Why do the doctors even bother with seeing us?
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There's nothing unreasonable about your expectations. The problem comes from others unreasonable expectations of what should be tolerated or tolerable for another person. Dare I say, particularly when this person is female. (had the same said to me aged 38)
Before the assumption can be made that low t3 is natural level for someone, surely there would have been no benefit from adding t3 support building to a substantial level? Naturally there was this solid foundation on which he was able to base this sweeping assertion.0 -
allergictodiets wrote: »"he says I have an unreasonable expectation of how well I should feel at my age". Nice. I was told that "low T3 must be my natural level that my body gravitates to" :-) True gems of wisdom!
Takes the wind out of your sails when you realize how little most medical practitioners know about medicine.0 -
lindsey1979 wrote: »
20+ years ago, NDT was frowned upon because its formulation wasn't as precise -- some docs worried that you weren't getting consistent dosages per pill. But, it's regulated by the FDA now just like the synthetics are (it's not a "supplement" but a medication), so the precision of its formulation falls within those standards now. So, it's no longer a problem.
I personally don't know why so many docs prefer the synthetics. I think that's what they're often told in medical school/early training, and they are loathe to waiver from it. I strongly suspect its a brilliant marketing campaign by the synthetics manufacturers to doctors (Synthroid in particular) -- just like how certain companies try to get their products into schools so kids grow up with them and they're familiar to buy as adults -- whether it's Coke with free sodas or Apple with free computers. I personally think that ANY kickbacks to doctors for/from pharmaceuticals should be illegal. Talk about a conflict of interest!
This is largely due to the nature of allopathic (MD) training and fear of litigation. Identify the symptoms, root cause, and base your treatment on the symptom (root cause analysis). In thyroid issues, previously the only reliable indicator was TSH level and treating other variables, such as T3, opens up the possibility of doing harm. So if there's no indication of T3 insufficiency, the focus is on T4.
Holistic practitioners (DO) are trained to treat the patient and will attempt to get an understanding of all the variables before attempting to identify a treatment regimen. Even so they will opt for the regimen with lesser risk.
The other issue is the nature of the regulatory approval process and the clinical studies involved. Doctors will always move towards the product with a lower risk adverse event profile. NDT simply has more variables and greater risk, thus levothyroxine becomes a more desirable product to prescribe.
Any form of compensation from pharmaceutical companies is currently illegal.
Compensation may technically be illegal, but if you know any docs, pharmaceutical reps and/or medical device sales folks, they know exactly what they can do to that skirts the line. And it's been going on for a very, very long time. There is a reason the pharmaceutical and medical device sales is one of the most profitable sales positions for recent grads.0 -
lindsey1979 wrote: »lindsey1979 wrote: »
20+ years ago, NDT was frowned upon because its formulation wasn't as precise -- some docs worried that you weren't getting consistent dosages per pill. But, it's regulated by the FDA now just like the synthetics are (it's not a "supplement" but a medication), so the precision of its formulation falls within those standards now. So, it's no longer a problem.
I personally don't know why so many docs prefer the synthetics. I think that's what they're often told in medical school/early training, and they are loathe to waiver from it. I strongly suspect its a brilliant marketing campaign by the synthetics manufacturers to doctors (Synthroid in particular) -- just like how certain companies try to get their products into schools so kids grow up with them and they're familiar to buy as adults -- whether it's Coke with free sodas or Apple with free computers. I personally think that ANY kickbacks to doctors for/from pharmaceuticals should be illegal. Talk about a conflict of interest!
This is largely due to the nature of allopathic (MD) training and fear of litigation. Identify the symptoms, root cause, and base your treatment on the symptom (root cause analysis). In thyroid issues, previously the only reliable indicator was TSH level and treating other variables, such as T3, opens up the possibility of doing harm. So if there's no indication of T3 insufficiency, the focus is on T4.
Holistic practitioners (DO) are trained to treat the patient and will attempt to get an understanding of all the variables before attempting to identify a treatment regimen. Even so they will opt for the regimen with lesser risk.
