# Lab result, dueling doctors, need advice.



## lillyjackmom (Mar 13, 2010)

I just got my labs back today and also went to see a homeopathic doctor. Here are my results:

TSH .315 (.450-4.5)
FT4 1.26 (.82-1.77)
FT3 2.6 (2.0-4.4)

B12 380 (211-946)
Iron Saturation 12 (15-55)

I haven't talked to my pcp who ordered the tests yet but I met with the homeopathic dr. today. He basically just looked at my thyroid levels and nothing else. He suggested I add T3. He is prescribing 1 grain "Nature Thyroid" 1/2 tablet for 3 days, 1 tablet for 3 days, then 1 1/2 tablet for three days, then 2 tablets from there out. Right now I am on 100 mcg Levothyroxine. He also suggested I take "Isocort" 3 times/day and a myriad of other supplements, as well as, adrenal injections.

I'm wondering what you guys think of all that. I'm especially wondering about the thyroid replacement. Should I take it all at once in the morning or spread it out? 2 tablets seems like a lot. I know my TSH looks to be hyper. I would love to hear your opinion since I'm really scared to mess around with my medications. When my TSH was .202 my pcp wanted to leave my medication alone now my homeopath wants to change it. Not sure what to think. Also, what do I do about my low iron saturation?

The homeopath, who is an MD as well, said I probably didn't need my thyroid out and that some doctors just like to be aggressive. Mind you I had 25-30 fast growing nodules and was having trouble swallowing. I'm kind of stressed out and not sure who to trust.

Any help would be greatly appreciated.

Stacie


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## hillaryedrn (Dec 14, 2009)

Ok, I have no problem with homeopathic treatment. That said, it bothers me that this person would totally disregard your difficulty swallowing and such a large number of growing nodules! It's not being "aggressive" wanting that thyroid out, that's being smart!! Hello. . . it's interfering with swallowing! Sorry, off my soapbox now. So, why is he prescribing so much thyroid replacement? That seems to be a whole lot when your TSH is pretty low to begin with.


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## Lovlkn (Dec 20, 2009)

lillyjackmom said:


> I just got my labs back today and also went to see a homeopathic doctor. Here are my results:
> 
> TSH .315 (.450-4.5)
> FT4 1.26 (.82-1.77)
> ...


Stacie,

How do you feel?

Is anybody going to address your iron?

A homeopath is naturally going to want you on "Armour", I've never heard of any supporting synthetic and they consider Armour natural.

Looking at your labs you are a bit low on FT-3 but if you are not symtomatic you can stay there. I ran that FT-3 for almost 4 years but suffered from mid day fatigue and constipation because of it.

One thing you could ask for is some Cytomel if you are having symptoms. Starting out by taking 1/2 pill (teny tiny 1/4) split 2x during the day - see how you tolerate as there can be an adjustment period and some hyper symptoms before adding the additional 1/2 pill then having a lab. Your FT-4 may increase as well so you need to be sure it does not go into top range.

My concern with your homeopath goes along with what Hillary stated -


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## lillyjackmom (Mar 13, 2010)

It upset me that since my thyroid is already out he said it probably didn't need to come out since it wasn't cancer. I'm not sure why all the replacement that's what scares me. He never weighed me or asked how much I weigh. I thought it was dosed by weight? He said just keep adding half a tablet every three days until I felt edgy, irritable, or like I wanted to kill someone (he was making a joke). Then back off and take the lesser dose. Should I be figuring that out myself? Is 3 days enough time to know if I should increase it?

I am having extreme fatigue, confusion, brain fog, and constipation, especially in the afternoon. I can hardly function and it gets to the point I'm not comfortable driving my kids around.

The other thing that bothers me is that I had 5 pages of lab work. My pcp tested for a million things because of my symptoms. I saw him scan through it. I had not seen it because it was faxed over directly from my pcp. He told me my FT3 was at the low end of normal and I needed T3. It wasn't until I left his office that I saw several other "abnormalities" on my lab work. I tried calling my pcp when I got home because I was wondering if the low iron could be part of my problem.

Do you think the lowish FT3 and the low iron could be what's causing my symptoms? I'm hoping to hear from my pcp

I haven't started the new med because I'm worried about the dosage. I took my old 100 mcg of Levo.

Thank you guys so much. I'm soooooooo frustrated!!!!!!


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## Debbie from Milwaukee (Apr 18, 2010)

I am also wondering about the "adrenal injections." Did this homeopathic doc do either a saliva test or a blood test to detect low adrenal functioning? I have read that adrenals can be affected if the thyroid is chroinically off. I would agree with you that you need verification from your primary doc before you get into these new prescriptions too much, as well as some explanation about all of the low nutrient levels. Another nutrient that often goes low with thyroid imbalance is ferritin, which is closely related to iron.

Here's another question: had you taken your usual thyroid meds before you got the blood test? If that was true, I wonder if that could have put the free T3 up a bit higher than it actually is. This homeopathic doc may be treating you more on symptoms than the actual blood test reading.


