A PA is less trained than a nurse practicioner (who is licensed to prescribe) or obviously than a full-fledged physician and from your description, it sounds like you may want to hunt for a doctor who is willing to work with you about his fee. We have a doctor in our area that only takes un-insured patients, but I think he's a rare breed. You might be surprised though about doctors being willing to work with you on their fee, though they likely won't offer a discount for lab tests, so you want one who will try to order the ones they feel the most important to your care.
You might look into seeing if there are any good internal medicine doctors in your area. There are some endocrinologists that specialize, but specialists tend to charge more.
The immediate relative I mentioned went on gemfibrozil, what I think they call the poor man's triglyceride lowering drug. It helped some but they eventually had to go off of it because they developed muscle cramps. It might be something to discuss with your new, more caring doctor. Also, my grandma had really high LDL and I think it was partly from genes, but between diet and a cholesterol lowering medication, her total cholesterol got below 200 when it had been over 300.
If you find the right nutritionist, they probably could offer some help, but if they try to sell you supplements, that could be quite expensive.
If you can get this PA to do the proper testing, you might be able to stick with her. Some doctors (and PA's) are "trainable".......
A lot of us have "bad genes", but that doesn't mean we are doomed........
With a TSH of 17+, you need to be on the synthroid.... but do get the other testing done. That's very important.
Thanks so much for the advice, I do want to look into the Mediterranian diet and Yes I should switch doctors. The issue there is I am uninsured so it is all out of pocket. Currently I see a PA in a family practice, more as a "favor' than anything, I do exercise regularly, perhaps too much, but I don't feel like I do. Almost daily for a t least an hour, and I vary it, zumba, Weight lifting, yoga, step, hiking, I have done this for years.
Logging my food on this site and I seem to be doing well, but thought it might be helpful if I ever get to a new doctor for reference. I am due to go back to discuss the trigylceride isseu, her final opinion when told I do watch my diet, exercise and take
Vit B, Calcium, Vit D and Fish oil was that i have "bad genes" Ok, but what to do about that. Any suggestions on what type doc I should be seeing?
I was thinking maybe i needed a nutritiunist,
Hypothyroidism also causes cholesterol levels to be higher than normal. My cholesterol levels almost always coincide with my thyroid levels - when my FT3 and FT4 are higher, my cholesterol levels are lower, and when my FT3/FT4 levels drop down, my cholesterol jumps up.
Weight gain/inability to lose could be from a variety of things, including thyroid issues, adrenals, insulin resistance, PCOS or simply from eating too many calories and not exercising enough. While I gained weight from being hypo, I've not lost it because, even though I eat "healthy" foods, I haven't committed to, and stuck with, a diet and exercise plan.
The first thing you need to do is get your FT3 and FT4 tested, then depending on those levels, you would be able to see where you are and make adjustments accordingly.
Regarding your hair loss, while some often happens as you age, have they made sure the cause is not anemia or something other than a thyroid issue? You might also consider doing something receommended to me when I was losing hair when I was younger- a trio of vitamin B 50 time released, 200 iu I think it was of vitamin E, and at least 500 mg of Ester- C vitamin everyday and see if it helps any.
I would question too, why am I not losing weight with this thyroid medication? Is there something else wrong in addition to hypothyroidism?
TSH is the thermostat for your thyroid and is emitted by your pituitary gland. Your thyroid was not doing its job properly- it was very sluggish, that's why that one number of thyroid stimulating hormone was so high- the pituitary was trying to stimulate your thyroid gland to emit the hormones your body needs for a healthy metabolism. Since you are taking synthroid (synthetic thyroid hormone), your TSH is responding in a way one would hope, by not turning up the thermostat so high, so to speak, to get the thyroid to do its job.
Your doctor should be regularly monitoring your TSH and your thyroid hormones as well while you are on synthroid. If he/she is not, it's time to get a new physician- one who actually cares enough about the patient to pay attention to obvious details like that.
Now, you are still not losing weight, you say. But your sluggish thyroid might have caused weight gain if you weren't on the synthroid. But, is there another problem, say with your adrenal function, for example, that is causing you not to lose (ie- do you have any Cushing's syndrome symptoms)?
Re: high triglycerides- there is a strong connection between your triglycerides and your sugar intake. Triglycerides are thought to be a cause of plaque formation in your arteries and it is important to try to get those reigned in. You might consider something like the heart-healthy mediterranian diet (see private message for more info)- this was recommended to an immediate family member when their triglycerides were very high. The doctor allowed only two desserts a week. There are also triglyceride lowering medications if you can't get them under control by diet, which you might ask your (maybe new?) doctor about.
Re: low HDL, also known as the happy level of the LDL, HDL, triglyceride trio- a proper amount of exercise is one of the main ways they know of to raise this number. If you could get thirty minutes of decent paced walking in a day, even if it is split up, you might find your HDL rising. HDL, as you likely know fights LDL, also known as lousy cholesterol.
Re: LDL- if this is too high, not exceeding the RDA of fat is something you'd want to strive for. Also, pistachios are known to help lower LDL, so you might go out and buy some of these nuts and make them a regular part of your diet. A number of the other nuts, like macadamias, walnuts, and almonds, are good sources of Omega 3 fatty acids and also are good for you. There is a type of margarine spread you should be able to find in your local supermarket that has a kind of plant sterols that is known to help reduce LDL.. .it's a bit pricey, but your health is worth it!
You need to insist on further testing, particularly, Free T3 and Free T4 to see where those levels are at. Those are the actual thyroid hormone levels, with Free T3 being the most important because it's the biologically active hormone, that correlates best with symptoms.
Your TSH, at 2.89, is still at the high end of the scale, and while TSH should never be used as the sole tool for diagnosing or treating thyroid disease, that's all we have right now. Not everyone automatically loses weight when they go on thyroid med - I'm proof of that, but getting your levels up should help.
It sounds like you are still under medicated, but without an FT3 and FT4, that can't be verified.
A doctor who refuses to test properly, will keep you sick. If your current doctor refuses to test FT3 and FT4, you need to run, not walk, away and find a doctor who will do the proper testing, so you can get the treatment you need.