The other issue is the nature of the regulatory approval process and the clinical studies involved. Doctors will always move towards the product with a lower risk adverse event profile. NDT simply has more variables and greater risk, thus levothyroxine becomes a more desirable product to prescribe.
Any form of compensation from pharmaceutical companies is currently illegal.
Compensation may technically be illegal, but if you know any docs, pharmaceutical reps and/or medical device sales folks, they know exactly what they can do to that skirts the line. And it's been going on for a very, very long time. There is a reason the pharmaceutical and medical device sales is one of the most profitable sales positions for recent grads.
This used to be the case, but not in the last seven years. If they are doing it, they are doing so illegally. You cannot compensate with anything of marketable value.0 -
Sometimes in my deepest darkest thyroid hour, I wish all the endo docs to have their own thyroid fail and for them to be stumbling around in the medical world dealing with the same smartaleck phrases their endo colleagues toss their way.
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I'm so glad I joined this group. I can read each post, agree with almost each one and not feel so alone. That in itself is a comfort.0
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I would like to add a 4th approach to hypo treatment, Reading the book, Recovering with T3, by Paul Robinson, first published 2011, with a forward by Dr John C Lowe, ISBN 978-09570993-1-9, he puts forward t3 only treatment as a possibility for those who do not respond well to any of the other available treatments. NDT does not suit everyone. Supplementation with t3 even in combination is seen as dangerous by many medics, they fear the patient is looking to go hyper. (as if this would be a benefit) This Brit eventually managed to find medical support for t3 only treatment after many false starts on the other approaches with less enlightened professionals, he is now well in control of his Hashimoto's, he takes us through his experiences emphasizing the need to proceed with contortion.0
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Oh OK thanks for answering my question!!! I believe the Canadian brand, Erfa, is NDT which I was taking until I ran out.
I'm really disheartened by the NPs I've seen because none of know much about hypo. The last one would order labwork and then reorder the same tests 2weeks later "let's try it now because before you weren't taking X" I can't afford shenanigans like that.
I found two things that Im hopeful about-- a place where I can order my own lab work and a pretty high dose thyroid glandular supplement.
I think I will be a much better doctor than the 3 NPs I wasted thousands on for very little result. I'm crossing my fingers about that supplement. It would be so awesome if it works.0 -
I've been on the same 100 mcg of levothyroxine for several years and my TSH has fluctuated from 3.5 to 2.1. I went in today to suggest raising my mcg because I can't seem to lose weight lately- or if I do it's like 1 pound every 3-4 weeks. Since I have tightened up logging, weigh everything, etc, etc, logic would tell you that maybe I should try to up my meds to bring my TSH down a bit. But no, my nurse practitioner said that because I was at a therapeutic level (2.1 in May) that she would not up my dosage and that maybe I just didn't need to lose more weight. I really felt judged- like she thought I was being vain, etc. Yeah maybe I am at the high end of a healthy weight for me, but really, why does it matter if I want to lose 10-15 more pounds? Why does she ask me- well how much more weight do you want to lose? Why does that matter- the point is if I'm eating 1300-1400 calories per day (more if I exercise a lot that day), I should be able to drop at least a half a pound a week. I get that she doesn't want me going into hyperthyroid mode, but still- what I weigh is my business unless I am underweight and putting myself at risk. When I told her I thought I should weigh 125-130- she said "and you probably weighed that when you were 18." NO ma'am I weighed 117 when I was 18- I think 125 is a reasonable weight for a 48 year old small frame, 5'4" woman.
And those levels should be just a guide- and then tailored to the individual. Just venting- Grrrrrr. Anyone have any thoughts on how to just help my weight loss along? I was losing fine- 5 pounds a month at first and then of course the closer I get the slower it is, which is fine, but it's kind of getting ridiculous and frustrating
I think I may try to just take my meds before bed instead of first thing in the morning- anyone have better luck with this?0 -
dramaqueen45 wrote: »I think 125 is a reasonable weight for a 48 year old small frame, 5'4" woman.
