Aa
Distraught
I went to my 5th endocrinologist yesterday, only to leave his office weeping. Even though I thought I had vetted his office by explaining my problem with previous doctors to his nurse, as well as the current issues and my desire to deal with my Free T4 and T3 levels....and even though both my PCP and my doctor of physical medicine wanted me to see another endo because of my continuing symptoms, I got blown off by the doctor AGAIN because my TSH and Free T4 were "within normal limits" before I was put on medication for a multi-nodular thyroid. Each and every doctor has ignored my hypo symptoms because my TSH is low. This doctor actually said " Well, if you want somebody to diagnose you by symptoms, you should go to one of those woo-woo doctors, I don't know why you are coming to me."
Since I went back on Cytomel from the generic two months ago, I've lost masses of hair and broken out in a rash. My scalp hurts. I took a ball of hair into his office the size of a baseball that has fallen out in the shower in the last two weeks. When I showed him the rash, he said I should go to a dermatologist. ( Been, over and over again. A rash was one of the first symptoms of my problem 7 years ago. Dermatologists don't know what it is, including doing a biopsy.) He said the hair loss was a lot, but he didn't know what would cause it. When I asked if he thought I was allergic to fillers or something in the Cytomel, he said "maybe." and shrugged. He asked why I was on generic T4 instead of Synthroid and said everyone should be on a Brand name product. When I told him I had been doing fine on the generic T4 and made sure it was from the same manufacturer every time, he said, " Well, I guess you know more than me." My weight continues to increase since my med dose was changed from 75 mcg T4 and 25 mcg T3 to 100 mcg T4 and 15 mcg Cytomel because the FREE T3 was a little higher than the range. Of course, I had taken the T3 right before the blood draw because they told me it made no difference.
He said he would try to bring my FREEs up, if that's what it would take to convince me I shouldn't be on meds. He said it would require me taking a lot more T4 (which has never done anything for me) and that then I would probably get heart palpitations, and would dissolve my bones. All these damned endos say that, even though all of my labs for calcium, cholesterol, eGFR etc. had gone from abnormally high (for me) back to normal on medication. My blood pressure has also returned to my lifetime norm of 120-124/ 68-72. Before meds it had shot up to 198/96 ! The nodules have shrunk. I developed osteoporosis BEFORE I was put on meds, and I ascribe that to my thyroid disfunction making it so that my body was using the calcium in my bones rather than in my blood. I have been on HRT and taken calcium citrate supplements for a long time, but my bone density just kept getting worse. My doctor did labs and a stress test recently and my heart is just fine.
I am so tired of arguing with doctors. or being in adversarial relationships with them. I asked this one if he could do an rT3 vs. FREE T3 ratio to see if I'm having a resistance problem, and he said "I don't use rT3 in my practice." period, end of discussion. I brought up adrenal fatigue, saying that the one cortisol test I had in the am was 20, w/ a high range of 19....that doctor who ordered it said that didn't matter. This doc just shrugged and said, ok, go have another cortisol test, along w/ estradiol, progesterone, testosterone, TSH, and the FREEs. But he didn't order a 24 hr. test.
I don't really feel like going back to someone like him, even though he will work with the FREE levels against his will. He said that " a lot of psych patients" see relief w/ T3, implying that depression is my problem. Doesn't exactly explain all the other symptoms, not to mention that I have only had depression when my T3 was lowered. Or that my shrink says she thinks the problem is my thyroid. Or that no antidepressant relieved depression, but T3 did, in 3 days. I told him that I was very aware of the role thyroid hormones play in the synaptic response, and that seeemed to **** him off.
I'm really at my wit's end. Does ANYBODY know a good endocrinologist in Los Angeles ? My PCP has been willing to work with me, but has come to the limit of her knowledge in titrating a proper balance between T3 and T4. HELP ! And thanks for being there, it helps preserve my sanity to know the rest of you are going through this too !
Since I went back on Cytomel from the generic two months ago, I've lost masses of hair and broken out in a rash. My scalp hurts. I took a ball of hair into his office the size of a baseball that has fallen out in the shower in the last two weeks. When I showed him the rash, he said I should go to a dermatologist. ( Been, over and over again. A rash was one of the first symptoms of my problem 7 years ago. Dermatologists don't know what it is, including doing a biopsy.) He said the hair loss was a lot, but he didn't know what would cause it. When I asked if he thought I was allergic to fillers or something in the Cytomel, he said "maybe." and shrugged. He asked why I was on generic T4 instead of Synthroid and said everyone should be on a Brand name product. When I told him I had been doing fine on the generic T4 and made sure it was from the same manufacturer every time, he said, " Well, I guess you know more than me." My weight continues to increase since my med dose was changed from 75 mcg T4 and 25 mcg T3 to 100 mcg T4 and 15 mcg Cytomel because the FREE T3 was a little higher than the range. Of course, I had taken the T3 right before the blood draw because they told me it made no difference.
