Sorry, this is a whinge and I know I'm preaching to the choir here, but why are GPs seemingly so opposed to the idea that a problem may be thyroid-related, often to what feels like a bloody-minded degree? As if they're somehow invested in it being anything but thyroid?
I had a phone consultation with a doctor at my practice, following a number of tests. (I'll post them when I get the printout I've requested.) He was concerned by various things, notably my weight, and went through a whole list of ways we could possibly tackle it – from the usual suggestions about diet and exercise (made, as ever, in a way that implied these would be news to me) to the possibility of bariatric surgery. But when I pointed out that my TSH had risen pretty much by 1 point (from about 3.7 to 4.63), bringing it pretty close to 5 – the high end of the reference range – he got really insistent that it wasn't a problem. And, yes, when I mentioned having numerous hypo symptoms, he just kept on telling me that it was "normal". No acknowledgement that it's at least approaching the borderline, just "normal". (I suppose there's some relief that it's 5 – I was bracing myself to be told that the high end was 10.)
And this is a doctor who, in my opinion, is one of the better listeners in the practice.
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Taffhamster
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Your post has touched a nerve with me. I saw my nice-but-now-I’m-not-so-sure endo this week and she uttered those immortal words, “you can’t blame everything on your thyroid”. When I asked whether that meant I just had to put up with all the lingering symptoms, she didn’t have an answer.
What is so darned frustrating is that all the other “ologists” that I have to see have been saying that my thyroid has a lot to answer for. Why is it that they acknowledge a link, but the endocrinologist doesn’t?
I think the word "thyroid" has become a dirty word in medical circles.
I've been baffled for years now. I'm in the U.S. and it is almost as mindless. I was hoping HealthUnlocked (great name) might be a little more forceful because there are too many suffering souls in the UK under the thumb of the NHS. For some reason, the NHS appears too powerful to answer for their negligence. On the bright side, the options have opened up for self medicating and I encourage it rather than sinking into the mire of obesity, brain fog and pain. While this may not work for everyone here, I'm sure the majority could at least steady their ship through a little trial and error. There are several doctors whose message can help along the way.
I hope you get some ideas from him that you can use. Grey Goose posted a video by another great thinker and he is even more scientific. Dr. Bergmen has many powerful videos on youtube which I've watched. I think we thyroid patients should all see the one about neuropathy...you will be surprised at some of his comments. They are easy to locate on youtube. The other man is Thomas Wolfe. If I can find it, I'll post it.
They are invested in it not being thyroid. They Don't get any funding points for thyroid.
And Don't forget Big Pharma's role in all this. They have a vested interest in us not getting better, and they control what doctors learn in med school, and all the rest that follows. If we got well, Big Pharma would lose a hell of a lot of money!
My TSH has been over 5 for the last year and creeping up from 3.2 since 2011 (if not before) and still my GPs (many seen) dismiss my query about hypothyroidism. For my weight I have been offered bariatric surgery by all GPs seen ENT and Rheumy and now GP has referred me to a weight loss clinic (second one seen) and they are also stating I should have this surgery. Pity they werent so quick to offer me knee surgery 5 years ago as I would be able to exercise properly then and maybe lose some weight. I agree with greygoose about big pharma it is they who are running the NHS.
Not only do drug companies run the NHS, the power they have in the U.S. is huge. Just count the money.
Pharmaceutical Industry. The global pharmaceuticals market is worth US$300 billion a year, a figure expected to rise to US$400 billion within three years. The 10 largest drugs companies control over one-third of this market, several with sales of more than US$10 billion a year and profit margins of about 30%.
I know that most doctors do not like to increase thyroxine to help with weight problems.
I also know that if my tsh levels are around 0.4 it becomes easier for me to lose weight. It's still hard enough and I have to exercise 3 or 4 times a week. Then I am just around 7 lbs over a bmi of 25 now. I've lost weight with having the flu.
A friend of mine takes 200 mcg thyroxine and her tsh went up to around 4. She is very careful with her diet. She was also feeling extremely tired and concerned about her weight so her doctor increased to 225 mcg.
I can only get help from a doctor if I plead and I do get emotional and tearful. Then I gain some empathy, then I get some understanding.
I think GP's worry about how too much levo can affect us too. It's such a see-saw. We definitely need more support.
My husband is hypothyroid and he has never had a weight problem. His bmi is 22 - so lucky :-).
I can so identify with this. So bloody frustrating. And causes unnecessary suffering. I'm so glad I found this website. The lovely people on here have helped me to sort myself out. Am now about to start self medicating,awaiting delivery of my T3. Will let you all know how I get on. X
Yes, but they do have room for prescribing to "boderline" cases, because I've just been diag as borderline with similar results. Mind you, I did get my antibodies privately tested, and I went to the GP with proof in my hand that I have plenty of them. I'm sure they would have not have ordered that test themselves because I was under 5.
So maybe get your antibodies tested privately, Taffhamster - sorry, I know it is expensive - and if you have them you will be able to back up your argument that you are at least borderline.
