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    Old 03-25-2005, 11:15 AM   #1
    kacl
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    Post Report on Dommisse Consultation

    Hi Everyone, I have Hashimoto's and like many on this board, I've had a hard time finding a good doctor. I learned about Dr. John Dommisse on this board from Meep and others and got his paper on the treatment of hypothyroidism. My TSH does not behave in the textbook fashion and after going through 4 TSH worshipping doctors, I decided to cut to the chase and see Dr. Dommisse. Midwest was interested in a report on my experience so here it is.

    I live in Southern California and Dr. Dommisse is in Tucson, Arizona, but he does phone consultations so I didn't have to go to Arizona. To get an appointment I needed to fill out their new patient forms, send in copies of my previous medical records, and prepay for the first two appointments. The first appointment is a phone appointment, which is just like an office visit. We went over my past history, symptoms, etc. Based on that he ordered a bunch of blood tests and sent the lab requisition to me in the mail. I was able to go to a lab covered by my insurance for the blood tests. I got my blood drawn at a local draw center and then they sent the results to Dr. Dommisse in Arizona. The second appointment is an analysis appointment where Dommisse goes over the results and writes up recommendations for supplements and prescriptions. Then the office mailed copies of all the test results and Dr. Dommisse's recommendations and prescriptions to me. I have been able to get the prescriptions filled at a local pharmacy.

    In addition to the usual thyroid blood tests, Dr. Dommisse also ran tests for a lot of other stuff: vitamins, minerals, amino acids, mercury, aluminum, insulin, insulin-like growth factor I. I wasn't sure if the non-thyroid tests would show anything, but they did. Not surprisingly, my thyroid tests showed I'm still hypo, but I also have some vitamin and mineral deficiencies. For vitamin E I'm high on the d-alpha tocopherol component, but low on the beta and gamma tocopherols. I'm also deficient in vitamin D, potassium, chromium, and calcium. The insulin-like growth factor I is also low, which indicates low growth hormone. On the one hand it's discouraging because I'm still a mess, but on the other hand, there is hope I will be able to get better with Dommisse's help.

    So far I'm taking Vitamin D3, calcium, magnesium, chromium, gamma vitamin E, and prescription potassium. When I first started treatment for the hypothyroidism, I tried Levothroid and did horribly on that. I also tried Levoxyl with similar poor results and then switched to Armour, which I've tolerated well. Dr. Dommisse thinks I had trouble with the T4 meds because of the mineral deficiencies and possibly because of sensitivities to the fillers/binders. I don't think the problem was the fillers/binders, but he may be right about the mineral deficiencies. He's prescribed an additive-free compounded T4 med, which I will be starting next week now that I've been taking the minerals and vitamins for a couple of weeks. I'm a bit nervous about it given my past bad reactions to T4-only meds, but at least I have a good supply of Armour on hand if I need it.

    Here's some interesting things I've learned. Dommisse says the dialysis method is the most accurate for the free T3 and free T4 tests, which is what he uses. This method is the least likely to get skewed by abnormal binding proteins, etc. The thyroidmanager.org web site has some really good information about all the different types of blood tests. I've also learned that potassium helps move thyroid hormones into the cells. So potassium deficiency can be a factor in cellular/peripheral resistance. I've noticed that I seem be using up my thyroid hormones a little faster since I've started taking the potassium. Depression is one of my hypo symptoms and when my levels get too low, the depression gets really bad. About a week after starting the potassium, I was getting really depressed and I had to bump up my Armour a smidge to compensate. So my personal experience seems to correlate with the potassium/thyroid info I found on the internet.

    As Meep has reported in the past, Dr. Dommisse does recommend taking thyroid meds, even T4-only meds, after meals. Meep doesn't agree with this and I'm in Meep's camp on this one. But it's easy enough to quietly ignore that bit of advice. Otherwise, I think I have a good chance of getting better with Dommisse's help.

    Katherine

     
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    Old 03-25-2005, 01:16 PM   #2
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    Re: Report on Dommisse Consultation

    Thanks so much for taking time to describe your experience. Sounds as if you have every reason to be hopeful.

    Do I understand he wants you to quit your Armour... which you tolerate well... in favor of this special T4... which you may not tolerate at all? I don't understand why he'd want you to switch. Does he not 'believe in' natural T4/T3 meds?

