It's not that doctors are dumb or lazy, just rather that many of them are mis-informed or have little knowledge about how the thyroid works. Don't forget they are really only GENERAL practitioners...meaning they know a little about a lot. Which is why when they can't figure it out they send you to a specialist, who knows alot about a little.
Having said that, there ARE G.P's who are good. These are usually younger ones though. Doctor's are human beings too, with personalities and their own problems. Some are too non-assertive to go beyond what is needed. I know here in Australia at one practice I was at, the G.P. I saw told me he was not allowed to order more than basic TSH unless the patient came in with an obvious goiter. That was not HIS decision rather the public health system who decided that a test costing over $600 was not justified on a patient's insistence. Our government would not pay unless you fit in the 'box' of being pretty much half dead to start with.
It is also lack of education to the health system. We are still using VERY outdated (from the 1930's I believe) reference ranges. These reference ranges actually INCLUDED people who were suffering from hypo and the opposite end hyper symptoms but were kept in the study and then it was averaged out mathematically for the number of people tested and therefore that range is seen to be accurate in many doctor's eyes, when in fact, it is highly flawed.
USA uses a more modern reference range, Australia does not. We have more patients here suffering needlessly because they have symptoms but are classified as 'normal'
It really is the patient's job to present with all the evidence of their disease rather than being iffy and vague. Saying, "I have put on soooo much weight" Will mean nothing to a doctor who sees obese people alot. Saying, "I have put on so much weight, and I have my food diary to show you my calorie intake being realistic but I still keep putting on weight." Will be more likely to be believed.
Also it is very important to document if your family, if diagnosed, has thyroid disease. Showing on paper a family tree and the disorder under the person's name is again more likely to be taken seriously, than, "I know Grandma was like me and always tired and put on weight too."
I think you can see my point. Doctor's are TOLD to make the appointment quick. They are paid by the amount of patient's they see per day, not by a regular hourly salary. So , some clinics prefer the doctor's to have 10 minute appointments (where you have to talk fast to get your point across) to fit in as many patient's as they can per day, so they can still get either State funding or Government funding or just a good kick back from the pharmaceutical companies. (THAT is another story for another time!)
So you can imagine if you come in late in the day, the doctor is more than likely already mentally thinking of clocking off and having a beer when he gets home!
For me personally, my lack of being diagnosed was a compounded issue. I think had I not had so many other issues happening in my life at the time, my doctor would have realised much quicker and been more assertive too. He was a very shy doctor who would blush when I had my Pap test done!
The weight issue is again a two edged sword. Many find they cannot lose weight even when their levels are good. Again I think as I have said in another post, we cannot blame the thyroid totally for this. Taking the tablet is not a guarantee we magically will lose weight. If you felt tired and unable to excersise when you gained the weight then it is likely (not always the case for every one, i am generalising here) that you would have continued an excersise programme. Also having been to USA I can safely say that the food portions and plate sizes in every place I ate at were enourmously huge and way above the sensible adult intake requirments! There are hidden things we just take for granted when we think we ought to be able to drop pounds too. Little things like having sugar in your coffee, can add pounds over a year. Mayonnaise, sauces, dips, etc which most people put on their food are loaded with calories.
What I am trying to say is that, again, it has to be an awareness. Yes, the body slows down when hypo, but also being aware that it takes time and determination to lose the extra pounds. You will read people who say they lost X amount of pounds once diagnosed and then you will read how some never lost anything. I do believe it is a mixture of getting the right levels for that person, and good eating and exercise plan. Even gentle walking is excersise. We don't have to rush out and get all physical to lose weight at a gym!
My sister has been on medication for over 20 years. She has started to put weight back on, but does not blame her thyroid. As she said, "I changed jobs and now I sit down all day. I eat stuff I shouldn't so it's my problem if I don't get up and do some excersise" (Her levels are exactly the same as they have been for over 5 years.
I was hypo but undiagnosed....and you can see me in my pic in 2006 how huge I was. I was not on medication and it was unbelievably hard work, but I aimed at losing a few kilos only at any time. I was more sleeping than excersising, but even though I KNEW something was wrong, I did NOT let it make me use that as an excuse. Now in 2009 I am alot thinner than I was. Even back to the same weight I was 10 years ago. BUT it is ALWAYS going to be a life long commitment on my behalf to do the right thing by my body.
I am now fighting my case all over again, and will get the answers I need to balance my poor old body. My levels are totally skew wiff. This time I am more educated than I was 15 years ago. THIS time I know what I am talking about and can throw that back at the doctor's who then have no reason to doubt my own diagnosis.
Phew!!!! That was long wasn't it! I could have written more, but need to give others their turn!
