until your thyroid is completely destroyed and you become permanently hypo?
Take care...
:) Tamra
Find a new doctor. Why isn't the current doc testing FT3/FT4? The free Ts are more accurate? Why wait to treat Hashi!!!
Treating Hashi in its early stages has clinically proven to reverse the antibodies. The key is to trick the thyroid into going to sleep by giving your body enough thryoid hormone now. Once the pituitary realizes you've got enough hormone in your body, it will tell your thyroid to go to sleep, then the antibodies will have nothing more to attack. Will your doctor wait until your thyroid is completely destroyed and you become permanently hypo?
Take care...
:) Tamra
From your lab results you do have Hashi's. Did they check your Frees? FT3 and FT4.
I do not understand why a Dr would want to wait until your sicker! That makes no sense at all but so many people go through this.
I would find another Dr who will listen to your symtoms. You really need to have your Frees checked too. I would also ask for a thyroid scan. Take care. Remar
I do not understand why a Dr would want to wait until your sicker! That makes no sense at all but so many people go through this.
I would find another Dr who will listen to your symtoms. You really need to have your Frees checked too. I would also ask for a thyroid scan. Take care. Remar
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