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Why doesn't an endo treat hypo with the same sense of medical urgency as hyper
I was diagnosed with graves disease about 10 years ago, and 7 years ago i underwent a total thyroidectomy. What i wasn't told was that after a TT you are diagnosed and treated for hypothyroidism. But, the endo I was seeing for my graves disease (who also suggested the surgery after suspecting thyroid cancer) said she would no longer be treating me after surgery, that my GP could treat me from there. However, about 3 months ago my body stopped absorbing the levo and I am struggling with getting my levels back to normal. My doctor said "tsh should be a 4 but is way off at 192 (not sure where the decimal belongs in that number since it was spoken as one ninety-two and i never actually saw the test results on paper). In three months time I went from 112 mcgs once a day of levo up to 300 mcgs once a day
My symptoms are worse than ever and after 3 weeks of being on 300 mcgs of levo they are still persisting. My GP wants me to see an endo bur everything i read online says they do not treat hypo with any sense of urgency. Who can I see that WILL treat my symptoms as an urgent matter?
My symptoms are worse than ever and after 3 weeks of being on 300 mcgs of levo they are still persisting. My GP wants me to see an endo bur everything i read online says they do not treat hypo with any sense of urgency. Who can I see that WILL treat my symptoms as an urgent matter?
A good thyroid doctor can be any type that will treat clinically, as described. If you will give us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.
By the way, your symptoms are very typical of hypothyroidism. Hair loss can also be related to low iron, for which the ferritin test is a good way to check that.
By the way, your symptoms are very typical of hypothyroidism. Hair loss can also be related to low iron, for which the ferritin test is a good way to check that.
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Hi, thank you. I'm in the capital district of upstate NY, i can use medical facilities between Albany and Lake George, NY.
I am on prescription Iron tabs because i was anemic to the point of needing a blood transfusion. I was wondering is vomiting What looks to be, coffee grounds a symptom of being hypo, as well? I am always nauseous and only recently actually began vomiting what looks like coffee grounds. I also have a constant burning in my stomach and my appetite waxes and wanes. I mentioned I'm 5'11" and weigh 150 lbs.
I am on prescription Iron tabs because i was anemic to the point of needing a blood transfusion. I was wondering is vomiting What looks to be, coffee grounds a symptom of being hypo, as well? I am always nauseous and only recently actually began vomiting what looks like coffee grounds. I also have a constant burning in my stomach and my appetite waxes and wanes. I mentioned I'm 5'11" and weigh 150 lbs.
What you need is a good thyroid doctor. By that I mean one that will treat clinically by testing and adjusting the biologically active thyroid hormones, Free T4 and Free T3 (not the same as Total T4 and Total T3), as needed to relieve symptoms, without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH levels.
You can confirm what I have said by reading at least the first two pages of the following link. I suggest reading even more if you want to get into the discussion and scientific evidence supporting all the suggestions and recommendations for diagnosing and treating hypothyroidism.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
Due to the half life of T4 meds like Synthroid, it takes at least 4 weeks for the dosage to reach over 90% of final effect on blood levels. In addition symptom changes tend to lag somewhat behind changes in blood levels of thyroid hormone. However, I expect that you will find an even bigger reason for your symptoms. Many hypo patients taking T4 meds find that their body is not adequately converting the T4 to T3, resulting in Free T3 levels that are too low in its range. Trying to dose a hypothyroid patient based on TSH levels does not work. You need to make sure they always test for both Free T4 and Free T3 every time you go in for tests. Many of us find that we required Free T4 at the middle of the range or slightly higher and Free T3 in the upper third of its range, and adjusted from there as needed to relieve symptoms. FT3 is metabolized by all the cells of the body to produce the energy we need.
In addition, hypothyroid patients are frequently deficient in 3 other important areas, Vitamind , B12 and ferritin. So you should make sure to test for those and then supplement as needed to optimize. D should be at least 50. B12 in the upper end of its range, and ferritin should be at least 70.
Your current doctor does not seem to know how to treat a hypothyroid patient. You might be able to change his approach by giving him a copy of the paper linked above. If the doctor will read the info he will find it all to be supported by scientific evidence that he will not be able to refute. If after that your doctor is unwilling to treat clinically as described, then you will need to find a good thyroid doctor that will do so.