Some doctors believe that hypothyroidism is very rare and that most people just want thyroid medication to lose weight. Karen Carpenter (a singer) stigmatized thyroid medication back in the 70s.
"What did stun Levenkron was Karen's next casual disclosure. She was also taking thyroid medication – 10 pills a day. He was shocked, especially when she explained that she had a normal thyroid. Realising she was using the medication to speed up her metabolism, Levenkron confiscated the pills. This was the first case of thyroid medication abuse he had seen in his dozen years in the field."
She ended up dying from ipecac poisoning, but media at the time hyped up her thyroid pill abuse. All it takes is a few stories like that to taint an entire disorder as "fake".
I'm not sure what I would do in your situation. From a doctor's view, the feeling of obesity and the feeling of hypothyroid often feel the same. Obesity does exist without a thyroid problem, and sometimes losing weight (healthily) improves thyroid levels. Your doctor probably assumes that you have an overeating and lack of exercise problem.
Do you feel that you have any improvement you can do in that area? I spent years perfecting my diet, exercise, sleep cycle, and trying every supplement in the book before I ever approached a doctor about my thyroid. It still took me about 5 years from that first appointment to get put on a baby dose of thyroid medication!
I kept an extremely detailed exercise and fitness log and brought it into appointments. That usually resolved any misconceptions about my intentions for thyroid medication.
Just from my own experience, thyroid medication may not help you lose weight. I feel better but I have gained about 15 pounds of pure fat (body fat percentage went up), although my diet/fitness has not changed. Apparently my body thinks this is the weight it needs to be. I've decided I would rather have energy and be happy than be thin.
Hi ticktick. I was interested in this: "sometimes losing weight (healthily) improves thyroid levels". Have you read or seen this somewhere? If you can remember where I'd be really grateful for a link or name or whatever!
"Researchers now believe that even small elevations in TSH (thyroid stimulating hormone), rather than indicating a looming thyroid problem, in some cases actually predict an emerging leptin and insulin problem associated with weight gain. It was found that when weight was lost, TSH scores returned to normal. Another study shows very clearly that leptin driven weight gain actually inflames the thyroid gland and induces thyroid autoantibodies to form, as if the leptin driven obesity problems are punching the thyroid gland in the nose. Once again, thyroid autoantibodies returned to normal when weight was lost."
You'll have to ask the author for his/her sources.
I've read it other places but this was the only one I could find again.
"A study published in the International Journal of Obesity in 2006 compared BMI and TSH levels in 6,164 adults from 1995 to 2001i. In this study, higher BMI was associated with higher TSH (TSH is higher in hypothyroidism), and increases in BMI throughout the six-year period was positively correlated with increases in TSH. In a 2004 study of obese patients referred for evaluation at a sleep disorder clinic found previously undiagnosed subclinical hypothyroidism in 11.5 percent of patients ii. They also found a strong correlation with BMI and neck circumference.
In a group of 72 patients preparing for gastric bypass surgery, 25 percent were found to have undiagnosed subclinical hypothyroidismiii. They concluded that overall, morbid obesity was associated with elevated TSH and that weight-loss after surgery generally resulted in decreasing TSH. It is important to note that this study, however, did not find a direct association between TSH and BMI.
Several studies have found changes in TSH in obesity with normal levels of T4 and T3iv,v. This has lead some researchers to believe that there is another cause of the elevation of TSH that is not related to low levels of circulating thyroid hormones. Currently, a popular theory is that insulin resistance leads to changes in the thyroid that can result in changes in the gland and possibly in TSH levels of thyroid hormone levelsvi. Other things being examined are associations with leptin and adiponectin."
And a general note that weight loss occurs in only about half of treated hypothyroid patients:
"Hypothyroidism is commonly associated with weight gain, but contrary to popular belief, treatment of the condition does not result in weight loss in the majority of patients, according to new research presented at the 2013 Annual Meeting of the American Thyroid Association.
"We frequently see patients who are disappointed that they do not have dramatic weight loss following initiation of thyroid hormone therapy, so these results were not entirely surprising," said Elizabeth Pearce, MD, from endocrinology, diabetes, and nutrition section of Boston University School of Medicine, Massachusetts.
"We found that modest weight loss following initiation of levothyroxine treatment for hypothyroidism occurs in only about half of patients," she told Medscape Medical News."
Hi Ticktick - many thanks for all of these. This is great information. I'm studying the effects of over and under eating on thyroid (or at least I'm looking for research TO study it!) and find this stuff fascinating. These are great leads. Unfortunately the last Medscape one doesn't seem to be working; it only takes me to a sign in page - do you have another link to it?
Nope, Hypohim, I'm afraid that still just brings up a sign-up page. I think perhaps Medscape is recognising my computer and now won't let me on again. The annoying thing is when I was on it the first time I didn't get a chance to read it - now it won't let me on at all!
Very weird, the article doesn't require membership to view, only to comment. I found it by googling some of the text from ticktickatick's post - maybe that would work for you too.
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