The thyroid is an interesting organ. It is sometimes call the "great imitator" along with other disease that can present as a wide array of symptoms. Fever, diarrhea, palpitations, weight loss, etc. Gets hard to treat in the hospital when these signs and symptoms still have to be worked up to rule out infection (HIV, sepsis, colitis), autoimmune disorders, cardiac abnormalities (rule out heart murmur is actually endocarditis and not just a flow murmur from hyperthyroidism), etc. Becomes a big PITA. Some requiring ICU level of care like one of my hyperthyroid patients did. You can't really just read about the disease online and match up signs and symptoms to what you have. We convinced ourselves back in 1st year of med school we had all of the diseases we learned about given random symptoms. When you start dealing with patients that actually have it, you'll see the difference.
Yes, quite familiar with the phenomenon of cyberchondria - but, at the same time, when you find a list like the one I stumbled across and 20-30 things on it strike a chord you can't just put the list on the shred pile and move on. I've had some doctors that I really liked and who spent as much time as necessary listening and discussing but none (of 3) have even remotely helped with the issues plaguing me these last 8 years. Given the restrictions of staying in network and how hard it is to find good ones I've felt I had to spend a lot of time reading and evaluating any possibility I could find.
Unfortunately, your experience with your GP dismissing thyroid problems is quite common. GPs don't know that much about thyroid issues and rely on unqualified peer opinions and medical guidelines that are often completely out-of-date. It happened to my mother, only after I insisted on further blood tests did the lab finally discovered her sub-clinical condition. Her condition was then also confirmed by a teaching professor of endocrinology at a leading medical school. She couldn't sleep either. From my own research into the matter, it appears thyroid problems do affect women much more than men but men are also definitely affected so dismissing the problem in men is a ridiculous diagnosis. Some forms of thyroid problems are also brought on by the person's particular environment and not necessarily a problem inherent to that person's physiology or sex. The symptoms of thyroid problems vary depend on whether you are hyper- or hypo-thyroid and some of the symptoms are also shared between the two. You must refer your concerns to a capable endocrinologist. Thyroid conditions can result in severe and sometime irreversible loss of quality of life if left untreated for too long. Start by obtaining proper medical information, if your GP or local endocrinologists aren't helpful you may need to look further afield. The following treatise on thyroid conditions has been widely acclaimed: THE THYROID SOLUTION by Ridha Arem M.D. ISBN 0-345-42920-6 published by Ballantine Books NY. This book is well-stocked by your local library, at least it is in Canada. FYI, Dr. Arem has a website dedicated to thyroid issues. "Dr. Ridha Arem is currently running the Texas Thyroid Institute, an endocrinology practice specializing in thyroid and hormonal disorders and weight loss at the Texas Medical Center in Houston, TX", amongst other credentials. It was through my reading his book that I was able to insist on the correct blood tests that finally led to my mother's thyroid condition being diagnosed. Her GP had not performed the full battery of tests. There can be a number of reasons why a "normal TSH" test result may not pick up an underlying thyroid condition. I won't go into explaining all the possible reasons why the TSH test is insufficient but one possible reason is that the accepted test range of TSH levels is a composite range obtained from test results from many patients with normal thyroid function. While this method of obtaining a proper reference range for normal TSH levels may appear fool-proof, it isn't. The reason why it isn't is because each person has his/her own "normal range" of TSH levels. Our TSH levels are not constant. So what is considered normal for one person may actually be low or high for another person. The following schematic shows what I mean: Image Unavailable, Please Login Based on the accepted normal test range, your score would indicate your thyroid is normal. But based on your own body's normal range of TSH levels, your score would indicate a very low TSH level. According to Canadian standards, the "normal" range is 0.35 - 5.00 (milli-international units/litre). That's a huge range. Imagine if your TSH was at 4.50 mIU/L one day and a couple of days later, went down to 0.90 mIU/L. You'd be in trouble and your doctor wouldn't know because he only performed or only referenced one TSH test result obtained on one occasion. As a medical researcher, I actually proved this to my own doctors. They were flabbergasted because the idea never occurred to them. I exhibited prominent hypothyroid symptoms at 2.30 mIU/L of TSH, well within "normal" test range - but according to my own blood test records, my normal range is actually 1.76 mIU/L to 1.80 mIU/L. Our medical system isn't "fool-proof" at all. It just (seems to work) most of the time and I would suggest it often doesn't work and we just haven't noticed (yet). Yes, I had felt like crap too. I also didn't need surgery or Synthroid. My remedy was dirt-cheap, immediately and completely effective. This is why I suggest each person who has a chronic health condition(s) become an expert on his/her particular medical history and condition. Doctors often only use their own information to diagnose you, totally oblivious to previously obtained data and diagnoses. There are medical experts who do know better than your doctors and if you can connect them to your GP or specialist, it may make a world of difference. Dr. Arem is one of these experts on the issue of thyroid problems.
