Need a good endocrinologist in Sarasota

[dsl09]

Dr. Lupo - I had my bloodwork faxed to your office and am hoping to get an appointment with you sooner than later.  My Antithyroglobulin level is 191 H and I also have a 164 H  ANA.  I have a history of Graves when I was young and then it turned to Hashimoto in my 20's.  I have been having my TSH monitored by my GP for the last 6 or 7 years and have been on .125 of levoxyl.  Over the last 6 months, I have gained 10lbs, feel very tired and exteme lack of energy.  I exercise 5 times per week and eat healthy and my weight won't budge - I have always had an easy time both losing and gaining weight up until 6 months ago.  My GP did some bloodwork and saw that my B12 was extremely low, I was also having vertigo symptoms.  She prescribed anti-vert for "situational" vertigo to take as needed (which I took only once, but am dizzy a lot)  and B12 shots weekly for the last 4 weeks (I feel no different) - then she took this last set of bloodwork that I mentioned first.  My TSH was .158. so she lowered my levoxyl to .112 and added .25mcg of Cytomel (this was 6 days ago) because years ago when my Hashimoto's was out of control,  I took a combo and it worked well.

I feel awful and really need to get into see someone ASAP.  Any advice or help you can give would be great.  I don't have the energy to do anything and I am very sensitive to the heat and the bright sun.

Thanks

[5thave]

Hi

I don't know that much about these things but you sound a bit like me. I am now 43 but have been battling thyroid for years. The age of 38 I didnt know my body anymore. To make a longs story short over the years this is what I have found. Your other hormones start to get out of wack. You get estrogen dominant, hence brown spots, weight gain. Natural progesterone helped me drastically. Natural thryoid Armour helped, adrenals low for me, boosted with supplements and B vitamins. Finally diagnosed with Hoshi's and guess what Celiac disease. It has taken me 2 years to lose the weight and made a huge difference but what a challenge figuring out what is wrong one step at a time. It seems that at 38 you start becoming a different person and you don't recognize the body you are in anymore. Hope my struggle is helpful in yours, if only I had had someone earlier to help diagnose I may not have struggled so long. Wishing you the best.

[dsl09]

Hi Dr. Lupo - I met with Melissa and I also went to Dr.Kelley (Rheumatologist) and he ruled out any Rheumatological issues even though I show a positive ANA, he said that this is somewhat common.  I had my bloodwork done after I met with Melissa 6/26th and it's been almost 2 weeks and not all results are back yet.  We are still waiting on T3.  Your office told me to discontinue cytomel and stay on levoxyl .112, my TSH is showing an overactive thyroid, but Hashimoto disease.  I have been treated for hypoactive for 15 +years.  My problem is that I feel so...bad, keep gaining weight - have no energy -get extremely fatigued after exercise.  I am very dizzy and my face has developed discoloration (brown) spots on my forehead and cheeks.  My question is I have done some reading on adrenal fatigue and all of my symptoms seem to match.

If you could please look into my case - I really didn't get much relief from my visit there and don't have a follow-up appointment scheduled for another 3 months at Melissa's advisement.  I can't bear feeling like this that much longer.

Thanks

[dsl09]

Yes, I have an appointment also with a Rheumatologist the same week of my appointment with Melissa.

Thanks for your help.

[Mark Lupo, M.D.]

The high ANA is concerning for a rheumatolgic disease and with the joint pain, a rheumatology consult will be useful.  The Tg antibody confirms autoimmune thyroid disease.  Weight issues are not always thyroid (actually are usually not thyroid) - even in patients with thryoid problems.  I can't order any tests until you are an established patient, so wait until you see Melissa then we can get things ordered/addressed.

[dsl09]

What do you think about my Antibody levels?

The cytomel is .25, so I guess I should cut it back.  I have set up and appointment with your P.A. in 2 weeks.  There are probably some labs that my GP didn't have done.  If there is any other testing that I need done, I would like to have it completed before I come in.  Should I just call the office to see if anything additional is needed? (they received the labs that I faxed).  I don't understand if I have gone hyperactive, why I continue to gain weight.  I have gone from 127 to 139 lbs.  I also forgotten to mention that the joints in my fingers have swollen to the point that my rings don't fit.

[Mark Lupo, M.D.]

25mcg of cytomel is a lot of T3 -- with the TSH of 0.158, decreasing the T4 from 125 to 112 and adding 25mcg of T3 (unless you meant 1/2 a 5mcg tab -- ie, 2.5mcg) would result in much more severe hyperthyroidism.  Would also consider screening for addison's (am cortisol, if >11, not adrenal insufficiency) but with the weight gain, this is not likely.

The thyroid levels at 0.158 are not too far off normal, so there may be a non-thyroid cause of symptoms.  

call the office to see if we have the labs, etc to make an apt.