Saturday, September 19, 2009

so much for that

Got a call back from my endocrinologist's colleague (also an endocrinologist - my Dr. is on vacation) yesterday. I had left a message for her to inquire into a different thyroid medication, more complete than Synthroid. So I told her I'd been doing a little reading and it sounded like some natural supplements were more thorough - maybe Armour? She said that she never recommended Armour "to any patient" because, since it's made from animals' glands, the dosage can't be calibrated at all and you have no idea how much you're getting. Like many things I've heard from doctors, this sounds extremely persuasive ten seconds after you hear it and after ten minutes you realize that it is certainly complete and total BS.

Superficially, if you just grind up the gland, yeah, you could be getting anything. But this assumes that I am slaughtering the unsuspecting creature on my back patio and cooking up the meds on the stove. In reality, of course, if anybody is ever prescribed this medicine, and they don't have to be hospitalized as a result, the prescribing doctor knows how to dose it. In an entire month on Synthroid, I take one and a half MILLIGRAMS of the actual ingredient. You couldn't dose this stuff randomly - you'd kill somebody.

Moreover, I'm pretty sure thyroid hormones are not the only ones for which supplements are derived from animals. (Insulin? I'm right about this, aren't I? Also, progesterone?) And since I took all of five semesters of chemistry and didn't even go to medical school, here's what I would do if I wanted an exact dosage. Take the part of the organ that has the chemicals you want and physically remove any accessible matter that is extraneous. Clean the remainder carefully. If non-essential components can be removed chemically without damaging the hormones you want (or if the hormones you want can be extracted chemicaly - chelation? Carbon fixation?), do so. Once you've gotten it down as pure as you can without damaging it, pulverize it into minute particles and dissolve it in solution. Homogenize it so it's evenly distributed in solution. Take a small sample and test the concentration of the active ingredient(s). Divide the quantity you need to give the patient by the concentration of your representative sample and you get the volume of the solution that you need. Take that volume, dehydrate the solution, and prepare the dehydrated remains in capsule form. If I can figure this out, something tells me the pharmaceutical industry can.

This woman is full of $hit.

She told me (of course) that my tests showed my thyroid function was perfect. I pointed out I had tested for low thyroid function, and had symptoms thereof; I now test for normal thyroid function, but have the same symptoms. I asked her whether a normal TSH range conclusively demonstrates that my symptoms could not be caused by thyroid problems of any kind. She said that nothing could ever be said with absolute certainty. (Yes, I took math and science in college too. What about that part of the sentence after the "but," where you say it's your professional opinion that this is ruled out as the cause? Oh, not going to go there, are we? Fine. I don't care about your health any more than you care about mine. That achieves some sort of balance, right?)

She then pointed out that thyroid symptoms are very non-specific (yes, I know. But doesn't the fact that, absent medication, I am clinically hypothyroid narrow it down a bit for you?), and said that I should see my general doctor to look into other causes. Here's the part where a medical degree might come in handy. I know depression could cause some of my symptoms (though I don't believe it could cause exhaustion while exercising. The difference isn't emotional, it's physical). But I don't think I'm that depressed. Other than depression and hypothyroidism, my layman's knowledge would suggest that only another hormone imbalance could cause these symptoms. Am I missing something here? And if I'm not, well, this woman is an endocrinologist. My "regular doctor" (if I had one) would not be. So...who should I be calling to look into the problem?

I also asked whether I should have my cortisol levels tested. She told me flatly that adrenal fatigue is "not a medical diagnosis." That's genius, lady. Once upon a time, the only medical diagnoses were impurities of the humors and the need for bleeding. I bet not too long ago hypothyroidism was considered laziness, and "not a medical diagnosis." See how greater knowledge causes the profession to stop patronizing its patients - or, rather, switch to patronizing its patients on a different subject? You can call it a diagnosis or a fruit cocktail, but if testing demonstrates that someone's blood hormone levels are out of the normal range, then treatment would seem indicated.

I've decided that I will leave a voicemail for my endocrinologist, tell her what her colleague said, explain that I don't think that my health is being regarded as a priority or my symptoms being taken seriously and I have never been a hypochondriac (not in real life) and feel that if I pay for medical care I should be supported in my attempt to live a healthy life, and that if she shares her colleague's perspective, would she please let me know so I can look for a different practice. I will also be canceling my appointment with the colleague (on October 2, to check my blood levels before my 10/12 surgery) - what conceivable use would that be? Verifying my TSH levels is making her happy, but it's not doing me any good. It's not my goal to make her happy for no collateral benefit to my health.

