Is my doctor on the right track?
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Is my doctor on the right track?
| Fri, 10-13-2006 - 9:50pm |
I saw my new PCP 6wks. ago and had every symptom of hypothyroidism. He said my thyroid was mildly enlarged, ordered TSH test. He called and said my results were low normal, prescribed Effexor (which I couldn't tolerate), Zelnorm (for constipation) and scheduled a sleep study. He told me to come back to see him in 3wks (I have an appointment next week). I am trying to be patient but I don't see his logic. I have facial puffiness,cold intolerance, constipation, fatigue, weakness (my body feels like spaghetti), low sex drive (I think it's just because I am tired) and I have gained 12 pounds in 3 mos. (despite decreasing calories and trying to remain active). My weight fluctuates 3-5 lbs. daily. I am exhausted...I feel like I am lying beneath bricks when I awake in the morning. Please give advice.

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Hi!
I'd call your doc and find out EXACTLY what your TSH was. If it's anything above 2 its worth investigating. If it's above 3 you should get some sort of thyroid meds!
It's so odd to me that a doc would prescribe 2 other medications but not even consider it could be your thyroid! Even a sleep study which are a lot of $!!! It's crazy!
I'd do a search on the net, print out a list of hypothyroid symptoms and put a check next to every symptom you've had/have and if you remember when it started.
I'd also ask him to run a free t4 (and free t3 if you can convince him) and see where those are at. Possibly even an antibody test to see if it's autoimmune.
Sometimes if you have proof of knowledge they are a little more giving as far as tests. I hope this helps. Being tired, constipation, feeling cold, hairloss, weight gain, puffiness, all of these are hypothyroid!!
April
Hi Baby-daughter,
It would be my opinion that your situation needs further checking and a different approach than what your doctor is taking.
Thank-you for the advice. I have been screaming to M.D.'s for 4yrs. that it is my Thyroid. They continue to repeat the same TSH test and it comes back normal. My symptoms have progressed and I am to the point that my body is completely out of whack!!! I have tried to be patient but after reading your e-mail; I realize I need to become more proactive. I am SO tired of feeling bad and I am becoming difficult to live with (and that is the worst feeling).
thanks
Baby-daughter
Hello,
I too am having a very difficult time with my nurse practioner and her apparent refusal to consider a thyroid condition. Each time I bring it up and begin to list my symptoms, she cuts me off. I am about to see another doctor. I have been trying to get a second opinion directly from an endocrinologist, however no one will accept me without a referral from my primary care provider!!! My tsh test shows "normal" and "right in the middle" levels. I understood it to be 3.04 or something like that. I have read that there are new levels being used, however my current nurse practioner won't condsider them or research them. I am looking for the information on the new criteria and any other helpful information.
I have gained over 60lbs in 5 years and continue to gain. I am on anti-depressants (started at the same time of my weight gain) I am so tired I have to take naps almost every day. I have no energy and other sypmtopms I have seen listed as having hypothyroid.
I would appreciate any help anyone may have.
mykidsmother
Hi - I just popped in to see what was happening here and saw your post. Here's a great article. Print it out and take it to your doctor! (You may have to click on the links to get the original article from the endo association.)
It's been a year or so since I've been on this board and I'm so saddened to see that nothing has changed with doctors and NP's. It sometimes takes as many as 4 changes of doctors to finally get the right one who will accurately diagnose and treat us! So don't give up!!! Cathy :)
Thanks for the reply...
I don't see an article link? Could you re-send or type it?
Thanks,
Baby-daughter
I have been more agressive and the M.D. has ordered a RAIU scan (My T3, T4 and Free t4 have all been low normal)). I continue to have worsening symptoms(I have every symptom of Hypothyroidism) and yesterday I awoke to a much enlarged Thyroid, hoarseness and pain. I believe I have had problems for so long (4yrs.) my blood test are not going to be too far below normal and for whatever reason my M.D. is reluctant to begin medications. If I don't get anywhere with him after the scan; I will find another M.D. and continue to scream (If I can!) until someone listens to me. I feel empowered since I received your response....THANKS!
Hi Baby-daughter,
I just read your post and hope that your visit in chat did help a little.
Who knows if your PCP is on the right track or not? It doesn't sound like the care you are getting is really relating to the care you should be getting. For one thing, I am a strong advisor of "if not happy with the dr." make a change. If you don't think his suggestions (which sort of sound like high costing tests) are the right ones, why not go to the base of what you think the problem is, and try to find an endo? Do you need a referal or can you just make the appt? Ask your dr. if his office can make an earlier appt. for you than what you could make for yourself. Sometimes they are very hard to get a visit with. If an endo sees a real problem, he will definitely treat you. Sure, your PCP is doing the full thyroid testing, but he reads it on an "average" and if you fall into the figures that are supposedly right, than his opinion is that it's not your thyroid. Most endo's will test further--I've been going to one for the past 10 years, and have seen a big difference in the testing and treatments.
You certainly do seem to have a lot of the hypothyroid symptoms, some of them being fatigue, chilly, loss of appetite, slow pulse, weight gain, enlarged thyroid gland, depression, dry skin, brittle fingernails, hair loss, constipation, vague aches and pains, menstrual changes, high cholesterol level, and even carpel tunnel syndrome, etc. I know you haven't mentioned all of these, but you have mentioned some. Your lab work will determine whether you are hypothyroid or not, but I still maintain that sometimes a PCP is not equipped to handle and understand the difference from one patient to the next and you are put into an "average" reading and told you are fine. I don't think you are "fine", to put it simply, because you have named not all but some of the symptoms that should be a definite red light to the right specialist. Also, please make sure that you get a print out of all your lab work--it's your body and you are entitled to it--if the dr. refuses that would give me a warning to find somebody else.
The normal range of TSH, T4, T3 in the bloodstream slightly varies from lab to lab. From my reading, a consensus report gives the normal range of TSH in the bloodstream as between 0.45 and 4.5, and lists the normal range of free T4 between 0.8 and 2.0--this was from a 2004 report that I came across in my reading, and this could have changed since then.
Hoping that you get to the bottom of this problem, and am seriously hoping that you will be able to make a change in dr.s for your medical care. I feel that your thyroid is acting up and time to get to the bottom of what's causing all your aches and pains. Bea
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