How to talk to your doctor to get tests & treatment

eudaimonia_sf

Hi, fellow hypothyroid people.

This summer, I began having extreme fatigue. After two months of it, I finally peeled myself off the couch to go to the doctor. After seeing three doctors and about twenty blood tests, I was recently diagnosed as hypothyroid.

The first two doctors checked my TSH levels and various markers for anemia. It was not until I went to the third doctor, armed with weeks worth of food and exercise logs, that I was able to convince someone that my inability to lose weight was not due to poor diet and exercise, and that my fatigue was not due to laziness. She ordered more tests (t3, free t3, t4, free t4 as well as thyroid antibody tests), and was able to make a diagnosis. I hope to get a prescription after the long weekend.

I wish I had brought all my MFP data to the first doctor back in June -- perhaps she would have taken me seriously, and I could be already on the road to feeling better.

I see so much frustration with respect to doctor communication here and elsewhere.

So my question to you is: what would you recommend people do if they suspect a thyroid problem in order to facilitate getting treatment?

So far, my tip would be:
- eat right & exercise if possible. Measure & weigh food, so they cant question your portion sizes. Be scrupulous and leave no room for question.
- log everything you eat & do
- bring printouts to your appointment

I'm just beginning this process, and would appreciate knowing what to expect next, and how to overcome potential roadblocks to effective care.

debbylee22

Hi,
Sorry you've had it rough. What you're saying is much the same story as many people. Drs have been taught to treat hypothyroid with synthroid (or another synthetic), and they don't really "get it" to treat for the symptoms. Its been hard on many people.

There is an excellent source of information you should go & read right away. They have helps for you, in getting the right treatment. It's Stopthethyroidmadness.com it even has lists you can print off, for seeing your Dr.

It sounds like you have a good Dr. now, so hopefully she will put you on Armour instead of synthetic many people do much better on the natural thyroid.

I took my MFP pages in when I saw my naturopath dr. She used them quite a bit! and was able to tell me which of the foods I should avoid (after finding my intolerances) too. Plus gave me suggestions of things I should add to treat my adrenals.

My regular Dr doesn't spend so much time, and fortunately has agreed to prescribe the Armour, as I requested, though he was skeptical.

marijasmin

It is very tough sometimes to get a diagnosis but you didn't give up and in fact i think because of your determination got a quick diagnosis. It may not feel that way to you though!! Good for you to get this identified. ::flowerforyou: :flowerforyou:

I would agree with Debbie, taking your pages with you and monitoring closely what you do is a key and you seem to have learned this earlier than most of us. In the early days I found almost all improvements I made helped. Gratefully took all the quick wins I could. After a while it took more effort to manage my condition. Please take a look at the diaries etc of those who are managing their thyroid condition well and who seem to have the same issues. Just try what they do and adapt to suit your life and health.

My only recommendation would be that after some time, you could choose to make one change and track your results, then make another and track the results on your body and energy. My daily temp is taken every day using an underarm method, it's my yardstick, a rough and ready measure to indicate how my body is trending over time. It is useful to have this type of impirical measure. It takes about a week for t4 to convert to t3, and for tsh to adjust so adjustments and changes work slowly. Supplementing with t3 is more instantaneous as the half life of t3 is shorter- more like 3 days in my case.

Change will come.

You are in the best place for support, I have found that here is the best site as members are actively making changes rather than just making moans about their meds and their doctor. They are eating properly, exercising and managing their weight and energy themselves rather than delegating this to their doctor. Sounds like you too belong here.

You asked what you can expect, early on if your meds are broadly ok, an improvement in your energy level, then a period of watching and waiting probably with further adjusting of your thyroxine. I am one of those that does ok on synthetic t4 with almost no improvement on armour. This is good as t4 ingestion is easier to control than the natural hormones and less complicated. I just adjust by 25 mcg up and down from my standard dose. Of itself putting thyroid on the right dose won't cure overweight but it puts us in a better positioning to tackle the issue. Most of us find sugar a problem, will supplement and adjust this to get optimal positions.

It is a moving target for me, but so worth aiming for.
Jas

eudaimonia_sf

Thanks - this is all great information! I hope others will contribute, so others looking for support can have one place to look for help as they begin dealing with their thyroid issues.

marijasmin, this does seem like a great place full of people trying to take charge of their own health and getting the right help from their health care practitioners (whether they be doctors or naturopaths or otherwise). i am glad to have found it.

tecallahan

At the risk of repeating myself (I've posted this many times), no thyroid medication will work properly unless your Ferritin/Iron levels are correct as well as your adrenals (cortisone, aldosterone).

The reason many people don't do well on synthetic T4 is because they have a problem converting T4 to T3. T4 is an inactive hormone and by itself does nothing for our metabolism. Various organs in your body are supposed to convert it to T3, however many of us don't have good conversion. As a result, we have plenty of T4 (inactive hormone), but not enough T3 (active hormone), so we feel fatigued and have all the symptoms of hypothyroidism.

For doctors that only test for TSH -- TSH will be perfect if you have lots of T4. TSH doesn't care if you have sufficient T3. That's why it's important for doctors to test for Free T3.

For people that have lots of T3, but still have all the symptoms of hypothyroidism, this generally means that the T3 is not being absorbed by the cells -- it is "pooling" in your blood and not being utilized. This could be because of REverse T3 or low cortisol from adrenal stress.

I know this seems technical, but the important part is to insist that the doctor treat your symptoms and not just your lab tests!

Good luck -- hope they give you Armour Thyroid - I have had and amazing results and actually got off of cholesterol medication and high blood pressure medication after starting on Armour. I spent 15 long, miserable years on synthetic T4 getting fatter and sicker every year.

carolyn002

thanks for the info ; )

eudaimonia_sf

> I know this seems technical, but the important part is to insist that the doctor treat your symptoms and not just your lab tests!

Yes, I get that this is happening. What I want to know is, how did you get your doctor to do that?

tecallahan

> I know this seems technical, but the important part is to insist that the doctor treat your symptoms and not just your lab tests!

Yes, I get that this is happening. What I want to know is, how did you get your doctor to do that?

LOL - you have to kiss a lot of frogs if you know what I mean. I've been hypo for 15 years - and fired 4 doctors along the way because I was sick and they were telling me I was normal. I did some reading and educated myself about my thyroid disease and finally found a Naturopath that listened to me and was interested in my symptoms as much as my labs.

It is not covered by insurance, but I don't care. At 60 years old I feel better than I have my entire life!