Thanks for the reminder about "The Thyroid Solution". I have a copy but had forgotten about it as it is in paper form and had been put away. <duh> My wife has been on Synthroid for years and I had done a lot of reading because I've never felt that she was getting the best results. Now I'm going back and re-reading all this stuff with my own issues in mind.
I understand your desire to learn about cures but it isn't helpful if you don't know for sure what your problem is and the mechanism causing it. To grasp for easy solutions is to find answers before you even have the questions prepared. This is what doctors find most distressing when a patient approaches them with a request for a prescription in hand - by focusing on uncertain solutions even before proper diagnosis you eliminate the diagnosis process. The proper way to deal with any problem is to: A) document the symptoms, B) identify and understand the likely system that is out of balance, C) locate the proper specialist for the system in question, D) work with the specialist to identify the likely mechanism causing your symptoms, E) identify possible means to restore balance (homeostasis) leading to elimination of symptoms. You should have accomplished step A by now and you need to work on step B, hopefully with a GP who can take a long view to actually understand rather than to give you a quick prescription to get you out of his office. Discussing uncertain cures at this point is no better than your GP giving you a quick prescription. Even if our hunch that you have a thyroid issue is correct, there can be vastly different causes for each hypo- or hyper-thyroid condition. You cannot use the same cure for each hypo- or hyper-thyroid condition. Doing that can really mess up the symptoms and even worsen your health. There are no shortcuts. You need to thoroughly understand before you take any action. I have formal post-graduate medical training and come from a medical family. If you are not in the medical field you should first locate a GP who is willing to take the long view. Some GPs are willing to take time to figure things out. If you feel frustrated, you might also try a backwards approach - contact Dr. Arem's clinic and ask them to recommend a GP in your area who is experienced and willing to work with patients with similar problems. Your problem may still turn out to be something else but from the looks of things, if you go this route you will likely get much closer to the answer because these people will also know other causes for the symptoms and whom else to contact.
From Dr. Arem's site I was led to thyroid-change.org where there is a list of patient submitted doctors and there is 1 not too far from me. I'll check my ins and give them a call tomorrow. Thanks! Also, from his book, it seems that a low-dose 3 month trial of thyroid hormone may not be out of the question so I think that is what I am going to aim for with this new doctor.
That looks like a good plan to me. However, as regards thyroid hormone therapy, be very careful. Your body has many built-in regulatory cycles and if you artificially add hormones into the normal cycle you risk disrupting the cycle and cause worse problems elsewhere. I would avoid making any assumptions or mentioning them until you have fleshed out the problem with your doctors. It's enough to describe your symptoms to them and perhaps mention you have had them for a very long time and want to rule out a thyroid problem. Good luck.
I alternate between ambien and Valium on bad sleep nights. 3/4 of a 10mg ambien or 7.5 mg of Valium works for me. I will also do 5 mg of Valium and 1/3 of an ambien.
Then I would contact the Arem clinic and ask someone there, websites are not always the ultimate repositories of information. Another approach is to ask the Medicare doctor if he can recommend an understanding colleague who will accept your insurance provider.
Michael , I tip my hat to you. It's great to see you (and others) be so helpful. I don't mean to brown nose, it's just refreshing.
Thank you for the compliment. Making useful medical connections was at one time a pet project of mine. It's such a waste to not have access to the right healthcare when the knowledge and technology is actually available.
Emailed the clinic asking for a referral. In the meantime searched my insurance provider database for "naturopath" because I haven't had much luck with Endocrinologists. None within 80 miles but 27 within 80-100 - all clustered around Stamford, Norwalk and Fairfield. lol Found the name of an Endocrinologist about 1 hour away who gets mentioned on several thyroid sites. Checked out his online reviews and he has lots of talk about how caring he is but a few red flags about never calling people back after specifically saying he would and, more importantly, several complaints about doing his own blood draws without mentioning the high costs. I have to be careful because my insurance is very specific and costly.
Sorry to hear about the hassles you're having. I know of one naturopath that I have learned an awful lot from, Dr. Peter D'Adamo. The ironic thing is that his clinic is in Brideport. He's the guy who became famous for promoting blood-group dieting. He's refined his system in recent years. I think naturopaths like Dr. D'Adamo can be very helpful with non-acute medical distress. I once made the drive between Toronto and Ann Arbor every 2-3 weeks for about 2 years. That's 5 hours each way. I got used to doing it - I like to drive. BTW, are you O-blood group by any chance?
Final appt with p-doc didn't go quite as I had hoped. The results of blood work he ordered never came up until I brought it up. He asked me how I'm sleeping when 5 minutes earlier I'd been telling him all about that topic, he didn't have any responses to anything I brought up, really kind of weird. Didn't encourage any of my "where do I go from here" questions. Just pleasant and uninvolved while letting me know I'm making a mistake going off the antidepressants. Quite strange. So, back to the search for an open-minded endocrinologist I guess! Oh and blood type? I'm embarrassed to admit I don't actually know my blood type.