You can confirm what I have said by reading at least the first two pages of the following link. I suggest reading even more if you want to get into the discussion and scientific evidence supporting all the suggestions and recommendations for diagnosing and treating hypothyroidism.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
Due to the half life of T4 meds like Synthroid, it takes at least 4 weeks for the dosage to reach over 90% of final effect on blood levels. In addition symptom changes tend to lag somewhat behind changes in blood levels of thyroid hormone. However, I expect that you will find an even bigger reason for your symptoms. Many hypo patients taking T4 meds find that their body is not adequately converting the T4 to T3, resulting in Free T3 levels that are too low in its range. Trying to dose a hypothyroid patient based on TSH levels does not work. You need to make sure they always test for both Free T4 and Free T3 every time you go in for tests. Many of us find that we required Free T4 at the middle of the range or slightly higher and Free T3 in the upper third of its range, and adjusted from there as needed to relieve symptoms. FT3 is metabolized by all the cells of the body to produce the energy we need.
In addition, hypothyroid patients are frequently deficient in 3 other important areas, Vitamind , B12 and ferritin. So you should make sure to test for those and then supplement as needed to optimize. D should be at least 50. B12 in the upper end of its range, and ferritin should be at least 70.
Your current doctor does not seem to know how to treat a hypothyroid patient. You might be able to change his approach by giving him a copy of the paper linked above. If the doctor will read the info he will find it all to be supported by scientific evidence that he will not be able to refute. If after that your doctor is unwilling to treat clinically as described, then you will need to find a good thyroid doctor that will do so.
Right away you need to go in and get tested for Free T4, Free T3 (not the same as Total T4 and Total T3), TSH, Thyroid Peroxidase antibodies (TPO ab), and if TPO ab is negative, then test for Thyroglobulin antibodies (TG ab). In addition, you need to test for Reverse T3, cortisol, Vitamin D, B12 and ferritin. If you run into resistance, insist on getting these tests done.
I have also sent you a PM with doctor info. To access, just click on your name and then on your personal page, click on messages.
I have also sent you a PM with doctor info. To access, just click on your name and then on your personal page, click on messages.
1 Comments
also get calcium test and PTH. I was nauseated for years due to Hyperparathyroid. The calcium is always high and vit d is always low.
A sympton, not abortion. Sorry, I'm typing this on acell phone screen and can't sew half of it until i submit it.
Hi, thank you. I'm in the capital district of upstate NY, i can use medical facilities between Albany and Lake George, NY.
I am on prescription Iron tabs because i was anemic to the point of needing a blood transfusion. I was wondering is vomiting Wray looks to be, coffee grounds a abortion of being hypo, as well? I am always nauseous and inky recently actually began vomiting what look like coffee grounds. I also have a constant burning in my stomach and my appetite waxes and wanes. I mentioned in 5'11" and weigh 150 lbs.
I am on prescription Iron tabs because i was anemic to the point of needing a blood transfusion. I was wondering is vomiting Wray looks to be, coffee grounds a abortion of being hypo, as well? I am always nauseous and inky recently actually began vomiting what look like coffee grounds. I also have a constant burning in my stomach and my appetite waxes and wanes. I mentioned in 5'11" and weigh 150 lbs.
Thank you for your reply. What is a thyroid doctor? Is it a hormone doctor? Is it an endocrinologist? Or is it a gland doctor? I did ask my doctor about giving me T3 medication and he said they don't like to use it to treat thyroid patients. I'm not sure who they were that he was referring to... Anyway I will read the link above that you posted for me. But he did tell me that I was anemic and has me on vitamin D 50000 units because he said I'm deficient. And yes my hair was extremely thick about 3 months ago it is now almost bald without any exaggeration. It has been coming out in clumps huge clumps as well as suffering from bouts of depression thick dry skin on my hands missed periods forgetfulness foggy headed severe fatigue and extremely painful muscle cramps as well as constipation and I'm not sure if this is related or not but I have itchy skin all over including itchy and dry eyes. I apologize for the lack of comma in my previous sentence for whatever reason that button is not working. Once again thank you so much for your information above.
1 Comments
See an Endocrinologist... best to you.
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