    Isn't it amazing how the garden-variety general practitioner has no interest at all in these sorts of vit/mineral deficiencies... when obviously, they can make all the difference in a person's health? They just want to dish out pharmaceutical coverups for every symptom the deficiencies cause.

     
    Old 03-25-2005, 01:29 PM   #3
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    Re: Report on Dommisse Consultation

    I'm not trying to step on toes here but I was on Armour for 2 mos. and did miserably despite the constant dose increase. I was feeling hyper and hypo and gained a ton of weight. All Hypo symptoms returned with a vengeance. What I'm trying to say is we're all different. I do know people that said Armour gave them their life back which is what made me want to try it. It just wasn't a good fit for me. So maybe the compounded T4 will work for you or maybe it won't. You don't know what will work until you try it but Armour isn't for everyone. I'm sure it works well for most but just not for all.
    In hindsight I felt much better on Thyrolar which I just started again today. Let's hope I still do OK on it !

     
    Old 03-25-2005, 10:50 PM   #4
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    Re: Report on Dommisse Consultation

    Yes, Midwest, he does want me to quit the Armour and try the compounded T4 med. Based on interviews he's done with Mary Shomon, I don't think he's against T4/T3 meds in general and he didn't say anything against Armour in my first phone appointment. I'm not sure why he wants to try the T4 only first. I will need to discuss that with him during my next phone appointment, which is in May. I am nervous about trying this because I had such a bad time of it before, but if I start to go downhill, I will switch back to the Armour and call his office.

    Juner50, everyone's different. Some do better with the synthetic meds and some do better with the natural ones. I'm not saying the synthetic T4 is bad in general. I just didn't tolerate it well. When I tried the Levothroid the first time, it made all my hypo symptoms much worse including the depression. I was suicidal within a week and a half. It was scary. I think I had such a hard time because I don't convert T4 to T3 very well. I do well with Armour's ratio of T3 to T4, which can be too high for some. I might do just as well with Thyrolar, though. I haven't tried it so I don't know.

    It is amazing more doctors don't check the nutritional stuff. Sometimes drugs are necessary, but if you can fix a problem by correcting a deficiency, that seems like a much better way to go. Well, it's better for the patient, not so good the pharmaceutical companies' profits.

    Katherine

     
    Old 03-26-2005, 07:59 AM   #5
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    Re: Report on Dommisse Consultation

    Wow... What an experience! (from the earlier T4 treatment)
    I couldn't tolerate T4 either. Was hypersensitive to even the smallest dose, and went hyper within a few weeks.
    But my goodness... you were suicidal from it? That's very scary. I'll keep fingers crossed it works better for you this time.
    Please let us know how Dr. D's treatment goes from here. We all learn so much from each other.

     
    Old 03-30-2005, 06:19 PM   #6
    kacl
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    Re: Report on Dommisse Consultation

    Hi Midwest,

    I thought you might be interested in this. I tried the T4 (in place of the Armour) and started feeling bad again so I called the doctor's office. It turns out I misunderstood Dr. Dommisse's instructions. He meant for me to take the T4 in ADDITION to the the Armour I was already taking. (Of course, it didn't say that anywhere on the stuff they mailed me and he didn't give me a new prescription for the Armour. ) That makes a lot more sense because my blood tests showed I was still quite hypo on the dosage of Armour that I was taking. So I expect things will go better now that the instruction SNAFU has been straightened out.

    Katherine

     
    Old 03-30-2005, 11:48 PM   #7
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    Re: Report on Dommisse Consultation

    Quote:
    Originally Posted by kacl
    Hi Midwest,

    I thought you might be interested in this. I tried the T4 (in place of the Armour) and started feeling bad again so I called the doctor's office. It turns out I misunderstood Dr. Dommisse's instructions. He meant for me to take the T4 in ADDITION to the the Armour I was already taking. (Of course, it didn't say that anywhere on the stuff they mailed me and he didn't give me a new prescription for the Armour. ) That makes a lot more sense because my blood tests showed I was still quite hypo on the dosage of Armour that I was taking. So I expect things will go better now that the instruction SNAFU has been straightened out.