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## Andros (Aug 26, 2009)

lillyjackmom said:


> I just got my labs back today and also went to see a homeopathic doctor. Here are my results:
> 
> TSH .315 (.450-4.5)
> FT4 1.26 (.82-1.77)
> ...


As evidenced by your Frees, it appears you are undermedicated but since you are on 100 mcgs. of T4, I am inclined to think that you also are not converting well. So I agree with the Naturopathic doc.

What bothers me is that on 100 mcg. of T4, your FT4 is below mid-range. That would lead one to think you are converting but then the FT3 proves otherwise.

Now, low ferritin in fact will impede the efficacy of thyroxine replacement. Your ferritin should be 50 to 100. I don't know about the iron saturation but clearly it is low. You might wish to have a ferritin test to double-check before taking any iron. Ferritin is the protein that stores iron for cellular uptake.

Do you know if that test is tranferrin saturation? I am working on the assumption that it is and you know what they say about assumptions. LOL!

The rest of the stuff, I don't know about but I am sure some of our other posters do. Hopefully they will be along w/input.


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## lillyjackmom (Mar 13, 2010)

Debbie- I forgot to mention that my Ferritin is 25 (range 13-150). And yes I had taken my thyroid med in the morning. That's a good point.

Here is how he diagnosed my low adrenal function which made me nervous. He said my heart rate was low. He put his fingers on a pulse point on my left wrist. He said "your adrenals are really low. Your kidneys are in the tank". Then he put his fingers on a pulse point on my right wrist and said I was " a little hypo".

I think he is treating me more on symptoms then actual blood work like you said. My pcp treats only on labs and normal ranges. Ugggggg how do I find some middle ground?


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## lillyjackmom (Mar 13, 2010)

Andros- for my low iron saturation is just says "iron saturation" my Ferritin is 25. Normal is 13-150. I know my pcp will not want to do anything with it since it falls within the " normal range". I'm so confused on what to do here. I agree with the homeopath too but I'm worried about the dosage and going up every three days. Is that ok? Does it seem like a high dose? The end result would be 2 grains.


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## Andros (Aug 26, 2009)

lillyjackmom said:


> Andros- for my low iron saturation is just says "iron saturation" my Ferritin is 25. Normal is 13-150. I know my pcp will not want to do anything with it since it falls within the " normal range". I'm so confused on what to do here. I agree with the homeopath too but I'm worried about the dosage and going up every three days. Is that ok? Does it seem like a high dose? The end result would be 2 grains.


I don't think it would be okay along with the 100 mcgs. of levoxyl you are currently on. And,as you probably already know, ideally, ferritin should be 50to 100 and the closer to 100 the better.

You really "are" sorting this out yourself but I don't think you realize it. You have a great hesitancy with this Naturalopath. That should tell you something. Listen to your insincts.


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## lillyjackmom (Mar 13, 2010)

I totally agree with what you said. He did tell me to stop taking the Levoxyl. Oddly enough I got a really weird feeling as soon as I walked in.

I have an appointment with my pcp next Thursday. I'm assuming she will address the other issues including the iron. Both my WBC and RBC was high. So was something called occult blood. I'm thinking that means blood in my urine. I'm not changing any meds until I see her.

I'm afraid she won't deal with the Ferritin or FT3 because she works strictly with the lab ranges. I'm hoping she will be open but she hasn't been in the past. This is what drove me to the homeopath. I thought he would look at the whole picture including lab work and symptoms. He barely looked at my lab work. I'm so frustrated! I'm not sure what to do now. I'm trying to have faith that she will listen and help me out.

I've been trying to eat very low carb and low sugar. Basically low glycemic index. That helps a tiny bit.

Can you direct me to any good info regarding Ferritin so that I can be better educated and a better advocate for myself during my appointment? Thank you so much for your help and support!


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## Andros (Aug 26, 2009)

lillyjackmom said:


> I totally agree with what you said. He did tell me to stop taking the Levoxyl. Oddly enough I got a really weird feeling as soon as I walked in.
> 
> I have an appointment with my pcp next Thursday. I'm assuming she will address the other issues including the iron. Both my WBC and RBC was high. So was something called occult blood. I'm thinking that means blood in my urine. I'm not changing any meds until I see her.
> 
> ...


You might see if you can find Dr. Gillespie's book. The link under "bunch more" is what Dr. Gillepsie has to say.

Many hypothyroid patients find that having good ferritin levels improves their use of thyroid hormone (their own body's or supplemented). The range of 70-90 is quoted as optimal for hypothyroid patients. Someone on another board asked me if I knew of any research she could show her doctor to support this. He wanted her to stop supplementing iron when she raised her ferritin from 17 to 44.

Here's some of the research I found that suggests a minimal ferritin
range of 50-70 and an optimal range for hypothyroid treatment of 70-90. I have read that in Dr. Gillespie's book, "You're Not Crazy, It's Your Hormones", she advises a ferritin level of around 100. I haven't read her book, so I can't confirm the research basis for her recommendation, but the experience of many hypothyroid patient certainly bear her out.

