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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Sarah T. on February 16, 2005, at 23:42:02
How do I get my doctor to test me for thyroid antibodies? My thyroid tests (T3, T4 and TSH) have been mostly normal, although the TSH has fluctuated a lot, but I have several symptoms of hypothyroidism including increasing hair loss over the past few months, very brittle nails, puffiness in my face especially in the morning, and worsening constipation. I feel as if my brain is not the same brain I had 7 or 8 months ago. My thinking is dulled and much slower than it used to be. I never feel well anymore. This started quite precipitously in mid-June and worsened, again quite suddently, in late September. Do I have to go bald before doctors take me seriously and do more extensive tests? I welcome any suggestions for dealing with these doctors.
Posted by KaraS on February 17, 2005, at 17:57:05
In reply to Possible thyroid problem - thyroid antibodies?, posted by Sarah T. on February 16, 2005, at 23:42:02
> How do I get my doctor to test me for thyroid antibodies? My thyroid tests (T3, T4 and TSH) have been mostly normal, although the TSH has fluctuated a lot, but I have several symptoms of hypothyroidism including increasing hair loss over the past few months, very brittle nails, puffiness in my face especially in the morning, and worsening constipation. I feel as if my brain is not the same brain I had 7 or 8 months ago. My thinking is dulled and much slower than it used to be. I never feel well anymore. This started quite precipitously in mid-June and worsened, again quite suddently, in late September. Do I have to go bald before doctors take me seriously and do more extensive tests? I welcome any suggestions for dealing with these doctors.
I can't believe they won't give you a basic antibody test. It's so standard for hypothyroidism. I wish I could tell you what would work to convince the doctors. Sometimes you can get your own tests done through the mail. The don't cost all that much. Have you checked out Mary Shomon's thyroid site on about.com? There's a lot of great info there and some of it pertains to tests. Although, even if you find out that you have Hashimoto's thyroiditis, your treatment wouldn't change. One thing you should make sure of (if you haven't already) is that your test results are normal for the revised limits. It appears that some doctors still go by the old standards which consider a TSH as high as 5 to be normal. There's still so much we don't know about the thyroid and how it interacts with many of the other hormones in the body. I have Hashimotos and I have been treated adequately according to the test results (although I'm overdue to be restested - my last set of tests were all normal), yet I'm always cold. There are too many people out there who are supposedly well by their doctor's standards who still are symptomatic by their own standards. I find that I do better on natural hormone (Armour thyroid) but that doesn't solve all of the problems either.
Posted by Sarah T. on February 17, 2005, at 21:12:51
In reply to Re: Possible thyroid problem - thyroid antibodies? » Sarah T., posted by KaraS on February 17, 2005, at 17:57:05
So far, they've only tested T3, T4 and TSH. I asked for further tests and they said that if the above tests are normal, there is no reason to do further testing. I know that is incorrect. I know something is wrong with me. In addition to the symptoms I listed, I am also always cold, just as you mentioned. Yes, I have visited that website you mentioned. It's excellent! It's one of the best sites I've seen. I will look into one of those tests by mail. I know something is wrong. I feel awful most of the time. The problem is that in order to get a good medical evaluation, I have to be persistent and energetic, and I just don't have the energy to deal with all of the hurdles in the medical system right now.
Posted by KaraS on February 20, 2005, at 2:57:11
In reply to Re: Possible thyroid problem - thyroid antibodies?, posted by Sarah T. on February 17, 2005, at 21:12:51
> So far, they've only tested T3, T4 and TSH. I asked for further tests and they said that if the above tests are normal, there is no reason to do further testing. I know that is incorrect. I know something is wrong with me. In addition to the symptoms I listed, I am also always cold, just as you mentioned. Yes, I have visited that website you mentioned. It's excellent! It's one of the best sites I've seen. I will look into one of those tests by mail. I know something is wrong. I feel awful most of the time. The problem is that in order to get a good medical evaluation, I have to be persistent and energetic, and I just don't have the energy to deal with all of the hurdles in the medical system right now.
I know. I'm in a similar situation with regard to some health issues (including my thyroid). Unless you are lucky enough to have wonderful doctors, it takes soooo much effort just to get adequate health care. I don't have the energy for it now either unfortunately.
Posted by KaraS on March 22, 2005, at 14:00:48
In reply to Possible thyroid problem - thyroid antibodies?, posted by Sarah T. on February 16, 2005, at 23:42:02
> How do I get my doctor to test me for thyroid antibodies? My thyroid tests (T3, T4 and TSH) have been mostly normal, although the TSH has fluctuated a lot, but I have several symptoms of hypothyroidism including increasing hair loss over the past few months, very brittle nails, puffiness in my face especially in the morning, and worsening constipation. I feel as if my brain is not the same brain I had 7 or 8 months ago. My thinking is dulled and much slower than it used to be. I never feel well anymore. This started quite precipitously in mid-June and worsened, again quite suddently, in late September. Do I have to go bald before doctors take me seriously and do more extensive tests? I welcome any suggestions for dealing with these doctors.
Hi Sarah,I realize that I haven't answered your question here in my other responses. In my case I had all of the symptoms of hypothyroid but my TSH was on the low side of normal (back then normal TSH was a bit higher). My gp refused to consider that I could have a problem with my thyroid based solely on my TSH level. Fortunately my pdoc knew a little bit more. She talked about a subclinical condition which I talked to my gp about. My gp was adamant that there's no such thing as a subclinical condition. Because I kept pressuring for a referral to a specialist and because my pdoc was wanting it, my gp humored me and gave me the referral. Low and behold, the endo could feel the enlarged thyroid and knew immediately that I had Hashimoto's. He did the antibodies test which also came back positive. He got me started on thyroxin at that point. This info was all sent to my gp. Unfortunately I never saw her again after that because I moved out of town but I really wish that I had a chance to confront her over this. I wanted to make sure that she read the results and that she would learn something from this in her treatment of future patients - but I never got the chance. Anyway, is there a possibility that your pdoc could push your gp for the test or could talk to your gp to get you sent to an endocrinologist?
Kara
Posted by Sarah T. on March 23, 2005, at 1:22:18
In reply to Re: Possible thyroid problem - thyroid antibodies? » Sarah T., posted by KaraS on March 22, 2005, at 14:00:48
Hi Kara.
Thanks so much for your post. I'm glad I saw it. I did see an endocrinologist last week, and he told me that my low TSH was not enough for him to order further tests! I mentioned the possibility of thyroid antibodies and said I wanted to be tested for them, but he said that even if I tested positive for antibodies, that wouldn't mean they were doing anything to warrant treatment. He said if I tested positive, that would mean that there would be the possibility of having other thyroid problems, and if those problems existed, they'd show up on other tests like T3 and T4. I don't believe he is correct. I am losing hair, my nails are very brittle, I'm exhausted, I'm chronically constipated, and my cognition has changed a lot in the last half year. I guess I'll have to try another endocrinologist. The endo did order another 24-hour urine to test for free cortisol, which has been elevated for my entire adult life. Although I've had a history of elevated urinary cortisol, my plasma cortisol is always normal, and the hair loss has only occurred in the last half year. Up until that time, my hair was quite thick. I don't have any of the characteristic features of Cushing's disease. I read that hair loss in Cushing's is usually temporal. The hair loss I've had recently is mainly from the top of my head, towards the back. I think I will probably have to get my pdoc to speak with an endocrinologist who is willing to cooperate. Thanks again for your help.
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