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  • Why are Dr's so reluctant to diagnose?

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    Old 11-27-2006, 09:04 AM   #1
    kelly 804
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    Why are Dr's so reluctant to diagnose?

    Hi!

    I'm just venting frustration, but why does it seem that doctors are so resistant to diagnosing thyroid disorders? I'm looking for a new Dr at the moment, because mine is refusing to listen to me. Both of my parents are hypothyroid (both also had a difficult time getting diagnosed--my father was so sick and depressed he was practically bed-ridden, his TSH was low but T3 and T4 were in the normal range, so the Dr kept telling him it wasn't thyroid. He went to a new Dr for something unrelated, and his skin and hair were so bad that the new Dr took one look at him and said, "You're hypothyroid." My mother was chronically depressed and could never lose weight--she had gastric bypass surgery, lost 100 lbs., then just stopped [still about 100 lbs. overweight]--she was eating so little that she lost all her hair and had swelling from malnourishment, but still couldn't lose any weight. Finally a doctor listened to her and checked her thyroid), I have a low body temp, am prone to depression, have a bad memory, can't lose weight, am constantly tired...and my doctor insists that I "just" have post-partum depression (how that's causing the low body temp and inability to lose weight he doesn't explain!) My TSH is 4.3, but because the lab still uses the old norm up to 5.5, my Dr. says it's normal (although I showed him an article about how the American Academy of Endocrinologists recommends a lower cut-off). I showed him a print-out of my calories and exercise for 6 weeks--on 1500 cal/day, exercising an hour a day, and breastfeeding, I *gained* 2 lbs! I gave him a list of thyroid symptoms, of which I had over half. He finally basically humored me and put me on 25 mg of levothroid, said I could take it if I wanted, said repeat bloodwork wasn't needed (?!). When I went back in a few weeks, telling him I was seeing some improvement and would like to see if a higher dose would cause more improvement, he told me my thyroid ultrasound was normal, therefore I wasn't hypothyroid--rather than raising my dosage, he took me off levothroid and put me on Zoloft. I completely crashed, sleeping 14 hours a day, having crying jags, and gaining several pounds a week. With a family history, symptoms, and a higher than recommended TSH, why is it so inconcievable that I would be hypothyroid?!

    And, sadly, everything I've heard seems to indicate that this Dr isn't unusual. Why are they so resistant to diagnosing and treating hypothyroidism? Even my Dr admitted that the only risk of taking levothroid if I wasn't hypo was that I would get hyper, in which case he'd take me off it. If a patient has symptoms, why the resistance to consider hypothyroidism?

    I hate to say it (and I may just be feeling particularly cynical at the moment!), but having had the same kind of resistance to treatment years ago when I was experiencing post-partum depression, I wonder if the resistance isn't rooted in "it's just a woman thing"--it can't be a "real" problem, because it's mostly women who get it.

    What do you guys think?

     
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    Old 11-27-2006, 09:31 AM   #2
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    Re: Why are Dr's so reluctant to diagnose?

    Like most things in life, I think there probably isn't a cut and dried reason for such difficulty. But mainly, IMO, it's the reliance on lab tests instead of clinical evidence that has caused us such trouble. In the old days, doctors were actual clinicians... meaning that they could arrive at a diagnosis by looking at the actual patient... who has all the signs and symptoms that a condition causes. The doctor who diagnosed your dad by just looking at him is a genuine "clinician". Hooray for him... I hope he's still in practice, because his patients are very lucky indeed.

    Doctors are no longer trained to be clinicians. They're told that every piece of information they could possibly need is contained on one piece of paper - the lab sheet. They're taught that patients are not reliable sources of information about themselves... that the information they supply is only "anecdotal" and can't be proved without hundreds or thousands of dollars' worth of tests. The fact that the tests themselves are not reliable is never - ever - questioned. It's a very sad state of affairs for everyone, not just thyroid patients.

    I urge you not to stop looking for a thyroid clinician. Or at least, for an MD who has your best interests at heart and won't blame everything on "anxiety". These idiots don't seem to understand that anxiety is a symptom, not a disease... At least - it wasn't considered a "disease" until Big Pharma came up with a drug for it. There's more money to be made in incentives from Big Pharma than there is in treating patients the right way... And that's another crux of the problem.

     
    Old 11-27-2006, 10:19 AM   #3
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    Re: Why are Dr's so reluctant to diagnose?

    Cynical? Try realist instead. Studies have shown that men's symptoms are more likely to be taken seriously than women's by most doctors, both male and female. Why? No reasons given just a few theories. Perhaps it's the preception that men are tougher than women and therefore, if they complain to a doctor, there must really be something wrong.

    I ran into a blatant example of this several years back. I had parotitis which is a bacterial infection in the spit gland where you get mumps. I went to the doctor who said he had heard of it but had never seen it before because it's kind of rare. He asked if it was painful. I told him it was very painful and that every time I looked at food or tried to eat, it felt like someone would hit me upside the jaw with a hammer. He gave me an antibiotic and sent me home. Ten days later, still no improvement. I went back and he said that he had a man come in several days after me and he had parotitis too. The doc said that the man had said it was the most painful thing he ever felt. (Oh, really?) He said he called a specialist for advice and was told that a different antibiotic was better and that darvon would help the pain. The man was doing much better now. He wrote me a prescription for the new antibiotic. When I looked at it, there was nothing for pain. I asked him about it and he said "Oh, I didn't know that you needed something for pain".

    It would be nice if we were always treated equally in the medical system but since we aren't, sometimes we have to get a little pushy. Problem with that though is it reinforces the notion that we're just the "hysterical female again".

     
    Old 12-03-2006, 07:19 PM   #4
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    Re: Why are Dr's so reluctant to diagnose?

    I've read that they have to be extremely careful in prescribing thyroid medication the wrong dosage can be life threating to a patient.

    Other then that I don't know what the medical field's problem is with their reluctancy including, endoctrinologists that seem to be as bad as regular family practicioners.

     
    Old 12-04-2006, 05:56 AM   #5
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    Re: Why are Dr's so reluctant to diagnose?

    hello, i deeply sympathize with you i went to an awfull endo in the uk and he disscharged me despite me telling him i wasnt well , i think you should go back and tell him how bad you feel and tell him you would like to try just a small dose so he isnt to worried and ask if he could keep a real close eye on your bloods, i really dont see why he cant do this if there was this kind of improvement if he dosent sac him cos after all that is supposed to be his job you really can get some awfull endos lol posting you lots of luck from the uk and hope you sort it all out love from katpurs ukxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxps if you havnt seen an ando yet ask if you could

    Last edited by pursie; 12-04-2006 at 05:58 AM.

     
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