what specialist do i need to see

[cortisolhelp]

Hi, this is my 2nd question posted on here, as stated on my other post. i was on 1000 cals a day and going to the gym 3 - 5 times a week and weight it stuck between 18- 19 stone, wont move for the past 6-8 months.

im convinced i have a medical problem, i had advanced thyroid tests 1 +half years ago which was normal, altho it could have changed by now.
About a month ago had cortisol taken which was 17 off the limit, im having another cortisol done this week.

Im in the uk and my doctor just doesnt want to know, i want to go private to discuss the possibiity of me having a medical condition causing my weight to not move. who do i see?

i dont think its a dietition or nutritionalist as all they seem interested in is your food intake and when you tell them, on the cals im on and the exercise and the weight i weigh, i should be losing something they wont have it and the only thing they say is your doing it wrong, which im not, i wouldnt be humiliating myself  going to the gym for the past year if i was cheating!

is it a blood specialist i want to see who knows about things which cause weight gain?

just a normal private gp, but try to find one who has experience with weight gain?

if you contact weight loss clinics they are all about weight loss surgery and not interested in getting to the bottom of the cause of why your not losing if you are doing things right!

in desperation im down to 600 cals one day and 800 the next, and i know this is bad as your body can go into shock, but i dont know what else to do, ive tried, 1000 cals, 1400 cals, 1600, 1800, ive tried, low fat diets, ww diet, slimming world diet, the list goes on, ive tried them all and i do them all right, i have ocd and have to do things properly or not at all.

Does anyone know who i need to see as when i google for people in the uk i cant find anyone suitable and i need to know im seeing the right person as they charge such a lot of money.

thanks for your help

[soozsb]

An endocrinologist.

[Barb135]

I just saw your post here.. sorry I didn't respond sooner.

Do be aware that many endos are not really good doctors and won't address the entire endocrine system, as their name implies.  Many of them specialize in diabetes and won't delve into the adrenal issues; many are not even good thyroid doctors.

I really do understand what you're up against with the NHS and I fear that we will be up against some of the same things, here, soon... I've already discovered that I will be.

Actually, from a bit of research I've done, both high cortisol and insulin resistance are linked to glaucoma.  I'm still looking into that.

What was the diabetes test you took today?  Was it an A1c test?  If so, that measures the blood sugars over a period of a couple months or so.

As mentioned, both here and on the thyroid forum, hypo symptoms can show up before labs actually go out of range.  You should ask for thyroid antibodies to test for Hashimoto's.

Yes, it's true that DHEA peaks at around age 20, then starts to decline.  Because of the natural decline, most doctors won't tell you to supplement.  I've never heard that DHEA helps with weight loss.  

Whether or not you build muscle will have  a lot to do with your diet.  Protein is the building block for muscle, so if you aren't eating enough protein, you won't build muscle.  Additionally, if you  have insulin resistance, you should maintain a low glycemic diet in order to keep your blood sugar stable, to prevent insulin spikes.

[cortisolhelp]

Hi barb,

Thanks for your help and advice, ive been trying to find out for years who i need to ask to see, and just didnt know who, i know its an endocrinologist!

Ive found one in my area and have been quoted £180 for a consultation although if he reccomends i have tests then he can refer me back to the nhs. Im going t see my doctor to see if he will refer me to it one the nhs and if not then ask for a referral private as for some reason you still need a referral even when going private!

Even though im still on my diet and exercise i have gained 1 stone in the past 3 days, i have been very stressed. I cant bare it any more!

I went for a 2nd cortisol private test on wed and am awaiting the results, am contimplating doing a DHEA-S test ( £85 ) , a full thyroid+ antibodies test (£110) and insulin antibodies (£110) as i feel like my life is just wasting away waiting for help from the NHS, although its hard to find the money whilst also considering going private for the endo! i wish it was easier to get help.

I found it interesting with the other things you said.

I do have every thyroid symptom and have 3 close relatives with hypothyroidism. I also have 3 relitaives in the family with PCOS and have some symptoms altho non of the masculin symptoms.

I also read either cortisol or insulin resistance can cause glaucoma? i cant remember which one, i was diagnosed with glaucoma 2 years ago.

I am beginning to think that because i have had borderline personality disorder for over 20 years , which basiclly means ive been constantly stressed for 20 years , that my cortisol has been raised for 20 years so theres a good chance one of my glands is damaged or ive become insulin resistant. I did get a diabetes test yesterday which gave me a reading of 5.3, i had just eaten before having it tho, like 10 mins before, i didnt realise i shouldnt have.
Or i still could have a thyroid problem which makes me think i need it tested again, and then even if its clear it could still be a problem because of my family history and my symptoms.

I did find it interesting that your DHEA levels peak when you are 20 and decline after and people in there 40s can find problems with it and usualy if your DHEA is low then cortisol will be high, which is why i was thinking i should get that tested, but also DHEA helps counteract cortisol and help weight loss and muscle mass which im both struggling with, ive been going to the gym for over a year and my muscles dont seem to be getting any bigger!
I just seem to be getting bigger, especialy the past 3 days! surely you should have to be stuffing your face 24/7 to gain 1 stone in 3 days!

[Barb135]

The most common cause of weight gain/inability to lose is low thyroid function.  If you haven't had a thyroid test in a year and half, you should get another one.  You need to have Free T3 and Free T4, along with TSH.  It's also a good idea to get tested for thyroid antibodies, as well, because if you have Hashimoto's, your thyroid function will decline.  I know that many people in U.K. have a hard time getting adequate thyroid tests, because of the strict NHS guidelines that call for TSH only.

Another thing that can cause weight gain/inability to lose is insulin resistance. With insulin resistance, your body produces enough insulin, but doesn't use it properly.  Insulin is often called the "fat storage" hormone, because whatever food you eat that isn't used right away gets shuttled into fat cells.

Third, is that you might want to look into PCOS - Polycystic Ovary Syndrome, which also causes weight gain/inability to lose.

Last, but not least, you said your cortisol is high.  High levels of cortisol cause belly fat.

All of these things can be checked out by a general practitioner, but you need to find one willing to look outside the box.  The other option might be an endocrinologist.