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Old 04-26-2006, 05:06 PM   #1
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Angry I got in a little spat with a doctor friend of mine.

Back me up here guys? It's just another example of what we're dealing with. It's really a shame...

Thoughts?

Me- "I also need to learn about what plain old T3 tells me about my thyroid.. sigh. I wish she'd test FT3. According to my labs, my results have dropped slightly since November. My T3 is lower now than it was before I started meds.."

Him - "...but what is your TSH?"

Me - "Last week when my labs were done, it was 0.04; FT4 was 1.1 (.9-1.8); T3 was 121 (60-181)"

Him - "That might be too low; you might benefit from LESS thyroid supplementation..."

(Insert me, looking completley perplexed at him )

Me - "TSH isn't a concern of mine or my doctors. Once you're on thyroid supps, your TSH becomes supressed. She doesn't even usually get it tested. She's been focusing on FT4, I just wish she'd focus on FT3 too. I feel nothing like I'm getting too much medicine, no hyper symptoms at all. Infact I wish she would have given me an increase the other day so we could get my FT4 up higher."

Him - "Endocrinologists would disagree. TSH measures accurately whether or not you're getting an appropriate amount of thyroid based on the best assessor of such things in the world, your pituitary. When you have hypothyroidism, your TSH is elevated, because the pituitary is shouting at your thyroid to wake up. When it's happy, it's in normal range. If you are taking too much, it drops nearly to zero. The only way to assess if you have a sufficient amount of thyroid is seeing what the pituitary thinks, thus the TSH. Most doctors don't bother to order the T3 or T4 once a person is on thyroid supplementation, because they give no useful information."

Me - "That's interesting because everything I've ever seen about it, even what my doctor has told me, it's been reversed. I'd say 95% of the thyroid patients I've talked to have felt *best* when their FT3 & FT4 were in the upper 1/3 of the lab range, with a supressed TSH because they were on medication. It's been my experience though most doctors will have the same reaction you did, thankfully mine didn't. Even after it was supressed she upped my doseage because I was obviously still symptomatic. So many people I've talked to that have doctors freaking out because they think they're hyper, they get their medication lowered despite still feeling hypo, and feel even worse. I realize everyone is different, but there's a connection there.

To be completley honest, I felt crappy when my TSH was between 1 and 2.. I still feel crappy when it's at .04. Then again, my TSH never went above 3 that I can recall which technically meant I was "fine", but I digress.

If you aren't bothering to test T3/T4 once they're on medication - why bother in the first place?

From my point of view: It makes more sense to me to follow what the thyroid is actually producing (once it's determined of course that there's a problem via TSH). Once someone is on medicine (either T4 or T3/T4) doesn't it make more sense to test *those*, since that's what you're prescribing to make sure dosing is correct? TSH isn't a reflection of either. TSH is a reflection of how the pituitary is acting. Just because the pituitary gland seems to be ok, whos to say the thyroid gland is functioning happily too?

What a TSH result tells me is that my pituitary gland is going "hey! Do this!" and it does, or doesn't. The pituitary doesn't control what the thyroid produces once there is a thyroid problem. It tries, but clearly the thyroid is fatigued/distressed and something isn't right. How can you be sure T3 and T4 are being produced correctly if the TSH is out of whack?

I've always seen TSH as a good check all sorta thing. It's a good screening test to do, but once it's known someone has an issue (the exception being something like hashimotos where TSH is all over the place) to monitor TSH sure, but to follow the actual thyroid produced hormones.

Honestly, I just wish there was more research done on all this. So many people are under treated and suffering, and I think doctors could really use a crash course on thyroid functionality as well. Keep an open mind, ya know? I'm not trying to argue with you here, but I think it would help if 1- there was more research done, and 2- if doctors would stop worrying about the labs so much and start worrying about how their patients feel. It's just as bad for your body to be hypo as it is hyper.

Last edited by irys; 04-26-2006 at 07:23 PM.

 
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Old 04-26-2006, 07:09 PM   #2
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Re: I got in a little spat with a doctor friend of mine.

That was probably the best explanation I have ever heard that every medical professional needs to hear.

BRAVO!

 
Old 04-26-2006, 07:32 PM   #3
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Re: I got in a little spat with a doctor friend of mine.

*bows* I was having a particularly clear brain-fog moment. LOL


I need to like print that out and send it to every doctor in the world..

 
Old 04-26-2006, 08:49 PM   #4
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Re: I got in a little spat with a doctor friend of mine.

Well, Iíve always found research supporting your arguments to be fairly easy to find. Iím not sure that there isnít enough of it to prove what we already know, to these practitioners.

But considering the influence pharmaceutical companies have over the curriculum in medical schools, and the vastly increased influence once Doctors are in practice (not to mention the financial incentives)Ö.. is it any wonder TSH is master?

If you could get Doctors to ignore the actual thyroid hormones, nobody would ever know the T3 levels. If you could instead, get Doctors to just focus on TSHÖ just think how much T4 med you could sell?

And if you could even get Doctors to somehow believe that your T4 med was better than the other T4 meds, even though they are bio-identicalÖ. You could charge twice as much for them. Hmmm, wonder whom Iím talking about?

Good for you. Glad you stuck to your guns!
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Old 04-27-2006, 05:28 AM   #5
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Re: I got in a little spat with a doctor friend of mine.

Quote:
Hmmm, wonder whom Iím talking about?
I know, I know!

$ynthroid!!!

 
Old 04-27-2006, 05:35 AM   #6
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Re: I got in a little spat with a doctor friend of mine.

*sigh* See, he just didn't listen to a word I said.


His response:

"I studied under one of the best endocrinologists in thyroid in the country, and he wouldn't have agreed with this, but I'm not treating you, and I will withdraw. I apologize if I've caused you any distress..."