He said he would try to bring my FREEs up, if that's what it would take to convince me I shouldn't be on meds. He said it would require me taking a lot more T4 (which has never done anything for me) and that then I would probably get heart palpitations, and would dissolve my bones. All these damned endos say that, even though all of my labs for calcium, cholesterol, eGFR etc. had gone from abnormally high (for me) back to normal on medication. My blood pressure has also returned to my lifetime norm of 120-124/ 68-72. Before meds it had shot up to 198/96 ! The nodules have shrunk. I developed osteoporosis BEFORE I was put on meds, and I ascribe that to my thyroid disfunction making it so that my body was using the calcium in my bones rather than in my blood. I have been on HRT and taken calcium citrate supplements for a long time, but my bone density just kept getting worse. My doctor did labs and a stress test recently and my heart is just fine.
I am so tired of arguing with doctors. or being in adversarial relationships with them. I asked this one if he could do an rT3 vs. FREE T3 ratio to see if I'm having a resistance problem, and he said "I don't use rT3 in my practice." period, end of discussion. I brought up adrenal fatigue, saying that the one cortisol test I had in the am was 20, w/ a high range of 19....that doctor who ordered it said that didn't matter. This doc just shrugged and said, ok, go have another cortisol test, along w/ estradiol, progesterone, testosterone, TSH, and the FREEs. But he didn't order a 24 hr. test.
I don't really feel like going back to someone like him, even though he will work with the FREE levels against his will. He said that " a lot of psych patients" see relief w/ T3, implying that depression is my problem. Doesn't exactly explain all the other symptoms, not to mention that I have only had depression when my T3 was lowered. Or that my shrink says she thinks the problem is my thyroid. Or that no antidepressant relieved depression, but T3 did, in 3 days. I told him that I was very aware of the role thyroid hormones play in the synaptic response, and that seeemed to **** him off.
I'm really at my wit's end. Does ANYBODY know a good endocrinologist in Los Angeles ? My PCP has been willing to work with me, but has come to the limit of her knowledge in titrating a proper balance between T3 and T4. HELP ! And thanks for being there, it helps preserve my sanity to know the rest of you are going through this too !
HbA1C is a diabetes test. ACTH is adrenocorticotropic hormone. It's the hormone the pituitary secretes to stimulate the adrenals. It's kind of the adrenal equivalent of TSH.
It sounds like his nurse was very helpful. I think I'd agree with you about getting the tests done. He's ordering what you want to see. If nothing else, you can take them to the next doctor. It's no fun to have to be prepared for a fight whenever you see your doctor.
Good luck...
It sounds like his nurse was very helpful. I think I'd agree with you about getting the tests done. He's ordering what you want to see. If nothing else, you can take them to the next doctor. It's no fun to have to be prepared for a fight whenever you see your doctor.
Good luck...
Oh goolarra and gimel thanks so much for noticing.
I asked all the questions you recommended before I went to see this jerk, explained all the trouble I've had because my TSH is historically low etc. Really spoke for a long time w/ the nurse, was asked to bring in all my blood tests as well as the chart I made tracking all of them and what my dosages were at the various times. The nurse said, oh you really need to get in to see Dr. C---------, because the other doctor I had called about turned out to specialize in diabetes. The nurse raved on and on about him, pulled strings to give me the first cancellation they had, she was so concerned about my hair.....and then what did I get ? This jerk. It's so demoralizing. I'm starting to think that I should go to Houston to visit my sister and see Dr. Arem or one of his acolytes in his clinic there, just to get an unbiased opinion on the balance of meds. I'm getting too exhausted to fight any more.
I think I looked at that site before, gimel, and didn't come up w/ anything, but I'll try again. I guess I'll take myself into the lab and get the labs he ordered anyway, although I don't want to have to fight w/ him all the time. He ordered TSH, FREE T4 and T3, Estradiol, Progesterone, ACTH, Cortisol, and HbA1c. I have no idea what ACTH and HbA1c are, do either of you ?
Gimel, should I send a message to your profile if I need you to help me call ? It's so generous of you. Tinnitus and dyslexic spelling and ultra-ry skin has come back w/ a vengence, and the hair loss has me really worried, since it had grown back enough to be acceptable, though not as thick as it used to be.
Thank you both, and I'll take the advice to post a request w/ LA Doctor in the heading.
Many blessings.
