I would really welcome any advice on this one. Today I went to see an endocrinologist. I wanted a second opinion about my thyroid test results. TSH 5.36 (upper limit 4.20, I'm in the UK), T4 15.6, (12-22) and antitpo 7.7.

The endo listened to my heart and felt my throat area. He asked for some medical history. I infomed him that I had been diagnosed with PCOS, and that my cycles had become regular for the first time in my life at 40. I have one ovary. That my GYN recommended HRT in April for the problem of night flushes/warmth and occassional insomnia. That because of a family history of breast cancer I did not want to take HRT and had been trying to find an alternative approach to the night sweats which had been a problem in Nov/Dec and March/April and at my two recent periods in JUly. I explained that I have been seeing a naturopath since May who recommended acupuncture and I seem to be having some relief. I explained that last week during AF week I had felt emotional, that there were times when I felt tired. My hands and feet feel cold at times. As my periods changed I have found that I need to eat more regularly and maintain my blood sugar levels. I told him that I take vitamins and supplements and that my recent dietary analysis with my naturopath confirmed that I am eating a pretty good diet. I excercise. I explained that there are times when I can't remember things. I have posted here about it. I think that's me in a nut shell.

He said 'OK, lets PARK the thyroid issue. It is sub clinical and you don't need anymore tests. Nothing you are experiencing is related to your thyroid. Your other symptoms are caused by depression. You don't really need to be taking vitamins. It's a money making thing. People like that (my naturopath) will take your money and tell you what you want to hear. You are looking to find something wrong with you!!!' That's about the gist of it.

I half expected his opinion to not treat my thyroid as I know medical opinion is split on whether or not to treat subclinical thyroids. Basically he is saying if your TSH goes over 10, then we'll treat you.

What I did not expect was to have to listen to him dismiss my efforts at dealing with my peri symptoms, with diet, excercise, and in the absence of HRT, as naturally as possible.

He finished by saying that if I did not listen to him and do as he said he could not treat me. I came out feeling bewildered, upset, frustrated, confused and in disbelief.

Am I missing something here?

robin

OMG Robin! What I would say is RUN from that doctor. Do you have socialized medicine in the UK? Can you see another doctor? Can you just get the naturopath to treat your thyroid? Stop the Thyroid Madness has a page on the UK, maybe it would be helpful for you to read it.

Kathy

Robin,
Actually, sub clinical hypothyroidism is when you lab results are withing the range but you experience symptoms of HypoT. Your TSH is over the range, it should be less than 2 or optimal around 1. But your Ft4 is withing the range, although on the lower side. The other thing to look at would be FT3. Both Ft4 and Ft3 are optimal in upper third of the range for you to feel good. In your case is not subclinical, but it may be wise to incorporate more iodine containing food into your diet: seaweed, fish, seafood, etc. Using right salt ( not refined, celtic salt) makes difference in thyroid function. overall, I believe menopause and HypoT symptoms are overlapping, so it is hard to differentiate.
To the fairness, I have had the same symptoms for 2-3 years at the beginning of perimenopause: cold hands and feet, brain fog, depression, crushing fatigue, and had multiple and extensive labs done on thyroid- all within the range. I think good diet with enough protein, veggies, fruits and good fats is essential, but vitamins and supplements are not. if you eat right, you get enough of everything.
I used to take handfuls of supplements, vitamins, etc. suggested by my naturopathic dr. and they only impacted my digestion. Once I stopped, I don't see any difference in the way I feel, it is ONLY related to hormonal swings. I have read every possible book on thyroid, since I was positive to be HypoT back then (self-diagnosed), but then I have talked to few good Endos I trust, they explained that many drs make living treating every middle age women for hypoT, Rx thyroid hormones (especially Armour) and this causes more problems down the road.
But by all means, get a 2nd opinion, and see another Endocrinologist. Sometimes, you need a small amount of Synthroid to feel better instantly. Boosting your thyroid when is not needed may make you feel a bit better initially, but shorten your life overall. Another thing to be looked at is adrenals, with adrenals not being "optimized" starting thyroid hormones will not make much difference.
Thyroid is known to start "limping" if your are stressed or if your hormones are swinging, as during perimneopause when hormones fluctuate.
it has gotten much better int erms of feeling tired and cold hands, but some symptoms has been replaced with terrible anxiety and mood swings, so I know it is my wicked hormones, that fluctuate hourly, and this affects thyroid hormones as well.
You can get another lab done and see if the numbers are consistent. But don't get frustrated only because you did not get a script for hormones, it may be wise to wait and see if you really need it.
best of luck.
I.