My first Endo appt is July 2nd. I am so tired of this rollercoaster ride!! I wish I could controll my heart palps at night. I guess I should not complain, I have been albe to sleep for the last 4 nights. I consider that a priveledge. Usually I sleep for two nights, up for 3 or 4 with 1 to 3 hrs sleep a night. I am hypo, but I have a bunch of the hyper symptoms. I think my problems have become worse since being on Synthroid. I am pretty sure I have Hashi's.
I hate how the GP's ask what your symptoms are, give you no answers, and avoid you like the plague. (like... here goes another thyroid hypochondriac) I have gotten to where I demand to be taken serious and expect an educated answer. The first night this started with a panic attack, went to the ER and the Dr. asked me if I was Bi-polar!! I said " Excuse Me?! Are you Serious?!" , "What does that have to do with my symptoms?" Grrrr. To answer your other question, I had some pretty bad symptoms at the onset of this thing and I could barely eat for two weeks. Now I seem to be hungry most of the time - the weight will come back now if I don't watch myself.
thanks to you both...red, you are a fountain of knowledge!! With me, I started on insulin about 10 months or so ago and was told I would gain weight, that said, i think the doc only expected maybe 10 lbs or so...I have gained over 40 lbs and I just chalked it up to insulin, but now I'm having this thyroid thing and thinking it may be a combination of the two. Also, I have a very poor appetite for the last 2-3 yrs...my family is constantly ordering me to eat!! I can go for many days on a carton or two of yogurt each day...it's hard for me to force myself to eat...Oh, also, I understand that the GPs don't know that much about thyroid, but, they should know enuf to order the proper tests...it took me all of 10 minutes to find that out on the internet!! Hoping this Endo knows his stuff and can help, guess I'm just frustrated...and it's not only a thyroid issue that I'm dealing with...possibly Sjogren's as well, mouth on fire all the time and wake up with my tongue stuck to the roof of my mouth, plus a myriad of other things too long to list...lol
Tristy, I can really empathize with you when the docs look at you like you are crazy or they laugh at you!! How rude!! The first thing a doc should prescribe is something for the frustration!!! LOL make mine a yager bomb!!
Ah! See that is also the problem! You don't eat enough and your body says...OOOOOH this is a famine..must retain fat cells to keep alive! You will actually produce MORE blood sugars to keep those vital organs alive...hence the insulin issue!
I should know coz I am guilty of it too. I have no real appetite but notice I can sneak on a few pounds when I only nibble here and there over a few days...so I force myself to eat a proper meal and have regular snacks. Things like dried fruit and nuts seem to even me out. Otherwise I get sleepy and dopey and Doc...(that was a joke!)
It really pays to learn what happens to the body when we eat food. It is amazing the intricacies of the energy, nutrition values we take in and how even 20 minutes later it can affect us.
We all get frustrated. The amount of endos who actually know and care is a very small percentage. All the really good ones are booked up for months in advance......wonder why, hey?
I guess I've been one of the lucky ones when it comes to my GP as well as my endo.
I had my usual yearly physical blood work done last March with my GP, he called me the next day (he makes all of his own calls, and not his nurse) and told me my thyroid levels (which ones I can't remember) were way too high, and had me come in the next day to redo the blood work, just in case there was a problem at the lab. He also asked me about any "unusual" symptoms I may have been having. Told him I had tremors, shakes, unusual amounts of energy, but would then crash (this cycled throughout the day), I couldn't sleep, had diarrhea 3 to 5 times a day, and was losing weight without trying (he had commented on my weight loss during my physical). All of which he said were typical of hyperthyroidism.
The following day, he called me back to refer me to a endocrinologist. Got into that appointment within a week. The endo started me on Methimazole immediately, then had blood work done again in July. Methimazole was not helping, so was told I needed RAI. Had that done in August. As far as your question about weight loss once I became hypo, I gained 30 pounds in one month, once my thyroid became non-functioning due to the RAI. No matter what I did, what I ate, the weight just wouldn't come off, and my initial symptoms from the RAI were all coming back.
My endo was shocked when he saw me at my last appointment, and immediately knew the synthroid was not converting from T4 to T3, did additional blood work. He phoned me two days later and started me on a combo of synthroid and cytomel. That was a month ago. He's upped my cytomel dosage two weeks ago, and I can tell you first hand that I am now losing some of the 30 pounds I had gained, as well as feeling normal again.
If you feel your GP or endo are not doing their jobs or not working with you properly, you can always change to someone else. There are fantastic GPs and endocrinologists out there, you just have to sometimes do the leg work to find the fantastic ones and get away from the ones who aren't as knowledgeable (however, and endo SHOULD be knowledgeable since the endocrine system is their specialty).