General Medicine

» Elaine Moore - Related testing

In response to Related testing posted by u25000:

Hi,
You might want to look for a holistic doctor or an integrationist, which is a physician who combines alternative and conventional medicine. I've found that osteopaths are a good choice because their philosophy is based on a more natural approach. They'd be more likely to understand the importance of nutrition. Best, Elaine

» nurseheatherone - Another Graves questions

In response to Another Graves questions posted by daisyelaine:

yes I do feel as though I have more hypo symptoms then Hyper, but what scares me the most is my doctor said nothing about my rapid change in my levels and just cut my medication in half and asked me to come back in 8 weeks for another check. I was thinking about getting my lasb done in about 2 weeks, which would be 5-6 weeks after my last check, is that reasonable to wait. Even if I were to go to the lowest dose of tapazole og 2.5 mg is it possible that it would still make me hypo. how do you convince your Dr's that you are hypo even with borderline hyper labs. I would just like to be euthyroid on meds and feel neither hypo or hyper, wishful thinking I know. Thanks, Heather

-- posted by nurseheatherone

» acaryjohnson - can I get away with less PTU?

I was diagnosed with Graves back in 2000 after using iodine to treat water on a camping trip. It took a year before my pcp referred me to an endo, and then she tried lowering my dose of PTU and ultimately taking me off to find I was in remission. I've been checked once a year since then and found the Graves was back this past spring. This time they wanted to do the RAI scan and I let them (which I regret now). I was put back on PTU and was normal within 6 weeks. My endo did not lower my dose at that time, which has been 50mg 3x/day and which I have maintained for the past 3 months since. However for the past month my hair has been falling out and thinning at an alarming rate. I have been on a new running exercise regime with a partner for 6 weeks and have still gained some weight. Also, my sex drive has dwindled. Just this past week I got bloodwork, which turned out as follows:
FT4 = 0.7 ng/dL, T3 = 0.8 ng/mL, TSH = 3.00 uIU/ML, and normal liver and CBC results as well.
After looking at many postings on your website, I am relieved that my endo has now said I can go down to 25mg (half a pill) in the mornings at least, but I'm wondering if I should go with half a pill in the middle of the day too? Also after seeing my lab results, I'm a little discouraged that he just said my TSH was 'kind of ok', and said nothing about my FT4 being at the low end of normal. I have been pretty careful about my diet, eating natural foods, no caffeine, but only recently started trying to cut out dairy (very hard!) Would you recommend I make any other changes, or even try to get some different labs taken? Thank you so much for your help and for this website!

-- posted by acaryjohnson

» Princess2007 - When to lower medication?

In response to When to lower medication? posted by daisyelaine:

Thanks Elaine. Just to be sure I understand correctly, does this mean that I should lower my dose now even though at 10mg its in the maintenance range of dosage?

-- posted by Princess2007

» u25000 - Osteopaths

do you mean DO's? My GPs tend to be DOs and they are the one's who let me down, I did see an MD before this one (male), current and previous 2 have been female. They have all had the same demeanor except that women are nicer. But not one once has recommended addtl tests. I read here that naturopaths can prescribe their ideas for a doc to follow, but how can they know w/out blood work unless they ARE an MD/DO. I would be willing to see a Naturopath, I know of one locally who is not a physician, but I am willing for the sake of curiosity. Or I can just go straight to an Integrationist. Oddly enough there is one at my new GP office but they didn't "sell him". He is a DO. So is the other local Integ. Also, I would like hair analysis, how do I have done. I think Elaine said once that these are not valuable.

-- posted by u25000

» Elaine Moore - Another Graves questions

In response to Another Graves questions posted by nurseheatherone:

Hi Heather,
You should be ok with the dose cut in half. It's unlikely that you're already in remission. So you'll still need to be on a low dose of ATD for a while. Labs in 2 weeks won't fully show the effect of your 5 mg dose. It could be that you only need a 2.5 mg daily dose, but it's best to reduce ATD doses gradually checking your thyroid levels between dose changes. If you develop noticeable hypothyroid symptoms after a few weeks on the 5 mg dose you could ask your doctor about having labs sooner. Take care, Elaine

» Elaine Moore - can I get away with less PTU?

In response to can I get away with less PTU? posted by acaryjohnson:

Hi,
With your low FT4 and TSH suggesting hypothyroidism, a dose of 25 mg daily is probably adequate. If possible, you can cut this dose in 1/2 and take 12.5 mg every 12 hours. The lab report may list the old TSH range and your doctor may not realize that a TSH higher than 2.5 suggests hypothyroidism, and he may not realize that TSH is falsely decreased in Graves' disease by our thyroid antibodies, making the result misleading.