    Katherine
    "He's prescribed an additive-free compounded T4 med," Thats interesting..I was unaware of the fact that they could actaully do that..If you dont mind me asking what is the name of the compound t4 you are taking? My curiosity is peeked... : ) take care

     
    Old 03-31-2005, 06:31 AM   #8
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    Re: Report on Dommisse Consultation

    Katherine...
    I was quite puzzled about his switching the Armour for T4, but I figured, what the heck... My "Thyroid Idol" must know what he's doing !
    I'm sure glad you got it all straightened out. Hope you're on your way to as instant a recovery as it's possible for hypos to have.
    Thanks for the update.

     
    Old 03-31-2005, 09:35 AM   #9
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    Re: Report on Dommisse Consultation

    all,

    it is astonishing that NO doctor, in my experience, has seen fit to discuss nutritional issues with me -- finally i went to an ND, and she has done me a power of good, but it took time ...

    interestingly, when i told my GP that i was consulting an ND, he "har-rumphed"; when i told my neurologist, he said, "well, certainly I haven't been able to do anything for you -- ask her about CoQ10 -- i think you should take some," [it's not the first time he's said it, either] ... now, just whom would you expect to have the larger ego?? certainly not the GP!!

    ho-hum,
    jb
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    Old 04-06-2005, 01:59 PM   #10
    kacl
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    Re: Report on Dommisse Consultation

    Sorry, I haven't checked into the board for a while. Likeme, the prescription just said L-Thyroxine. I think the T4 hormone is the same as in other brands of T4 medicines like Synthroid or Levoxyl. I think the difference is in the inert ingredients such as dyes, fillers, binders, etc. The doctor thought I might be sensitive/allergic to the fillers and binders.

    I'm doing better with the Armour/T4 combo than with the T4 alone. I don't feel much different so far, but it hasn't been long enough yet for the extra T4 to build up in my system.

    OK, I need to vent a little bit. Why is it that every time I try something new I feel worse? I had a hard time with the potassium the first week I started taking it. I felt really tired after taking the morning dose. Then I was able to adjust back to the status quo of feeling blah. Then Dr. Dommisse prescribed some hydrocortisone because my free cortisol test result was near the bottom of the reference range. I started taking that last Friday and felt better at first and then crashed. After e-mailing the doctor about it, I've cut back the dose from 15 mg to 10 mg and seem to be back to blah again. And every physical dip seems to be accompanied by an emotional dip as well and that's rough. I've been working on getting treatment for the hypothyroidism for almost a year and I don't feel any better than when I started. It's so frustrating. I've just about given up hope that I'll ever feel better. And I'm really getting tired of popping pills every day. Has anyone else had a hard time and then eventually gotten better or is it really hopeless?

    Katherine

     
    Old 04-06-2005, 04:43 PM   #11
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    Re: Report on Dommisse Consultation

    i had a hard time for about a year and a half -- thing is, the synthroid interfered with my anticonvulsants, and i had to get that sorted and when i had, i then changed ACs so back to square 1 ... the thing that's helped me most is going to an ND (i never thought i'd say this -- mine was the "better living thru' chemistry" generation and it there was a pill to be popped, i took it) ...

    i've been seeing this ND for about 8 months now, and every month she introduces something new -- i'm now on DGL tablets, omega3/omega6 oil, quercetin, lipoic acid, calcium, acidophillus, and coQ10 ... she's explained to me what each supplement does, and somehow, they've managed to ease my AC/synthroid interactions, and i'm no longer depressed (omega3/omega6 oil) ... i've actually gone off the zantac and motilium i used to take b/f each meal DGL/licorice), i take no ADs (again, b/c of the oil), my seasonal allergies aren't as bad (the quercetin) ... i just began taking the coQ10 at my neurologist's behest ...

    she's been of more help to me than anyone, actually ...

    i'm terribly sorry that you're having such a struggle, but it can take as long as two years to get sorted out for normal people, and i'm in my third year -- i've been feeling better for the last couple of months now ...

    jb
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    Old 04-06-2005, 05:16 PM   #12
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    Re: Report on Dommisse Consultation

    Thanks for the encouragement. I guess there's still hope for me. The first four docs I went to weren't terribly helpful so I guess it's only been about 3 months since I started with Dommisse. I just never imagined when I started that it would take so long or be such a roller coaster ride both physically and mentally. It helps to know that there are others out there like you who've struggled and eventually made progress.