I will also be calling Tepeyac to see whether Dr. L (or anybody else there) can recommend an endocrinologist who is not a pain in the @$$. Even better would be a suggestion from my internet friends in the trenches, who have had to live with the consequences of lazy medical care. (Hey...I seem to have the same approach to running that Dr. Go the non-Armour prescriber has to treating patients. Coincidence...?) Any ideas, folks? In view of the fact that I live in a really big city, I'd rather not drive more than 25 miles, on the theory that any product or service I want can be had here for ready money, provided only I know where to look.


  1. What I'd suggest is call a pharmacy (calling a compounding pharmacy is even better). Ask to speak to the pharmacist and ask him which doctors in your area prescribe Armour and other thyroid medications that are mixed specifically for each individual patient. He will give you names - it's too easy.
    I did this - I found a couple doctors, but unfortunately, they were out of network for me.
    The only reason most doctors don't use Armour is because it is not made by Big Pharma. They can't patent a natural substance (just like natural progesterone), and why would they convince you to use something they can't make money on?
    Your doctor's logic is flawed - but you know yourself better than any doctor ever will. Good for you for sticking up for your own health.

  2. I wish I could give the horrible stomach issues I've had this past week to this loser doctor. Argh.

    Good luck finding a doctor that is sane!!!

  3. Hmmm... I'm not so sure about that last statement, myself. Living less than an hr from NYC, I probably would have thought at one point that anything and everything I needed medically could be found there- and indeed, they do boast some of the best Drs in the world. BUT, for certain areas of treatment, I still found the need to have to travel for the best care. (To PA for surgical treatment, to IL for reproductive immunology, etc.)

    As for the suggestions, I have none. Some help I am, huh? :) But I do know that FJIEJ HATED Armour, and is feeling worlds better on Synthroid. Not that Armour is horrible for everyone, but maybe you just need a different dose. Or maybe a change altogether WOULD help. I really have no idea. I did just find out, though, that apparently hair loss is a sign of HYPERthyroid, not hypo like I once assumed. Which makes more sense now since I have tons of hair loss and my T3 was high.

    Anyway... I'm not a real hypochondriac, either. I just play one on the blogs.

  4. I just ran across your blog for the first time and want to tell you that you are right on. I co moderate a thyroid forum that recommends natural thyroid like armour. I'm personally on it as well as my husband. Check out one of my posts about the subject:

    If you are interested in finding a Dr that is more open minded to armour. you'll find my email on my blog........I have a list of good drs......if I know where you live I'll check if any are near you.

  5. I really hope that you can find a doctor soon that will help with your thyroid stuff. Thyroid levels are so important; it's great that you're so proactive. I don't have any ideas on finding a doctor, but I'll keep you in my prayers.

  6. Sarah - that's BRILLIANT. It's so...perfectly logical. Why could I not think of that??? I'll call tomorrow at latest. Normal thyroid health, here we come!

  7. Gosh, I am so sorry you're having all these problems with the thyroid doctor. I hope you can get it resolved soon!! I don't know how you ladies with debilitating fatigue, etc. deal with it on top of IF... Will be praying you have more energy soon!

  8. I say if you feel there's something wrong (and you're not suffering from, say, anxiety-induced hypochondria or something), then you should continue to explore it. Are there any docs in your area who take a more holistic approach? Who might be willing to consider things like food allergies, cortisol levels, etc etc? Specialists don't mean any harm; they're just trained to think in certain, specific ways, and you're needing something a bit more out of the box.

  9. The bane of some doctors' existence is having patients who read, research, and cogitate. I understand that the Internet has caused many people to self diagnose, and often times incorrectly, but I'll be many of them are right on target, too. doctors can be too ready to dismiss a patient's concerns simply because their patients don't have a medical degree.

    I wouldn't see the endo doctor's collegue, either. She sounds like a pill. I've only had one doctor I didn't like (well, technicaly, I haven't "liked" any of them since I'm a very private person and a doctor visit leaves nothing to the imagination; but this one had a supercilious manner I didn't care for). She wasn't worth the aggravation.