The normal range for ferritin is usually between 30 and 300 mg/dL, but Dr. Friedman
recommends iron treatment for everyone with a ferritin less than 60 mg/dL. The goal of
treatment is to raise ferritin levels to a value between 70 and 90 mg/dL and is usually
achieved with oral iron treatment. Raising ferritin levels to this range may be needed for
patients with hypothyroidism to have an optimal response to thyroid hormone treatment.
Dr. Friedman's philosophy is proper ferritin levels are crucial
http://www.goodhormonehealth.com/Iron Deficiency and Fatigueaug06.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC156009/

There are a bunch more links here.........
http://boards.fool.com/Message.asp?mid=24943674&sort=username

Also, you could do what we do in our own home. We use cast iron for cooking and we do eat foods high in iron. I am not much of a meat eater so I get mine from other sources.

Table 1: Iron Content of Selected Vegan Foods

Food
Amount
Iron (mg)

Soybeans, cooked 1 cup 8.8 
Blackstrap molasses 2 Tbsp 7.2 
Lentils, cooked 1 cup 6.6 
Spinach, cooked 1 cup 6.4 
Quinoa, cooked 1 cup 6.3 
Tofu 4 ounces 6.0 
Bagel, enriched 3 ounces 5.2 
Tempeh 1 cup 4.8 
Lima beans, cooked 1 cup 4.4 
Swiss chard, cooked 1 cup 4.0 
Black beans, cooked 1 cup 3.6 
Pinto beans, cooked 1 cup 3.5 
Turnip greens, cooked 1 cup 3.2 
Chickpeas, cooked 1 cup 3.2 
Potato 1 large 3.2 
Kidney beans, cooked 1 cup 3.0 
Prune juice 8 ounces 3.0 
Beet greens, cooked 1 cup 2.7 
Tahini 2 Tbsp 2.7 
Veggie hot dog 1 hot dog 2.7 
Peas, cooked 1 cup 2.5 
Black-eyed peas, cooked 1 cup 2.3 
Cashews 1/4 cup 2.1 
Brussels sprouts, cooked 1 cup 1.9 
Bok choy, cooked 1 cup 1.8 
Bulgur, cooked 1 cup 1.7 
Raisins 1/2 cup 1.6 
Almonds 1/4 cup 1.5 
Apricots, dried 15 halves 1.4 
Veggie burger, commercial 1 patty 1.4 
Watermelon 1/8 medium 1.4 
Soy yogurt 6 ounces 1.1 
Tomato juice 8 ounces 1.0 
Green beans, cooked 1 cup 1.2 
Kale, cooked 1 cup 1.2 
Sunflower seeds 1/4 cup 1.2 
Broccoli, cooked 1 cup 1.1 
Millet, cooked 1 cup 1.1 
Sesame seeds 2 Tbsp 1.0

Sources: USDA Nutrient Database for Standard Reference, Release 18, 2005 and Manufacturer's information.

The RDA for iron for vegetarians is 14 mg/day for adult men and for post-menopausal women and 33 mg/day for pre-menopausal women.

http://www.vrg.org/nutrition/iron.htm

I personally avoid soy but other veggies that are goitrogens are not once they are cooked.


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## lillyjackmom (Mar 13, 2010)

Thank you so much for your help and taking the time to post all that info! I've been trying to do some research and understand a little better. I feel much more informed for when I go to the doctor on Thursday. I'm trying to have faith that she will be willing to help. I'm not sure where I would be in this process without you all on this board.

Stacie


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## Andros (Aug 26, 2009)

lillyjackmom said:


> Thank you so much for your help and taking the time to post all that info! I've been trying to do some research and understand a little better. I feel much more informed for when I go to the doctor on Thursday. I'm trying to have faith that she will be willing to help. I'm not sure where I would be in this process without you all on this board.
> 
> Stacie


You are welcome,Stacie!! We would all like nothing more than to see you feeling a whole lot better.


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## CA-Lynn (Apr 29, 2010)

I'm going to be the odd duck here and mention that any odd feelings you get when you walk into a doctor's office should be heeded.

I am not a fan of naturopaths, even those with MD's. My feeling is that the priority seems to be to promote their "products" rather than practice good medicine. Again, just MY observation from stories I've heard from patients' own experiences.


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## lillyjackmom (Mar 13, 2010)

I don't think your an odd duck at all! I'm sure there are great homeopaths but I did get that feeling you mentioned from this one. If I would have bought everything he suggested I would have paid $700. Who can afford that? I had 5 pages of lab work with several abnormalities and he never addressed any of it.


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## Calla (Jun 19, 2010)

Lillyjackmom, may I ask, was the doctor a homeopath or naturopath? I thought you had said he was a homeopath with an MD. Naturopaths are different from homeopaths- and they don't have MDs, they have NDs. They go to different schools and have different certifications, etc. I am personally a big fan of my own naturopath because she listens, suggests tests for my primary care doc to run so I don't pay out of pocket, etc. She also lets me know when she doesn't know what's going on with me! She would never diagnose someone just by checking their pulse (I have been to acupuncturists who do that, but that's part of Traditional Chinese Medicine). Anyway, just wanted to put in a good word for Naturopaths 

In any case, what you said about having a bad feeling is the most important-you need to be with a practitioner that you trust, regardless of what initials they have after their name.


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