Trying to convince my doctor to treat me for hypothyroidism

Discussion in 'Ask For Help or Advice' started by jaa, Feb 15, 2013.

  1. jaa

    jaa Member

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    Hey all,

    Last week I had bloodwork done to measure my serum TSH. I called the doctor's office today and the receptionist told me my TSH was measured at 2.575 mIU/L and the doc noted that my thyroid was fine. I have scheduled a follow up appointment with my doc for Monday, at which point I plan to try to convince him that I am hypothyroid. I will include some relevant medical history and current symptoms in this thread with the goal that you guys can correct any erroroneous conclusions I have made or provide additional ammo I can use to strengthen my case on Monday.

    Background

    I'm a 29 year old male who has lived in an area of Canada with very little total sunshine hours. I was a vegetarian for most of my life (~5yo - 28yo) with some of those years as a vegan. My diet was very low in protein for most of the years I lived at home (~24yo) as neither myself nor my parents knew much about nutrition. For the past year and a half I've eaten mostly a PHD diet and have starting eating Peat style for the past month. I've been active my whole life. Lots of cardio, which I've cut back on in the past year or so, but I still engage in kickboxing which causes some mouth breathing. I've had psoriasis since I was 7 (runs in the family) and was diagnosed with psoriatic arthritis last winter - a few of the joints of my fingers experienced pain and swelling for a few weeks last winter and the winter before, but I experienced zero symptoms since then. My pulse is ~60bpms (up from 50 - 60 before I started peating, though I rarely exercising now); my morning armpit temperature is ~96F (unchanged since I've been intermittently measuring this for a year); and, the last time I gave blood my blood pressure was 101/54. I also have a slight case of panda eyes (whiter skin tone around my eyes) which I've read on the internet is linked to Hashimoto's.

    My Case

    I plan to (re)present my doc with my perceived hypothyroid symptoms - low pulse, low body temperature, cold hands and feet, dry skin, pain and stiffness and swelling of joints, panda eyes, and impaired memory. I will also explain my risk factors - short stature (may indicate hypothyroidism in teens), low protein, lots of cardio exercise, and pre-exisiting auto-immune disease. I will also present him with the following excerpt from http://thyroid.about.com/od/gettestedan ... hlevel.htm:

    "In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because more than 95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

    So that's my case. Please critique!
     
  2. Lucy

    Lucy Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Hi jaa, my concern here is that even if you manage to convince them you are hypothyroid, they might treat you far from optimal. First of all they usually prescribe levothyroxine (synthetic T4), which many people don't improve on or feel even worse on it (in case they don't convert T4->T3 it can have an antimetabolic effect), and also, doctors will probably want to determine the right dose looking at your TSH and not symptoms clearance.

    Therefore I've given up on doctors (my TSH is around 1 so I don't even have much chance to be diagnosed, at least where I live) and just buy my own meds and dose according to symptoms. Doing that got me completely cured once, unfortunately I stopped taking hormones and my health got bad again. Trying to get well again now!

    For more on this problem you can read hundreds of patient stories here https://www.facebook.com/ThyroidAssocia ... 5853958522

    But maybe your doctor is thinking outside of the box?
     
  3. OP
    jaa

    jaa Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Thanks for the advice Lucy. I have a feeling my doctor will want to stick to whatever the guidelines say (he's an older general practitioner), but we'll see. Ideally, I would get my thyroid meds prescribed to me so that my insurance would cover most of the cost.

    I have also contacted Erfa (http://www.erfa-sa.com/thyroid_en.htm) for a suggested list of doctors in my area. Does anyone have experience with that product?
     
  4. Lucy

    Lucy Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Well there's no harm in trying with your doctor as long as you know a few things, like that only T4 can make you worse. Some people will not respond/do worse on desiccated thyroid even and need pure T3. I think Peat often suggests pure T3 first to see you respond to the active hormone, and then adding T4/desiccated, but good luck explaining that to your doctor... ;)

    I don't have experience with Erfa myself but I heard it's one of the best/cleanest brands out there...
     
  5. OP
    jaa

    jaa Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Thanks for the info Lucy. I have a bit of research to do by Monday.
     
  6. ilovethesea

    ilovethesea Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Hi Jaa, I'm in Canada too and I take Erfa dessicated thyroid (plus a little bit of Synthroid but hoping to get off of that at some point).

    Definitely think it would worthwhile asking Erfa for a list of doctors. Otherwise, if your MD won't prescribe it see if you can find an open minded one who works with an ND. I had to go through a loooooong list of endocrinologists who were complete a*holes about me wanting to be on natural thyroid. Finally I ended up getting it from my ND but like you said it's expensive (I paid $60 for 60 tabs) whereas if an MD gives you a script it's around $20.

    Not sure what province you are in, but I believe in BC NDs are allowed to prescribe... in Ontario NDs can't prescribe yet but somehow they can get around the regulations if they work with an MD or something - so that's how my ND was able to sell it.

    Anyway I ended up having to dump my regular MD, and started going to the MD that my ND works with just because she will prescribe me the thyroid. I save a lot of money now.