My response to that:
"You have no need to apologize. I'm trying to understand, I'm trying to educate myself.. I just think it's rather upsetting that (at least most of the ones I've dealt with) doctors get so set in their ways that they don't realize that things they previously knew could possibly change. Why do you think endos are realizing now that a TSH shouldn't be as high as 5 and they are lowering the ranges for it to 3? Again, more research.

That is what upsets me."


(I'll also mention to y'all that he didn't know the TSH ranges were being lowered and when I sent him the article? He said he didn't know who the AACE was. Some endo he studied under, huh? ) This is also the guy, upon mentioning I was on 90mg of Armour told me I'd do just as good to be on a water pill. That it was "doing nothing for you."

It's not that I want him to apologize, it's that I just want him to READ what I said. ugh. MEN. Well, his apology was good I guess, except I don't think he understands WHY he feels the need to apologize. I didn't think my previous response to him was particularly nasty or anything..



EDIT: I reallyreallyreally want to thank him for being the one that *isn't* treating me, but I'll be a good girl and bite my tongue.

maybe.

Last edited by irys; 04-27-2006 at 05:49 AM.

 
Old 04-27-2006, 05:59 AM   #7
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Re: I got in a little spat with a doctor friend of mine.

Good girl!

And maybe, just maybe...(lots of wishful thinking here...) He'll share his new found knowledge with his friend which is "one of the best endocrinologists in thyroid in the country". I would like to be a fly on the wall if THAT confersation ever takes place!

Just imagine and endo that doesn't know what the AACE is. Hmmmmm...
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Old 04-27-2006, 06:08 AM   #8
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Re: I got in a little spat with a doctor friend of mine.

Knowing him, he probably just rolled his eyes at me and will continue mis-handling his thyroid patients.

 
Old 04-27-2006, 06:17 AM   #9
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Re: I got in a little spat with a doctor friend of mine.

Quote:
Originally Posted by irys
Knowing him, he probably just rolled his eyes at me and will continue mis-handling his thyroid patients.
You could very well be right.
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Old 04-27-2006, 06:33 AM   #10
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Re: I got in a little spat with a doctor friend of mine.

Hi irys! Thanks for sharing you little spat!
I feel better when I tell someone something I believe to be true, even if they don't accept it or follow it. At least they have been informed. That is all we can do - get the message out to as many as we can. Maybe the next person you have a conversation with will have some "clout" and actually get the ball rolling on changing the views of the medical profession. MOST of the medical profession rely on their books and tests, which they are reluctant to change without a LOT of proof. WE just need a few more converts and studies!

Oh, BTW, it is not just men! There are MANY women docs who are just like him! It's bad doc vs good doc.
Divermon & Midwest: My old female practitioner doesn't prescribe levothyroxine - only $ynthroid. My pharmacist even prefers Levothyroxine over $ynthroid.
That $ sign was great, midwest!
Hyperkim - AACE - isn't that a bandage?
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Old 04-27-2006, 07:15 AM   #11
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Re: I got in a little spat with a doctor friend of mine.

You guys are killing me!!!!!!!

BOY, if it wasn't for humor where would we be?
(besides the local jail for homocide?)

 
Old 04-27-2006, 08:33 AM   #12
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Re: I got in a little spat with a doctor friend of mine.

Ya'll got me with a really silly grin stuck on my face now. Hey maybe it'll last all day! That just kills my family when I get in a goofy mood. Woohoo!
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Old 04-27-2006, 02:05 PM   #13
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Re: I got in a little spat with a doctor friend of mine.

Quote:
His response:

"I studied under one of the best endocrinologists in thyroid in the country, and he wouldn't have agreed with this,....
And yet, he has no clue as to who the AACE is. I guess it was just his ego talking.

So sad that these people are practicing medicine.
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Old 04-27-2006, 02:55 PM   #14
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Re: I got in a little spat with a doctor friend of mine.

Quote:
Originally Posted by irys
*sigh* See, he just didn't listen to a word I said.


His response:

"I studied under one of the best endocrinologists in thyroid in the country, and he wouldn't have agreed with this, but I'm not treating you, and I will withdraw. I apologize if I've caused you any distress..."


My response to that:
"You have no need to apologize. I'm trying to understand, I'm trying to educate myself.. I just think it's rather upsetting that (at least most of the ones I've dealt with) doctors get so set in their ways that they don't realize that things they previously knew could possibly change. Why do you think endos are realizing now that a TSH shouldn't be as high as 5 and they are lowering the ranges for it to 3? Again, more research.

That is what upsets me."


(I'll also mention to y'all that he didn't know the TSH ranges were being lowered and when I sent him the article? He said he didn't know who the AACE was. Some endo he studied under, huh? ) This is also the guy, upon mentioning I was on 90mg of Armour told me I'd do just as good to be on a water pill. That it was "doing nothing for you."

It's not that I want him to apologize, it's that I just want him to READ what I said. ugh. MEN. Well, his apology was good I guess, except I don't think he understands WHY he feels the need to apologize. I didn't think my previous response to him was particularly nasty or anything..



EDIT: I reallyreallyreally want to thank him for being the one that *isn't* treating me, but I'll be a good girl and bite my tongue.

maybe.

You doctor is dumb as dirt. As someone once told me "what do you call the person who graduated dead last in his medical class" DOCTOR

 
Old 04-27-2006, 07:07 PM   #15
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Re: I got in a little spat with a doctor friend of mine.

do you mind if i print this? my TSH is 0.32 and i to feel like crap still. You've come to help me think more about the T3 and T4.


I applaud your courage for standing up for yourself! not many of us do that.

~J

 
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