Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
So I went in to see my doctor today about my lab results. Turns out she's on vacation so I saw the NP instead, who proceeded to tell me that everything is perfect except for my Vitamin D and B levels. I realized in horror that she was going to just send me on my way with no help at all, so I kindly argued with her about the results.
I pointed out that my Frees came back in kind of low, and she agreed, but said since they were still in range it's fine. And more importantly, because my TSH is normal it does't require treatment. She was really hung up on my TSH results. She said they should be approaching 10 before any kind of treatment.
I pointed out that the TPO results came back positive, and she agreed again but said that that can mean a lot of things, or nothing at all.
I explained my symptoms to her and she said she understands that I'm obviously struggling with what sounds like a thyroid problem. And then she said that a lot of my symptoms sound like hyper symptoms (the anxiety and insomnia) and said that hypo people NEVER have those symptoms so something else must be going on with me.
Then I told her about my family history of Hashi's, that the TPO can indicate that, and that my understanding is when the body attacks the thyroid and kills off some of the cells, they can dump their stored hormone into the system and cause hyper like symptoms. And that's EXACTLY what I think I'm experiencing. My thyroid swells, I get hot flashes and anxiety, jittery, insomnia. Then after a few days that goes away and I get cold and exhausted and brain dead.
Bottom line, she said until I get worse she isn't comfortable giving me medicine. I really tried to talk her into a starter dose and she wouldn't budge. I think she finally realized I was prepared to stay there all day and argue with her, so she finally agreed to discuss it with my doctor, but she sounded primed to talk her out of it. And she said she'd refer me to an endocrinologist for a second opinion.
I cried all the way home.
I pointed out that my Frees came back in kind of low, and she agreed, but said since they were still in range it's fine. And more importantly, because my TSH is normal it does't require treatment. She was really hung up on my TSH results. She said they should be approaching 10 before any kind of treatment.
I pointed out that the TPO results came back positive, and she agreed again but said that that can mean a lot of things, or nothing at all.
I explained my symptoms to her and she said she understands that I'm obviously struggling with what sounds like a thyroid problem. And then she said that a lot of my symptoms sound like hyper symptoms (the anxiety and insomnia) and said that hypo people NEVER have those symptoms so something else must be going on with me.
Then I told her about my family history of Hashi's, that the TPO can indicate that, and that my understanding is when the body attacks the thyroid and kills off some of the cells, they can dump their stored hormone into the system and cause hyper like symptoms. And that's EXACTLY what I think I'm experiencing. My thyroid swells, I get hot flashes and anxiety, jittery, insomnia. Then after a few days that goes away and I get cold and exhausted and brain dead.
Bottom line, she said until I get worse she isn't comfortable giving me medicine. I really tried to talk her into a starter dose and she wouldn't budge. I think she finally realized I was prepared to stay there all day and argue with her, so she finally agreed to discuss it with my doctor, but she sounded primed to talk her out of it. And she said she'd refer me to an endocrinologist for a second opinion.
I cried all the way home.
I have soooo been there before, many times, unfortunately!
Run!!! far away from dealing with this NP. They are clueless. The elevated TPO indicates hashi's just as you said. Your symptoms seem to stem from Hashi's as one can swing back and forth between hypo/hyper as the thyroid gets destroyed from the antibodies. Can you post your labs with ranges? You seem to have a good understanding of the labs. I absolutely cannot wrap my brain around why these doctors tell patients to let it just continue and not treat and address the problem. It is also well know that folks with autoimmune problems, aka Hashi's should be off of gluten because the gluten mimics the thyroid antibodies and causes further distress in the body. So that is something to consider if you aren't GF already.
Keep moving and search for a doctor that will help you, not keep you sick.
Then, I call and say, "Is my doctor in today for my appointment? Or should I reschedule."
If I wanted to see an NP...I'd make an appointment with an NP.
If you're doctor sounded sympathetic, you might take another pass and make it clear to the "gate keepers" in a polite way that you'd like to see your doctor. The actual doctor.
In thyroid-land you can't give up. But, at the same time...you have to know when to not waste you're time. If your doctor seems reluctant and won't budge. Make it clear you're moving on.
I went to doctors for years and said I suspect that I have thyroid issues. Every one of them checked it and said it was okay. I lived in the Boston area and had found a few good ones for sinuses, pediatrician with a NP (adored both of them), retina specialist & GYN but never any luck with GP. I had found a dentist that I thought I'll have to fly back to see him! Finally found one that I liked. Went to her for initial and for one follow up before we relocated. I believe she would have listened and figured it out with me.
My sinus dr. was fantastic but he said something along the lines that moving to Texas I would not find the same level of care. Well he was right, I didn't find the same level...It's been better!
The 1st GP was not paying attention. Even left the room and came back and said "we were discussing your allergies". To which I said no we weren't! Huge red flag. Never went back! My new GYN gave me a new GP to try. I hit the jackpot! Love her! She listens and refers me to equally great doctors.
Now I know it was Hashimoto's. Probably a very low number. By the time I finally had someone listen it was 25. And my other levels were off.
Find someone who listens and cares! I'm glad I never wasted time with the idiot doctor. I found THE doctor! I hope you do too!
CD mentioned in another thread that "It's also common to wake in a complete panic." This totally happens to me! Blind panic the moment my eyes snap open. Not every morning, but on days that I'm going to be trying to cope with anxiety. Does anyone know what causes that?
Awaking with panic or anxiety is normal if you are hpyothyroid and/or hypoadrenal and undermedicated.
So sorry to hear about yet another clueless medical professional!
I just shared the following link on another thread this morning:
http://www.thyroidscience.com/hypotheses/dommisse.feb.2008/dommisse.feb.2008.pdf
An open-minded doctor just might change his/her ways after reading it.
My doctor knows I research....extensively. She has repeatedly commended me for this.
I'm very diplomatic when I present information to her. I'll tell her I'd been reading (and it's always a reputable source) and start off the conversation with "it's my understanding....."
I always knew there are seemingly a gazillion different types and manifestations of health conditions. It seems impossible for a doctor to stay current with everything.
An open-minded doctor will be receptive to new information from reliable sources.
We just need to have our "ammo".
Good health requires an active partnership between patient and doctor.
You'll be able to find your match.....but you do need to keep on looking.
I kissed 4 toads before finding my prince(ss).
Best of luck to you!! (and feel free to come here and rant in the meantime)
If I have Hashi's, then I'm fourth generation. It goes back to my Great Grandmother at least - every woman on my Mom's side has it. It just seems obvious to me that that's the most likely cause.
But if that's not it, that's ok. I just want the her to CARE that something is wrong and to try to find the reason for it. Her solution was to just sit back and wait for it to get worse before doing anything about it, which makes no sense to me at all. So I guess I'll be shopping around for a new doctor (ugh).
My daughter just had her blood work done to see if she had it. She is not having any trouble but if she has it there are things she can do now to help. I wish someone had listened to me 20 or 30 years ago!
I think its safe to assume that you are hypothyroid and/or hypoadrenal. Do test for FREE T3 and Free T4. And get the saliva test for cortisol levels ASAP.