I'm 47 and 5'2" with small bones, and it's taken me a year to get from 125 to 117.0 -
Thyroid UK seem to be recommending a tsh of under 1. It would be good if all "experts" sang from the same page. To be able to work towards this would help so many.0
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Yes, yes it would. Because I am at a 2.1 I am "fine"- but not really- not when you consider that eating 1300-1400 calories per day nets a weight loss of about a pound every 4 months- smh.
I asked about that and mentioned that 2.1 is toward the higher end of "normal" as "normal" is now .3-3 and she said that depends completely on where you send the blood work to get the lab results. Really? I thought normal was dependent upon years of research and study. Silly me.0 -
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dramaqueen45 wrote: »I've been on the same 100 mcg of levothyroxine for several years and my TSH has fluctuated from 3.5 to 2.1. I went in today to suggest raising my mcg because I can't seem to lose weight lately- or if I do it's like 1 pound every 3-4 weeks. Since I have tightened up logging, weigh everything, etc, etc, logic would tell you that maybe I should try to up my meds to bring my TSH down a bit. But no, my nurse practitioner said that because I was at a therapeutic level (2.1 in May) that she would not up my dosage and that maybe I just didn't need to lose more weight. I really felt judged- like she thought I was being vain, etc. Yeah maybe I am at the high end of a healthy weight for me, but really, why does it matter if I want to lose 10-15 more pounds? Why does she ask me- well how much more weight do you want to lose? Why does that matter- the point is if I'm eating 1300-1400 calories per day (more if I exercise a lot that day), I should be able to drop at least a half a pound a week. I get that she doesn't want me going into hyperthyroid mode, but still- what I weigh is my business unless I am underweight and putting myself at risk. When I told her I thought I should weigh 125-130- she said "and you probably weighed that when you were 18." NO ma'am I weighed 117 when I was 18- I think 125 is a reasonable weight for a 48 year old small frame, 5'4" woman.
And those levels should be just a guide- and then tailored to the individual. Just venting- Grrrrrr. Anyone have any thoughts on how to just help my weight loss along? I was losing fine- 5 pounds a month at first and then of course the closer I get the slower it is, which is fine, but it's kind of getting ridiculous and frustrating
I think I may try to just take my meds before bed instead of first thing in the morning- anyone have better luck with this?
I know that this isn't exactly what you asked, but do you think there may be some value in focusing on body composition rather than weight? Recomping is not easy, but sometimes focusing on the scale number can ultimately be a disservice --- after all, aren't we all ultimately more concerned with body fat percentage than scale weight?
Now, I know the young lady in this article is much younger -- but it does show as a powerful example of the difference in body compositions at different weights. At her thinnest, she was 117, but she looks AMAZING at 131 and 142 (she put on some serious muscle) -- I believe she's also 5'4". It was reading this story that really drove home to me the benefits of weight lifting and focusing on body fat/composition rather than scale weight.
http://www.nerdfitness.com/blog/2011/07/21/meet-staci-your-new-powerlifting-super-hero/
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dramaqueen45 wrote: »Yes, yes it would. Because I am at a 2.1 I am "fine"- but not really- not when you consider that eating 1300-1400 calories per day nets a weight loss of about a pound every 4 months- smh.
I asked about that and mentioned that 2.1 is toward the higher end of "normal" as "normal" is now .3-3 and she said that depends completely on where you send the blood work to get the lab results. Really? I thought normal was dependent upon years of research and study. Silly me.
Where are your T4&t3 levels? My TSH needs to be completely suppressed in order to get those in the appropriate range and I am not hyper as a result. Some practitioners can be so arrogant. Ask to see someone else....however I wouldn't be surprised if everyone in the practice tows the same line. Good luck! Remember that the closer you get to "goal weight" losses slow down. And I second Lindsey's opinion on weight training.0 -
allaboutthecake wrote: »Sometimes in my deepest darkest thyroid hour, I wish all the endo docs to have their own thyroid fail and for them to be stumbling around in the medical world dealing with the same smartaleck phrases their endo colleagues toss their way.