Robin:
I'm gong to weigh in her with my two cent's worth. The technical definition of subclinical hypothyroidism is a TSH out of range but T3/T4 levels in range. The ACOE now recommends treating anything with a TSH over 3..especially patients with positive antibody titres. But..that being said, one of the wisest things I ever heard a doc say is to believe the patient in front of you, not the lab results. Ultimately..you're the boss.
I agree that thyroid symptoms (both hypo AND hyper) can mimic peri symptoms, but it is very important..in fact critical that hypothyroidism be treated. Google Mary Shomon and thyroid for more info.
Avi

Ladies-

This caught my eye because these past months have been a nightmare without end for me. In the course of testing my blood for
progesterone and estrogen etc., gyno said the TSH came back low(.206 and the range was .350 to 5.5) while the Free T4 was normal (1.10 - range being .61-1.76). He told me to see an endo. From my readings, could be alot of things including stress which has been unbelievable.

In any case, I had read that thyroid issues can cause muscle pain. I have been in horrid pain and the wacky doctors are now
telling me I might have Lyme (highly unlikely) and put me on antibiotics. I'm desperate so I figured I'd try them.

Question- can out of whack thyroid (hyper in this case) cause severe pain- back, leg, neck?

Tried to get appt. with endo but they are all on vacation as one would expect. Is this something they would just watch?
I have been in a downward spiral and wonder if the wacky thyroid is part of the cause or simply an end result of the stress and pain.

Aviano-been meaning to write you and Kelly about this. This is the first abnormal result I have received regarding thyroid.
I'm so glad you had good experience with Vliet.

Iradan-your comment about limping thyroid and stress/peri rings true. Don't know whether to investigate further.

Robin- I know how you must feel after your appt. For doctors, its black or white. If you are not feeling too bad, I would stay away from MDs as long as possible! If I wasn't so far gone, I would take my own advice! I'm baffled by this too- I have always been on the bottom normal range of TSH and had cold hands and low temp. I don't know what to make of any of this anymore.

Robin

I know you saw a BUPA doc on this occassion. Can you get your GP to refer you to an NHS one for a second opinion?

I experienced very similar to you when I saw a Cardio about my palps. He denied it was peri, said I was too young for hormones to be the cause at only 42, said everybody (including him and his trainee who was sitting in) had these skipped beats just as frequently as me (oh right, all day every day, every 2-7 beats then) and that I just should ignore them like they did , said Magnesium wouldn't help at all (but agreed it was harmless to take) - basically dismissed my problem completely as non-serious so.... go away!

...oh and then he contradicted himself by saying he sees many women of my age with this but they don't know why!!!!He denied palps had anything to do with stomach issues too yet my GP afterwards said he sees many people with both and thinks there is a link.

To quote my GP these "experts" know an awful lot about very little! Chin up Robin, these consultants are pompous, arrogant, insensitive fools!

The things that helped me were reading what others have done on PS and also the acupuncture as you know. Virtually no palps for 3 months now!!

Have you asked if your naturopath help with thyroid probs?

As for vitamins being a money-making exercise - ha - he is a private BUPA doc so what exactly is he doing then!!! You could always report him to BUPA and demand that you see another! Failing that i would try the NHS route - you should be entitled to a visit to another doc through that! (Oh and I would go armed with paperwork this time that state people over certain levels should be treated and stick it under the guys nose if he gets stroppy!!!)

Lidgey - yes, that's a good idea to get your thyroid tested - it wouldn't hurt

just to add my humble opinion. when there is any question with a thyroid issue, do what ever it takes to find a doctor who will listen and treat symptoms NOT LABS. yes labs are important, but not as important as how YOU feel. if a thyroid problem rears it head, and is not treated, more than likely, you are not going to feel well !! it is a HUGE part of well being, as it affects every cell in the body. just an example: i have a good friend who stays busy all the time. she complained of the normal symptoms of low thyroid and female hormones. i begged her for months to get a REAL thyroid panel done. she finally went to my doctor, and she has FULL BLOWN HASHIMOTO DISEASE. i know people don't take it seriously when we suggest getting these thyroid antibody test done, and the free t3 and 4 levels, but i can't stress enough how important this is if your having symptoms. THE DOCTORS ARE MISSING THIS .