I asked all the questions you recommended before I went to see this jerk, explained all the trouble I've had because my TSH is historically low etc. Really spoke for a long time w/ the nurse, was asked to bring in all my blood tests as well as the chart I made tracking all of them and what my dosages were at the various times. The nurse said, oh you really need to get in to see Dr. C---------, because the other doctor I had called about turned out to specialize in diabetes. The nurse raved on and on about him, pulled strings to give me the first cancellation they had, she was so concerned about my hair.....and then what did I get ? This jerk. It's so demoralizing. I'm starting to think that I should go to Houston to visit my sister and see Dr. Arem or one of his acolytes in his clinic there, just to get an unbiased opinion on the balance of meds. I'm getting too exhausted to fight any more.
I think I looked at that site before, gimel, and didn't come up w/ anything, but I'll try again. I guess I'll take myself into the lab and get the labs he ordered anyway, although I don't want to have to fight w/ him all the time. He ordered TSH, FREE T4 and T3, Estradiol, Progesterone, ACTH, Cortisol, and HbA1c. I have no idea what ACTH and HbA1c are, do either of you ?
Gimel, should I send a message to your profile if I need you to help me call ? It's so generous of you. Tinnitus and dyslexic spelling and ultra-ry skin has come back w/ a vengence, and the hair loss has me really worried, since it had grown back enough to be acceptable, though not as thick as it used to be.
Thank you both, and I'll take the advice to post a request w/ LA Doctor in the heading.
Many blessings.
I looked through my listing of Doctors recommended by members as being good thyroid doctors, but unfortunately did not come up with one in L. A. The best I can offer right now is this link to Top Thyroid Doctors in Calif. If you will go through the list and read the patient reviews, it can lead you to some good prospects. If you will then send me the names of ones that you think might be worthwhile checking out further, I'll be glad to help with phone calls to their offices to try and find out if they fit my definition of being a good thyroid doctor.
I ask if the doctor is willing to treat a patient clinically, by testing and adjusting free T3 and free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. I also ask if the doctor is willing to prescribe meds other than T4 types. If the answer to either question is no, then I keep on looking.
http://www.thyroid-info.com/topdrs/california.htm
I ask if the doctor is willing to treat a patient clinically, by testing and adjusting free T3 and free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. I also ask if the doctor is willing to prescribe meds other than T4 types. If the answer to either question is no, then I keep on looking.
http://www.thyroid-info.com/topdrs/california.htm
I'd suggest that if you want a referral, you might post a new thread and be sure to get L. A. into the headline. You'll attract people from your area that way. Commenters will have to answer by PM as MH discourages referrals on the open forum.
OMG, this doctor sounds like the ultimate in-love-with-himself jerk. It's terrible to have to make the trade-off between clinical competence (he is willing to order SOME of the right tests) and clinical abuse. Hey, doc, do you really want to know why my BP is so high??? It's called the fight or flight response, and it happens every time I see YOU.
When I was interviewing endos, I asked which tests they odered regularly for their thyroid patients, which meds they were open to using, if they had experience managing thyroid with a couple of other health issues I have, etc. I also asked if they expected to be blindly followed or welcomed patient input. Amazingly, you actually get some very honest answers to this question (especially if you're not talking to the doctor, himself). I asked if they treated by symptoms or by labs alone.
In your case, since you're concerned with RT3 dominance, you might ask their feeling on that as well.
Sorry, I can't help with an endo referral in your area...want to make a quick trip to Oregon?
OMG, this doctor sounds like the ultimate in-love-with-himself jerk. It's terrible to have to make the trade-off between clinical competence (he is willing to order SOME of the right tests) and clinical abuse. Hey, doc, do you really want to know why my BP is so high??? It's called the fight or flight response, and it happens every time I see YOU.
When I was interviewing endos, I asked which tests they odered regularly for their thyroid patients, which meds they were open to using, if they had experience managing thyroid with a couple of other health issues I have, etc. I also asked if they expected to be blindly followed or welcomed patient input. Amazingly, you actually get some very honest answers to this question (especially if you're not talking to the doctor, himself). I asked if they treated by symptoms or by labs alone.
In your case, since you're concerned with RT3 dominance, you might ask their feeling on that as well.
Sorry, I can't help with an endo referral in your area...want to make a quick trip to Oregon?
Bump. PLEASE, someone, info on doctors in Los Angeles, or proper questions to ask when considering an endo ? I thought I asked all the right questions, but apparently just spent $25 for nothing. I really need advice on this situation, and am at the end of my medication. I hate to order more of the same if my dosage is going to be changed again.
Oh, and I forgot the height of ridiculousness...he told me that the reason i might be gaining weight is because I had a cortisone shot in my foot about 4 months ago for a neuroma I developed because my feet swelled up so much before I was medicated for my thyroid. He said " Cortisone isn't good for you, you know." I replied, "Neither is not being able to walk".
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