^That! I confess that I've thought that at times...
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lindsey1979 wrote: »dramaqueen45 wrote: »I've been on the same 100 mcg of levothyroxine for several years and my TSH has fluctuated from 3.5 to 2.1. I went in today to suggest raising my mcg because I can't seem to lose weight lately- or if I do it's like 1 pound every 3-4 weeks. Since I have tightened up logging, weigh everything, etc, etc, logic would tell you that maybe I should try to up my meds to bring my TSH down a bit. But no, my nurse practitioner said that because I was at a therapeutic level (2.1 in May) that she would not up my dosage and that maybe I just didn't need to lose more weight. I really felt judged- like she thought I was being vain, etc. Yeah maybe I am at the high end of a healthy weight for me, but really, why does it matter if I want to lose 10-15 more pounds? Why does she ask me- well how much more weight do you want to lose? Why does that matter- the point is if I'm eating 1300-1400 calories per day (more if I exercise a lot that day), I should be able to drop at least a half a pound a week. I get that she doesn't want me going into hyperthyroid mode, but still- what I weigh is my business unless I am underweight and putting myself at risk. When I told her I thought I should weigh 125-130- she said "and you probably weighed that when you were 18." NO ma'am I weighed 117 when I was 18- I think 125 is a reasonable weight for a 48 year old small frame, 5'4" woman.
And those levels should be just a guide- and then tailored to the individual. Just venting- Grrrrrr. Anyone have any thoughts on how to just help my weight loss along? I was losing fine- 5 pounds a month at first and then of course the closer I get the slower it is, which is fine, but it's kind of getting ridiculous and frustrating
I think I may try to just take my meds before bed instead of first thing in the morning- anyone have better luck with this?
I know that this isn't exactly what you asked, but do you think there may be some value in focusing on body composition rather than weight? Recomping is not easy, but sometimes focusing on the scale number can ultimately be a disservice --- after all, aren't we all ultimately more concerned with body fat percentage than scale weight?
Now, I know the young lady in this article is much younger -- but it does show as a powerful example of the difference in body compositions at different weights. At her thinnest, she was 117, but she looks AMAZING at 131 and 142 (she put on some serious muscle) -- I believe she's also 5'4". It was reading this story that really drove home to me the benefits of weight lifting and focusing on body fat/composition rather than scale weight.
http://www.nerdfitness.com/blog/2011/07/21/meet-staci-your-new-powerlifting-super-hero/
Very true. In fact I have redefined my legs after I started lifting and going on long bike rides. I need to figure out my body fat percentage because you're right- that's the main thing is to lower that. I do however want 125-130 to be my ultimate- not too focused on numbers but I know when I'm carrying extra fat, and even though I'm at a "healthy" weight for my height- that is again a very general number. It's all about individual differences. But yes I will try to not focus on the number.0 -
dramaqueen45 wrote: »lindsey1979 wrote: »dramaqueen45 wrote: »I've been on the same 100 mcg of levothyroxine for several years and my TSH has fluctuated from 3.5 to 2.1. I went in today to suggest raising my mcg because I can't seem to lose weight lately- or if I do it's like 1 pound every 3-4 weeks. Since I have tightened up logging, weigh everything, etc, etc, logic would tell you that maybe I should try to up my meds to bring my TSH down a bit. But no, my nurse practitioner said that because I was at a therapeutic level (2.1 in May) that she would not up my dosage and that maybe I just didn't need to lose more weight. I really felt judged- like she thought I was being vain, etc. Yeah maybe I am at the high end of a healthy weight for me, but really, why does it matter if I want to lose 10-15 more pounds? Why does she ask me- well how much more weight do you want to lose? Why does that matter- the point is if I'm eating 1300-1400 calories per day (more if I exercise a lot that day), I should be able to drop at least a half a pound a week. I get that she doesn't want me going into hyperthyroid mode, but still- what I weigh is my business unless I am underweight and putting myself at risk. When I told her I thought I should weigh 125-130- she said "and you probably weighed that when you were 18." NO ma'am I weighed 117 when I was 18- I think 125 is a reasonable weight for a 48 year old small frame, 5'4" woman.