The symptoms you're mentioning are typical for hypothyroidism and should resolve on your lower dose. Your doctor may have focused on the TSH rather than the FT4 to bring less attention to the fact that your ATD dose has been too high and caused hypothyroidism.

I'd also avoid processed (pre-packaged) and fast foods (very high in salt and iodine), aspartame in NutraSweet, sugar and saturated fats to help your immune system heal and incorporate some stress reduction techniques, especially regular mild to moderate exercise. Take care, Elaine

» Elaine Moore - Osteopaths

In response to Osteopaths posted by u25000:

Hi,
It's too bad that the osteopaths (DO or doctor of osteopathy) in your area haven't been helpful. It could be that your insurance carrier is one that frowns on doctors who order tests that don't strictly follow what's recommended for your diagnostic code. Especially in HMOs, doctors who order too many "extraneous" lab tests can be dropped and in some cases insurance companies only pay for the tests associated with certain diagnostic codes. For instance, with these plans, a diagnosis of hyperthyroidism would qualify for thyroid function tests and thyroid antibody tests but not tests for celiac disease. It'd be worth trying the integrationist doctor as he or she might be more likely to justify ordering other tests.

The problem with hair tests is that they don't necessarily show your current nutrient status, and hair products affect results. Blood levels show the status of these nutrients or how available they are for your body's cells at the time the blood was drawn. Hope this helps, Elaine

» acaryjohnson - can I get away with less PTU?

In response to can I get away with less PTU? posted by daisyelaine:

Thank you so much. I plan on buying your book, maybe this weekend if I can since my library doesn't have it. I hope that I can convince my doctor to update his statistics. Just to clarify, I'll be going from 150mg/day to 25mg/day? Is it possible I am in remission? I also hope to convince my doctor to get a TSI lab for me. As I mentioned, I had graves as of 7 years ago and I just wanted to say that you have the most helpful information on your website of any I have seen by FAR. Thanks again.

-- posted by acaryjohnson

» u25000 - Couple clarification requests

1. Oct 2001 I had a Total T4 done: 30.5 (4.5-12.)HI. I was 8wks GA pregnant. As I understand T t4 is not done during preg because preg hormones elevate Tg(? enzyme or protein) which renders this test innaccurate?
2. Feb 2003 I was days pregnant when the orig tests were done to determine further testing for my disease: T3 Uptake 44 HI(26-37), Tt4 21.1 HI (4.5-12.), Ferritin 108 (10-200), Total Iron % saturation 51 HI (21-50). Were any of these made inaccurate by pregnancy?
3. Feb 2004 after RAI and one month on levoxyl which began a/"prev mth" labs: my ft3 4.4 (1.1-4.7 (prev mth 3.2)) ft4 3.3 (.6-2.2 (prev mth 2.2)) so he had me stop lt4, I understand he couldn't determine my speed of recovery, but why even start me when previous mths labs were still dropping into normal and were w/in range. By starting lt4 so soon, I feel he wasn't very accurate w/numbers and I clearly would've paid better attention had I understood. So by giving me lt4 he caused a spike which inadvertently led to me stopping meds after only one month and going on this rollercoaster of mismanagement.
4. March 2004, his final labs w/me he ordered T3 Uptake 41 (23-37), ft4 1.37 (.8-1.8) tsh -.01; based on previous labs, I had stopped lt4 so ft4 was normal tho lo side, and t3 was elevated due to prev mths lt4 surge, right? He said it was okay to conceive, but am I correct to say that I wasn't because he had spiked me in error and threw my numbers off so I required more time. This misled me when I couldn't conceive after several mths and lost faith in him. Again it seems a numbers thing where he failed to give me the attention to detail.
5. July 2005: Ferritin in 2003 was 108 (10-200(early in disease)) well now it is 17 (10-291) with still no lt4, and my tsh is finally normalizing these past few months, while my ft3 and ft4 continue to move very slowly in the lo range (they were subdued 3 wks error my 2nd endo who gave me Ptu for the neg tsh); what can you tell me about this Ferritin change?
6. By the way, I did find that when I would visit the ER they did do an ER panel which includes calcium and Electrolytes Panel. But I found after my 3rd loss 2005 I got a Comprehensive Panel which includes both plus a few, so atleast I now what to ask for when I do see my DO or talk w/insur CO, or to order myself, however how do I learn whether I have thinning bones, Bone density, who should order this. Since I do have an Integrationist in mind, would you recommend I don't need to see a Naturopath? thanks much

-- posted by u25000