Yea see a different doctor he's obviously a pill pusher. While I started the week waking up at 5:30 am, I have since slept till 830ish. But today I woke up at 930! I haven't slept thst late in a long time.
Went to bed @ 8:00pm last night, woke @ 11:30pm but still tired so, determined to get back to sleep, I made it all the way until 7:00am! That's only the second "normal" night's sleep in over 8 months! Dr. Arem's clinic said he doesn't know any Endocrinologists in NJ. :-( I've always known that psychiatrists in this country are pretty much only about medication management but still a disappointment when you run something past them and get NOTHING. Talk about non-commital!
Stig, I think you misread what I suggested earlier. I suggested you contact Arem's clinic for the names of GPs in your area, not specialists (e.g. endocrinologists). I imagine the US healthcare system handles patients in a similar manner as we do in Canada. We Canadians have to see a family doctor or a walk-in clinic (i.e. a GP) before being referred to a specialist like an endocrinologist. We cannot just book to see an endocrinologist. The logic is that patients won't really know what's wrong with them without the help of a family doctor or GP to start the process and shouldn't be directly contacting doctors who practise internal medicine (e.g. endocrinologists). The only time Canadians can directly book an appointment with a specialist is when the specialist already saw the patient less than 6 months prior for the same issue. Dr. Arem is an endocrinologist himself so he would be treating patients as an endocrinologist and not as a GP referring patients to other endocrinologists. So he wouldn't necessarily know of good endocrinologists in your area. You asked them the wrong question. What Dr. Arem would know are GPs who referred their patients to him. That's what I suggested earlier. You should be looking for GPs in your area that referred patients to Dr. Arem. If those GPs referred to Dr. Arem, they would understand thyroid problems better than other GPs and may know of other good endocrinologists closer to you. Your psychiatrist did not want to comment on an area outside of his specialty. All specialists do that. An endocrinologist would also stay away from making any comments on treatments you receive from your psychiatrist. It's not their domain and they have to avoid questioning or interjecting on medical advice/treatment given by other specialists on medical issues outside of their specialty. You must understand and work with these protocols if you want to communicate and relate effectively with your doctors. Find an understanding GP who has worked with Dr. Arem's clinic before. I'm not sure why the 80-100 distance is that critical as you wouldn't be making daily or even weekly drives; or does it affect your insurance?
Contacted the Arem clinic for a referral to a GP - no response at all. Regarding doctors not commenting on areas outside their specialty at some point in the doctor / patient dialogue I'm always looking for some sort of human connection - for example a conversation with my GP where he realized I knew things about Alzheimer's (his Father was going rapidly downhill) that he did not - and he's been a bit more "human" with me ever since. The distance isn't critical at all - at this point I'll go anywhere that's in network as long as I get some results. Communicating and relating effectively is a two-way street. If a doctor is so busy typing everything into the computer that 5 minutes later he's asking me about something I already mentioned as if it never came up even 'though I've been consciously pacing out the conversation to let him keep up with his documenting everything that's discussed then it is obviously not working.
Did you email the Arem clinic or speak to a live person? You never know who picks up the emails in a clinic. Sometimes, you have to find the right person to speak to; depending what the person's job is, he/she may not have the information or the inkling to follow up on a request that is outside of what they normally do. They are geared to answering existing patients or enrolling new ones. If you ask about GPs instead, they may have to go out of their way to help you. That's why I said it would be a backwards way of going about to find a GP. An email asking a question that is outside of their normal job routine may not get answered for the same reason why your doctor was more into typing on his computer than listening to you. If you get someone on the phone, you may just want to spell out your problem very directly; that you can't find a GP who can screen you for possible thyroid problems and that you'd like to know if the clinic has been referred by GPs in your area. You might also give them a hint and ask if they have any patients from your town or area NY, CT, NJ, etc. See if they can provide the names of their GPs. I agree with your sentiments regarding negative experiences with doctors. Unfortunately, that happens more often than it should. I've experienced that also and could not believe the really bad advice I received, especially compared to the excellent care I subsequently got from other doctors. I would just find a better doctor.
Good luck and remember to insist on proper explanations of what the acupuncturist does and more importantly, on WHAT caused your condition and WHY acupuncture works on it. In the meantime, if you're still worried about your thyroid being out of whack try incorporating sardine sandwiches into your diet, say 2-3 times a week. The humble sardine is much safer than other ocean fish to eat because it is low in the food chain. Fish higher in the chain accumulate and concentrate toxins, like mercury. Eating sardines is a natural way to help balance your diet for thyroid function.
