Quote:
Originally Posted by NotGolfer
still waiting for a comment or more here!
|
Hopefully I can help you out a bit.
First of all, you didn't mention what the problem is. Are you questioning the original diagnosis of hypothyroidism or having trouble getting regulated---ie: maintaining a TSH between 0.5 and 2.5???
The original diagnosis is pretty close to child's play----a high TSH with low or borderline T4 levels, especially with classic symptoms of fatigue, weight gain and edema. There are other causes of high TSH, such as a pituitary adenoma or a hypothalamic dysfunction elaborating TRH, but they are rare, and would be associated with HYPERthyroidism since the feedback from high levels of T4 are ignored. Almost all cases of hypothyroidism are from Hashimoto's thyroiditis, an autoimmune destruction of the thyroid's ability to produce T3 and T4. This could be confirmed by the presence of anti thyroid peroxidase and anti thyroglobulin antibodies. End of diagnosis.
If the problem is regulation, the first thing is to run as far away from Armour thyroid as possible. It was a life saver in the 50's and 60's, but synthetic levothyroxine has almost totally replaced it. Strange that there seem to be doctors in Florida still using it. I suppose some patients WANT it, because it is "natural", well at least as natural as eating the crushed thyroid glands of pigs, cows and horses can be. The problem is that the product varies in potency and is difficult to titrate.
The synthetic hormone is much easier to work with, but there's another problem----bioavailability. There are so many generics out there that absorption can vary. It wouldn't be a problem if you could get the SAME generic brand each month, since dosing is done by TSH level, however retail pharmacies generally stock the cheapest "flavor of the month", so as the actual brand of levothyroxine varies, so does your TSH level. The solution is to always prescribe brand name Synthroid, no generic. Sometimes an endocrinologist will throw in Cytomel (T3) for good measure, but I've rarely found that necessary.
I don't think there are any endocrinologists in TVH, but I'm sure there are some who accept UHC Villages insurance.
Lastly, avoid "naturopaths" and "herbalists" like the plague. Stick with board certified internists or endocrinologists. This is a pretty easy problem to control, almost always with a single small pill. No need to buy out GNC on the advice of some quack.