# Feeling horrible... going to new doc this week



## Enigma (Jun 13, 2011)

I am feeling worse than I did the first month of meds (see my signature) - my hair is falling out more, I am more tired, brain fog, etc. I know that my TSH is still above where it needs to be, but it is disappointing to have felt good for a month and then horrible for this past month. My doc has been disappointing, always blaming other meds I'm on for my symptoms and also told me that having high antibodies doesn't matter (it doesn't change the way he treats or thinks of the disease). It's just frustrating knowing these things and always having to make sure that he is checking everything.

Anyway, I found a local clinic that is only for women and specializes in thyroid and related issues. I was able to get in early due to a cancellation and will go on Thursday afternoon! They have their thyroid testing and treatment philosophy on their website, which made me choose them. At the very least, if they aren't as thorough as I had hoped, I can reference their website and hold them accountable! It is not so easy with "regular" doctors.

They are also more apt to use Armour/Naturethroid rather than only T4 and also check the T3 levels (according to their site). This has not been an option with my current doc, so this will be a relief. Whether or not Armour will work better for me, I am not sure, but at least they are willing to consider it and are familiar with it so we can weigh all the options.

Do you guys have any advice on how to approach my new patient appointment/discussion? I am hoping that since my thyroid problems are very cut-and-dry (not just symptoms, but wacky blood work, too) that it the discussion will be more of a "This is how we treat this type of situation and this is what I suggest" versus me saying "Plllease look at more than just the blood work because I feel horrible" type discussion.

Here are some excerpts from their website and a link. 
_
In this simplistic approach, the range of TSH levels that is considered "normal" can be quite wide. Many labs in the US consider a TSH of 0.5-5.0 to be within normal range. Within this "normal" range, many practitioners won't diagnose a thyroid problem like hypothyroidism even if it actually is struggling. Outside this range many practitioners will diagnose thyroid disease and write a one-size-fits-all prescription for a synthetic thyroid supplement, usually Synthroid, Levoxyl, or Levothyroid.

*Our approach to the thyroid test*

In publishing new clinical guidelines in 2002, the American Association of Clinical Endocrinologists fairly dramatically formalized a reversal of its previous doctrine, establishing a narrower "normal" TSH margin of 0.3-3.04. At Women to Women, we have used the TSH thyroid test for many years as a screener. And in our view, a woman's TSH level should ideally be less than 2.0, but she should also be thriving and free from hypothyroidism symptoms. If she reports symptoms, or shows a TSH level greater than 2.0, she may have subclinical or clinical hypothyroidism.

For women with more pronounced hypothyroidism symptoms, we feel that the TSH test is inadequate because it doesn't tell us enough about the underlying problem. To do that, we need more detailed tests to show what the thyroid is producing and what is available for the body to use.

The predominant product of the thyroid is T4 (thyroxine), which is then converted by the liver into the usable form T3 (triiodothyronine). There are many causes of inadequate T4 production, including adrenal stress, poor nutrition, and autoimmune thyroid disease. Similarly, many factors cause inadequate conversion of T4 into T3, including lack of adequate nutrients and minerals and poor liver function.

There are blood tests now that provide a complete picture of how well the thyroid produces T4, how much of the active form T3 is created, how well the body converts and uses the T3, and whether there are significant anti-thyroid antibodies present._


----------



## northernlite (Oct 28, 2010)

I work my way from top to bottom and answered you on another post.

Good luck with the new practice, their info sounds wonderful and I am hopeful that you will find people there who will look at the whole person.

As I stated in my post on the other thread, you are still way undermedicated and you need to get that TSH down and make sure your FT3 is going up at the same time. There are not many people on here that would feel well with your numbers. See if the 75 mcg will start you in the right direction.

My personal opinion is to give the T4 route a fair chance before switching to the combo. Since they check FT3 make sure yours is coming up as your TSH falls. The best T3 is the one your body produces so if it will happen naturally let it. If your body no longer converts T4 to T3 well then supplement with T3 added to your T4 or a combo like Armour.

I've been at this since Nov and am finally getting close to the sweet spot for me for the second time. It is a slow process and hard to be patient when you feel so poorly.


----------



## bigfoot (May 13, 2011)

That's great, only a few more days! Just tell the doc how you are feeling, how your treatment has been going so far, and what you are really concerned about. They should be able to take that and run with it. The best treatment in the world isn't worth a hill of beans unless your doc is on board with you.

Congrats and good luck on Thursday! Let us know how it goes... :anim_32:


----------