LIDGE, you sound like you have maybe a little hyper going on here, but i will let aviano answer that. she has more knowledge in that area. but yes i do know hyper can have some very severe symptoms. some are the same as hypo. you need to have these antibodies checked:
thyroid peroxidase
antithyroglobulin
thyroid stimmulating immuglobulin
my spelling of those may be a little off (brain fog)

Hi Robin, I can't comment on the thyroid thing specifically. But as far as the doc telling you that taking vitamins is a waste of time, and that naturopaths are just out for money...Well, I guess that doesn't surprise me. Traditional docs are taught traditional medicine, and are very often suspicious of anything "alternative"! I agree with the others, try to find a doc who at least respects your choices and your decisions in regards to the vitamins and naturopath.

Regular docs are so behind the times! When I saw mine last year, I mentioned something about bioidentical hormones, and he huffed and said, "I wonder where they get those from anyway." He wasn't even the least bit familiar with them! That's okay with me, because I'm not seeing him for the bios, I am just going to him for the basic health stuff. The thing is, his attitude does not make him look smart, it makes him look dumb, LOL!

Good luck!

Lidge:
The TSH of .2 is low and may be indicative, as KellyJ says, of hyPERthyroidism..You doc's advice to see an endo is relevant as the course of this disease can sometimes be perilous. Have your endo/doc check Free T3 and TOTAL T3 and T4 levels. In addition, antibody tests for Hashimoto's/Graves (TPOAb, TSIAb, TRAHAb) should be checked. If these are all normal and your Free Thyroid levels are low..this is indicative of a pituitary problem..even MORE of a reason for a good endo evaluation. If it ends up that you have Graves, check out the book "Graves Disease" by Elaine Moore. Elaine runs a Graves disease forum on the about.com site and is to hyperthyroidism what Mary Shomon is to hypo..
Good Luck and let me know if I can help more.
Avi

Hi 584296a, Iradan, Avi, Lidge, Squigs, kelly and Greenie

Thank you all for your advice, support and encouragement in this. I have of course read every one of your replies. Firstly, please forgive me if I don't reply individually to each of you now. It is just that I am due to leave on our family holiday shortly and have been rushing around doing all of the last minute packing, washing, well you know how it is. We have to be up at 3.00am to get to the airport on time!!!!!!!

I had hoped that this endo would recommend a full thyroid screen. Unfortunately that wasn't the case. Yesterday I 'Asked the Experts' for advice as well and have been encouraged by that advice. I have made an appointment with my GP for after the holiday and will be talking over the recommendations with him.

The lab that did the last set of tests via my GP recommended retesting in 6 months. The endo however said no further testing. I have also managed to speak briefly to my GP yesterday and he is happy to retest as per the labs original recomendation if I need that option.

My naturopath uses a lab too and they do a full thyroid panel of tests. I suppose I thought that as we already pay for private BUPA cover that it seemed sensible to try to get further testing by a BUPA endo, the cost of all tests would be covered by that policy. Not the case.

Well, once again thank you all. Will let you know how I get on and what I decide to do!

Hugs
robin

Well back from holidays and still confused by what I should do about this.

I went to see my GP. Explained what the endo had said. GP says I am not depressed. I could have told him that. He says to stick with the acupuncture for the menopausal flushes. Although he is happy to retest my TSH again he does not see it as necessary to treat now.

Haven't seen my naturopath for 6 weeks and am feeling pretty good. No night warmth.

The thing that confuses me about my naturopath is this. He says that the acupuncture will help the thyroid and also he does not advise me, he just gives me website details and tells me to read up about it. He has not given me HIS medical opinion. I am paying him for some kind of direction.

My GP says that with my thyroid levels as they are I won't be having any symptoms attributable to thyroid. Endo says only treat when TSH is above 10.

Could this settle on it's own? Is that possible? Should I wait a couple of months and get my GP to retest my TSH, T4 and Antitpo? Do I find another naturopath? These are the kind of questions I am asking myself now.

robin

Kathy

Thanks for your reply. I first started seeing my naturopath in May with concerns about two things. Night flushes, which were keeping me awake and my thyroid results. His advice has been to treat me with acupuncture. At first I thought that he meant that the acupuncture would just treat the night sweats but he later said he felt that the thyroid should improve with it too.