    It's kind of amazing how unhelpful conventional doctors can be on this stuff. Conventional allopathic medicine seems to be quite good at dealing with acute illness and injury, but it doesn't seem good at dealing with more chronic conditions. It seems like a lot of us have had to go the alternative route to get help with balancing our hormones and correcting nutritional problems that exacerbate or even cause the hormone imbalances.

    Thanks,
    Katherine

     
    Old 04-06-2005, 08:31 PM   #13
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    Re: Report on Dommisse Consultation

    Katherine,
    Just wanted to let you know that it has taken me a while to get where I am, too.

    First, in late 2002, I had to fight with my then-primary doctor to even do a screening TSH test. He refused to do anything about it when it came back at 4.83... said he wouldn't treat till it was 6.0. So, I took myself to an endo, who confirmed I had Hashimoto's and started the only treatment she uses, Synthroid. She messed me around with it - which made me feel like death - for 6 months before telling me I was 'hypersensitive' to it because it made me hyperthyroid in the smallest dose. Since she didn't know what else to do for me, I took myself to a third doctor in October of 2003. He gave me Armour, and it took another 9 full months before I came even close to feeling consistently just 'pretty good'. Another 3 months after that, I could say I was at nearly optimal levels for me, and my tissues have been healing mode ever since.
    So... from time I first sought treatment for a myriad of symptoms that eventually all proved to be thyroid-related, and the time they have mostly resolved due to treatment,
    about 27 months had passed.
    So you won't have to go back and count on your fingers (like I did ), I felt pretty bad for a full two years.
    And I didn't have the adrenal and other issues you have.

    So... try to be patient. I know, easier said than done... but come here and vent when you need to. We're good listeners... and you will eventually feel better. Just hang in!

     
    Old 04-07-2005, 02:14 AM   #14
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    Re: Report on Dommisse Consultation

    as midwest1 says, it took me a long time to get dx'd too ... in may of '01, i went to my GP b/c i was tired -- he dismissed it as my "brain thing" ... in june, i went to him for depression that was becoming deeper and deeper -- he dismissed it as paxil poopout ... then i went to him for bloating -- he gave me elastic hose ... my depression deepened in '02, and i became exhausted and cold ... finally, in march of '02, i went to another GP (a CFS specialist), and he said "it's probably thyroid" -- when i went back to my GP with this info, he looked shocked ... in the interim, i'd seen my neurologist, burst into tears, told him my thyroid story, and he immediately called the first of two endos who prescribed some synthroid for me ... then began my adventures getting out of this thing (incl. a broken hip -- beware of osteo -- if you can tolerate the magnesium, start taking 2:1 cal/mag -- i forgot to mention that my ND also gave me that, but i can't tolerate the mag -- gives me the runs ... of course my GP/endo prescribed fosamax, which doesn't build bone -- it just prevents it from being destroyed ... ); it can be quite a balancing act between both ACs and synthroid and at first, no one believed me!! ...

    i felt pretty good in the summer of '04, but in sept, i changed ACs and it started all over again, only this time i went hypER -- altho my numbers didn't change (another thing my ND said is that one can be "sick euthyroid" -- ie, numbers don't change, but one can have either hypER or hypO symptoms) ... that's why i've given up on the tests -- i think they're pretty meaningless, unless one's GP requires them for a dose change ... fortunately, my GP doesn't require them -- he lets me change the dosage by myself, i think b/c he's ashamed of having missed it ...

    also, endos are better at treating diabetes -- that's seen as a serious disease, while hypO symproms aren't, altho they can lead to heart disease, arthritis, osteoporosis -- the list is, as they say, endless, but they're all considered diseases of aging; in addition, most ppl with thyroid disease are women, so you have that to contend with too ...

    i think i'm ok now -- i can read my body well enuff to tell when it's going off, how much synthroid i need (i'm pretty well settled at 150 mg), when to increase my DGL or fish oil capsules ... it's been a tough fight tho' ...

    good luck,
    jb
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    Old 04-07-2005, 08:38 AM   #15
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    Re: Report on Dommisse Consultation

    It does take time to feel better, I know it took me years. I still think it is a life long struggle though. I have good days, bad days, and in between days. I think I am leveled on my meds now cause I feel pretty good. I still suffer from some sleepless nights and sinus problems and depression. I take T4 and T3 and also antid's.
    JB, what do you take fish oil for? I tried them once, but burped up fish oil all day so stopped. I think I am going to search information on nutrients and minerals and try some.

     
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