I have discussed the issues of inaccurately assessing thyroid function by using the archaic methods of measuring only TSH. Some physicians will also measure the T4, but very few will measure the T4 and T3 levels. Some endocrinologists have the audacity to say it doesn’t really matter and all of the T4 is converted to T3, the only active form of the thyroid hormone. Because of this intellectual arrogance, too many patients are suffering from the classic low thyroid state manifested by inability to lose weight, or to gain weight, afternoon exhaustion, dry hair and skin, cold intolerance and fatigue. Every day I see patients who have been improperly diagnosed as having normal thyroid function, when in fact they truly suffer from a low thyroid state. I recently saw a very nice lady in my office that epitomizes the inability of conventional medicine to accurately diagnose patients with low thyroid function, when in fact they are really suffering from classic hypothyroidism. The patient is a 44 year old woman, who over the last few years has developed increasing issues with weight gain, despite working out in the gym and exercising 5-6 days a week. She states that she eats very little, living on portions fit for a bird, but continues to gain weight or at least not lose weight. She was carefully evaluated by her gynecologist, who referred her to a local endocrinologist specializing in thyroid problems. She was seen once by the endocrinologist and later by a nurse practitioner and started on only synthroid or T4. She continued to worsen, struggling with extremely low energy levels, almost incapacitating her with exhaustion in the late afternoon. She had “lab tests” completed and her synthroid was increased without any improvement. She was told by the thyroid specialist that she was doing great, but she was still exhausted, gaining weight and cold all the time, wearing a sweatshirt to go grocery shopping in her local Publix supermarket in the middle of the summer. Her job was suffering from her overwhelming exhaustion and her stress levels grew exponentially. She felt horrible.
A friend of hers sent her to me to be evaluated for thyroid issues and we checked lab values of TSH, T4, and T3. The lab values were so classic for a condition coined by one of my patients: “A failure of conventional medicine.” Her TSH level was. 853, a level deemed absolutely normal by 80% of the physicians assessing thyroid function and who refuse to listen to a patient’s symptoms, and heed their signs. This single assessment would have resulted in most physicians telling her that she had “normal” thyroid function. The next level we looked at was the T4. The free form of T4 may also be evaluated as well, but the total T4 of 11.1 (normal range 4.5-12) was obtained, and again the patient would have been told that her thyroid was working great, and that her weight gain was undoubtedly from eating too much and not exercising enough. But she worked out 6 days a week and ate almost nothing. Finally we checked the T3, the level I believe is the most important of all the labs tested, as it is the only active form of the thyroid hormone that interacts with our body, improving our metabolism. The level was 82( range 83-200) Many thyroid “experts” insist that all T4 is converted to T3, and that is absolutely not true. Stress is the biggest offender for blocking the activation of the thyroid hormone, and drugs like beta-blocker for blood pressure and heart issues, and statins for reducing cholesterol markedly reduce the conversion of T4 to T3. What do you think? Does all the T4 go to T3? The T4 is in the 90% percentile of normal and the T3 is below normal! Wonder why she felt so rotten. Her thyroid function was very low, and the only way to figure it out is to test the T3 and to LISTEN to the patient. It’s time we as physicians wake up and disregard these antiquated guidelines established by specialists in the pockets of the pharmaceutical companies. Demand to be listened to by your doctor and don’t let him/her disregard your symptoms! Ask to have your thyroid corrected with a T4/T3 combination (like Armour), and not just T4.
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I have been suffering with similar symptoms for over a year, but additionally a very strange swelling in my legs that was making it impossible for me to bend my legs or walk very well at all. It started in January 2009, this strange swelling appearing out of nowhere. Additionally, I was chronically fatigued, sleeping only 2 hours a night, gained 40 pounds in January, lost my eyebrows and eyelashes, had body-wide chronic pain, swollen hands and face, and having very strange sensations in my chest, like a fluttering of the heart muscle. After about 3 onths of this, I went to an endocrinologist who ran some tests and came back with a TSH of 5.8 Additionally all my other hormones were bottomed out too. They put on me on a very low thyroid dose of 25 mg. From March to December, my condition worsened and even though I was eating only 800 calories a day and excersing almost daily, I was unable to lose any weight, my face became so swollen I did not even recognize myself - I started to call it a 'moon face' and my legs were still so very swollen and painful I could hardly make it through the day. They tested me for congestive heart failure, venous sufficiency and many other things, that came back not only inconclusive but almost bankrupted me. They told me to stop using salt and gave me a diuretic (which ended up making things worse).
ReplyDeleteDuring this time, I also had to have surgery to repair a torn mensicus and my orthopedic surgeon was very concerned about the swelling in my legs. He said that I needed to have my thyroid increased, but the doctors office would not do it because my thyroid tests now came back in 'normal' range. So i just continued to suffer.
Finally a very close friend encouraged me to see Dr Robert Carlson. Dr Carlson did not treat me like a number or a chart; he treated me like a person. He took the time to listen to me and the symptoms I was having and then devised a personal plan for wellness for me.
Since visiting with Dr Robert Carlson, I feel better than I have in many years because I am on the right amount of thyroid for my body. The weird swelling in my legs, ended up being something called Myxedema which is a product of a very underactive thyroid. In doing my own research, i learned it can be a very dangerous condition because it can produce a coma. I believe Dr Robert Carlson saved my life!!!
With the dosages of thyroid he has me on, I have energy now, I am no longer depressed, my brain is no longer fuzzy, and the swelling in my legs is gone. I can walk again after 12 months of not being able to walk very far, I was able to walk 1.5 miles after Dr Robert Carlson put me on the proper dose of thyroid.
It is a shame that the healthcare community have become so reliant on tests, treating everyone and every body as if we are all the same. We are NOT. The human body is a very complicated machine, and how could a large majority of the medical community even think that what is good for one is good for the other? THEY ARE NOT LISTENING to their patients and relying too much on numbers spit out of lab tests. Dr Robert Carlon listened to me and my complaints and now has me on the right path for my phycial and emotional well being!