I have visited the Stop the Thyroid Madness website and continue to try to get better informed about this.

thanks again for your support
robin

Iradan thanks for your advice about diet. I overhauled my diet about three years ago and added some vitamins and supplements for several peri symptoms that I had at that time. My naturopath did a dietary analysis and the only significant thing was my diet is low in iron. I will definately look at adding more iodine if that will support my thyroid. At not time has my naturopath suggested any vitamins or herbs or supplements.

I definately went through a very stressful time about 4 or 5 years ago and so I suppose the stress of that could have started or contributed to the problem.

If you don't mind me asking what sort of problems would there be later on from treating the problem now with Armour as you say?

I wasn't frustrated about not getting a prescription but rather with this endos dismissive attitude and reluctance to answer my questions. Since we expected to pay for his time I felt that the least he could do was to answer any questions I had.

I'm with you I need to know all the facts before I agree to take something.
Sorry you are having terrible anxiety. That really s*cks. Hugs to you robin

Hi Avi

This is the confusing thing. How I feel and the lab results. Generally I feel fine. However there are days when I feel tired. Obviously when the peri stuff decides to kick in from time to time it is difficult to know if it 100% peri or whether it would be thyroid too. (Hope that makes sense). There were times when I wasn't sleeping well. Waking up warm, so thats peri. There was a period a couple of months ago when I would wake up and feel 'yukky' for a bit then feel okay.

My GP says that I won't be having any symptoms as a result of thyroid. If that really is true it makes my easier cos I know it is peri.

robin

robin

Lidge

My GP basically says that the more opinions I ask for the more conflicting opinions I will get and he is right. Each doctor/specialist has his own medical opinion. How are we expected to know what to do.

Lidge I hope you are finding some answers.

thanks and hugs
robin

Squigs

You are right this one was pompous and arrogant. He said if you don't do as I say I can't treat you. Really. I thought I was asking for his opinion. I thought he was being paid for his opinion. I thought that was the way a consultation worked.

He did say he would not charge me for the consultation. When I got back from holidays there his invoice. I sent it back and reminded him that he had actually decided not to charge me.

I am not sure I have confidence in my naturopath about the thyroid issue. The acupuncture and the night sweats yes.

I am so glad that you have not had any palps for 3 months.

hugs robin

kelly

This is the confusing thing. With my peri stuff, which the main problem is night sweats. The night sweats don;t happen all the time. I will have a spell of them, feel rough and then they subside. It may be weeks or months between each bout. Same with the sleep. I can sleep well most of my cycle but have a restless nights sleep before and/or during my period.

So, I really don't know if I am having any symptoms of hypothyroid. I mean I definately have cold hands and feet, always have had. There are times when I feel tired. I definately don't have eyebrows which are hardly there for the last third. I am not losing my hair. In fact I have always had a thick head of hair and I don't have a weight problem. I sometime can't remember things. How do I know if that is thyroid or just peri.
robin

Greenie
I really appreciated your support on this. There was a time when I was eating on the run and not a particularly balanced diet and my body was not happy. I know that it needed the extra support of supplements. My hair and skin improved. My overall health improved. I can't take HRT, don't take any prescription meds so if flaxseed oil, evening primrose oil and some vitamins make me feel good then I am going to take them.
thanks you greenie
robin

robin, the only way to know for sure is to get a full thyroid panel...you can order this for yourself and take it to a lab, but you will have to pay for it. i don't know the site, but if your interested, i'll get it for you. it would be well worth the money. hugs, kelly

Hi kelly

This is where I was about two months ago. My GP won't agree to a thyroid panel just retesting my TSH T4 and anti tpo.

I know I can get a thyroid panel done via my naturopath, but I am not sure I have the confidence that he will know how to interpret it? Confidence in my naturopath is low at the moment because of his lack of direction of this whole situation generally, really from the first consultation with him. He has all of my results yet when I go for acupuncture for night sweats he never brings up the subject unless I do.

hugs
robin

I phoned to make an appointment for a six month retest of my thyroid and last week the only result that came back was a TSH. This was 3.29, down from 5.36. After three phone calls to the surgery to ask them to check the results it turns out that only a TSH was requested not TSH, T4 and antitpo.

Why is this so difficult? So next week I'm going to go back for another blood test and double check that they are asking for the right tests.

Is there anyone else here in the UK who is having problems getting good advice from doctors or endos about thyroid levels and options about treatment and monitoring.

thanks
robin