    However I didn't even know pure T3 existed so I guess looking into that will be my next thing!

    Feel free to PM me if you need my doctors names.
     
  7. OP
    jaa

    jaa Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Thanks ilovethesea. I'm not sure how things work in my province (NL), but I am anticipating a bit of frustration in my future trying to sort this out :D
     
  8. OP
    jaa

    jaa Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Well my doc shut me down. The TSH range in Canada is < 5.0. When I showed him the AACE guidelines of < 3.0, and that they rec'd changing it to <2.5, he said something along the lines of what they are measuring might be different, which sounded like BS to me. I haven't been able to find anything on the internet about it. He took my oral temp (97.5F in the afternoon), and took my pulse (60bpm) and said my thyroid was fine. When I asked about my cold hands and feet, he just said I'm one of those people who gets cold hands and feet.

    Anyone ship non-prescription thyroid meds to Canada?
     
  9. Lucy

    Lucy Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Boy I'd kick his ass if I could :mrgreen:

    I'll send you a PM...
     
  10. j.

    j. Guest

    Re: Trying to convince my doctor to treat me for hypothyroid

    Maybe you could go to another doc and when he says they're measuring something else, say no, look, it's the same thing.
     
  11. kiran

    kiran Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    If only doctors were so easy to convince ...
     
  12. j.

    j. Guest

    Re: Trying to convince my doctor to treat me for hypothyroid

    Yeah, I don't bother going either, just thinking aloud.
     
  13. Isadora

    Isadora Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    I might have just convinced my doctor... My TSH was 6.24 in november. I will check it again and if it is still high, we will start supplementation, despite my euthyroidian Free T4 so far.

    I told her about my Progest-E adventure and she was very much against my continuation of it. She looked at the bottle and said that I should really stop looking for advice on the internet. I 'fessed up to having ordered Cynoplus and Cytomel and she insisted that thyroid supplementation is even more serious business and that one could get a heart attack from careless handling of such stuff. "Ce n'est pas anodyne", to quote her exactly.

    Has anyone dropped out of sight on these forums lately? :poke

    So I'm having new labs done tomorrow. I'm really curious to see what they'll look like after these weeks on a Peat diet. She ordered the Anti-TPO as well... Fingers crossed! :pray
     
  14. j.

    j. Guest

    Re: Trying to convince my doctor to treat me for hypothyroid

    In the Ray Peat Fans facebook group someone posted that her brother died, just didn't wake up. He was young, following Ray Peat's works and using thyroid.
     
  15. j.

    j. Guest

    Re: Trying to convince my doctor to treat me for hypothyroid

    My experience was that after 3 months on the Peat diet I felt a lot better, but my labs didn't reflect much difference. However, those first 3 months I was mostly focused on avoiding PUFA. My TSH dropped from 3.2 to 3.1.

    But the next 3 months I started taking more seriously the advice to consume at least 80 grams of protein per day from dairy or eggs. I started drinking more milk, between one and two liters, and my next test (3 months after the previous test) showed a TSH of 1.7.
     
  16. charlie

    charlie The Law & Order Admin

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    Re: Trying to convince my doctor to treat me for hypothyroid

    She might want to look into the work of Dr. Broda Barnes and maybe even grab his book Hypothyroidism: The Unsuspected Illness.

    I thought the guy was old?
     
  17. j.

    j. Guest

    Re: Trying to convince my doctor to treat me for hypothyroid

    Maybe, I had the impression he was young, but I'm not sure.
     
  18. j.

    j. Guest

    Re: Trying to convince my doctor to treat me for hypothyroid

    Have you read that book, Charlie?
     
  19. Isadora

    Isadora Member

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    Re: Trying to convince my doctor to treat me for hypothyroid

    Very sobering news, thank you, j.!

    R.I.P. :(

    @Charlie: she never thought this was not an illness, she was simply banking on my body's capability of "snapping out of it". She did warn me repeatedly against my Paleo ways, but I wouldn't listen, of course. Nor would she read "Deep Nutrition"... Well, she was right on that one!

    Maybe I still could "snap out of it" based on a Peat diet alone... I wonder if I should simply be patient.

    I think it was this puzzling joint pain that prompted her to change her mind and see if that would improve with thyroid supplementation -- a more "anodyne" option, after all, than hydroxychloroquine (Plaquenil) which was my rheumatologist's idea for keeping a presumed Lupus at bay...

    I am loading up on protein and have done so for most of my life. To me, the great novelty in the Peat diet is the OJ and liberal use of sugar, so I am doing all of that. PUFAs avoidance, of course, gelatin, coconut oil... I might try some goat's milk (yuck!) -- as all the other milk available to me here is not of good quality... Otherwise, I love milk and would have liked to continue drinking it.
     
  20. charlie

    charlie The Law & Order Admin

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    Re: Trying to convince my doctor to treat me for hypothyroid

    No, but I want to.

    I figured that since it was written by a doctor then maybe she would consider reading it.
     
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