And those levels should be just a guide- and then tailored to the individual. Just venting- Grrrrrr. Anyone have any thoughts on how to just help my weight loss along? I was losing fine- 5 pounds a month at first and then of course the closer I get the slower it is, which is fine, but it's kind of getting ridiculous and frustrating
I think I may try to just take my meds before bed instead of first thing in the morning- anyone have better luck with this?
I know that this isn't exactly what you asked, but do you think there may be some value in focusing on body composition rather than weight? Recomping is not easy, but sometimes focusing on the scale number can ultimately be a disservice --- after all, aren't we all ultimately more concerned with body fat percentage than scale weight?
Now, I know the young lady in this article is much younger -- but it does show as a powerful example of the difference in body compositions at different weights. At her thinnest, she was 117, but she looks AMAZING at 131 and 142 (she put on some serious muscle) -- I believe she's also 5'4". It was reading this story that really drove home to me the benefits of weight lifting and focusing on body fat/composition rather than scale weight.
http://www.nerdfitness.com/blog/2011/07/21/meet-staci-your-new-powerlifting-super-hero/
Very true. In fact I have redefined my legs after I started lifting and going on long bike rides. I need to figure out my body fat percentage because you're right- that's the main thing is to lower that. I do however want 125-130 to be my ultimate- not too focused on numbers but I know when I'm carrying extra fat, and even though I'm at a "healthy" weight for my height- that is again a very general number. It's all about individual differences. But yes I will try to not focus on the number.
I know it's hard. The scale is just so much easier because it's a definite, easy-to-read number. But it's also so frustrating because it can fluctuate so much -- just even from water weight retention and hormonal differences throughout the month.
That's why I liked that article in Nerd Fitness in particular because you got to see one girl with very different body compositions. I don't find it as helpful to talk about the differences among people because even though very true, it's hard to see how it applies to any one individual. But, when you see the differences in one person -- like you do with Stacey -- it's pretty powerful. The fact that she looks so awesome at 142 blew my mind, especially when you compare it to where she was at 117 (and even 131).0 -
indianarose2 wrote: »dramaqueen45 wrote: »Yes, yes it would. Because I am at a 2.1 I am "fine"- but not really- not when you consider that eating 1300-1400 calories per day nets a weight loss of about a pound every 4 months- smh.
I asked about that and mentioned that 2.1 is toward the higher end of "normal" as "normal" is now .3-3 and she said that depends completely on where you send the blood work to get the lab results. Really? I thought normal was dependent upon years of research and study. Silly me.
Where are your T4&t3 levels? My TSH needs to be completely suppressed in order to get those in the appropriate range and I am not hyper as a result. Some practitioners can be so arrogant. Ask to see someone else....however I wouldn't be surprised if everyone in the practice tows the same line. Good luck! Remember that the closer you get to "goal weight" losses slow down. And I second Lindsey's opinion on weight training.
I have similar issues. My TSH isn't completely suppressed but it is very low. Since I have Hashi's, my doc only looks to the TSH to make sure that I'm not being overmedicated. So long as my body is still producing TSH, I obviously am not overmedicated. He said if I ever get to the point where it's completely suppressed, then we'll talk about it then (because he definitely said it's possible and what he seeks with some of his patients). I also don't have any hyper symptoms and even have an annual EKG to check my heart rhythms (which may be a little bit of overkill, but is a CYA measure -- and I understand that).
When you have Hashi's, TSH isn't as helpful of a test because you have the antibodies blocking the effective hormones. It's great for those without those antibodies, but it's not very helpful for those of us with such antibodies and inflammation.
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