Dr. Peatfield in Hospital Again

[Rainbow100]

I'm sorry for him but also disappointed for myself because I was due to see him in a couple of days :o(. I first posted here about a month ago saying that I had just been diagnosed as subclinical hypo by my Endo - (TSH 3.15  /   FREE T3 4.1 pmol/L (3.9 - 6.7)

 /  : FREE T4 13.4 pmol/L (12 - 22) and he suggested starting on 50mcg Levo.

Approx 2 weeks ago I went ahead and ordered .25 grain WP and have received it now but was holding off starting because I figured it makes sense to see what Dr. P says especially about Adrenals. I had the saliva test 12 months ago via Genova Labs and it came back bang in the normal range. I have also done just once the the blood pressure test (sit down/stand up etc) and it does not suggest an adrenal problem. 

I have been faithfully keeping a temps log every day and; (i) basal temp average  36.4C 

(ii) morning ave (excluding basal) 35.4  (iii) afternoon/evening ave 36.3

The morning temps look a bit low which is no surprise because I always like cold crap at that time ! 

My guess is that the adrenals are fine.

I wanted to see Dr. P for the peace of mind, can anyone recommend A.N. Other who has experience with guiding NDT usage ? Or should I go ahead and start on the WP ? If so then start with 0.5 grain split over 2 doses or 0.75 grain split (bearing in mind Endo suggested starting on 50mcg Levo) ?

What does the venerable committee think ? 

Thanks in advance !

[scorp1o]

Sorry, can't help with a name but am sad to hear that Dr Peatfield is unwell. He saved my bacon when the NHS said I didn't meet the blood test thresholds and was not hypothyroid. Hope he's ok.

[Jazzw]

If you've got no adrenal problems that's excellent news as it suggests you'll cope just fine with taking t3-containing medication. The only other things I'd caution before getting started (you could just get started) are to check out what your ferritin, Vit B12 and Vit D levels are. There's still a small, but distinct possibility, that nutritional deficits are causing your body to want to produce more thyroid hormone to compensate. Do you have thyroid antibodies? Ordinarily I'd check your earlier posts but I'm on a train with a ropey 3G signal...

[Rainbow100 in reply to Jazzw]

Hi Jazz,

Printout reads Thyroid peroxidase antibod lev - (AN3305)  <4 lU/mL 

(ref range <25 = negative).

I hadn't paid much attention to this previously, can you help me out with the meaning of this please ?

[Jazzw in reply to Rainbow100]

That means that the test didn't detect any antibodies. Which is a good thing (though doesn't totally rule out Hashimoto's as sometimes the little critters don't show up every time). 

So what about B12, Ferritin and Vit D? Any testing done?

[Rainbow100 in reply to Jazzw]

I think I have tests done in the past for B12, ferritin and vit D (though not full iron panel) and I seem to recall that all levels were pretty much normal. Also i've tried supplementing with all of those on pretty high levels and noticed absolutely no difference at all.

fyi my main symptoms are serious constipation, bloating and sluggish digestion, depression, fatigue (especially in the mornings), 'difficulty in sweating', brain fog plus others !

[Jazzw in reply to Rainbow100]

OK. Good to rule these things out, though be aware the situation can change quite quickly the more hypothyroid you get, because hypothyroidism reduces acid in the stomach, and therefore you start absorbing less and less of the good stuff in the food you eat.

In that case, as you have a good baseline and your FT3 and FT4 are at the bottom of their ranges, I think I'd be inclined to give the WP a whirl. You don't need to split the doses unless you particularly want to - I only take my NDT once a day and I'm now on 3 grains.  Best to start with half a grain, and if you have no adverse effects, you can raise by half a grain every fortnight or so, until you get to 2 grains a day. At that point it's best to hold for a while, a good few weeks, then get your bloods retested to see where you're at.

Alternatively, you could take up the endo's offer of levo. You might do very well on levo - and you'd get it free. You almost certainly wouldn't stay on 50mcg - after 6 weeks you should have more bloods done to see what effect it's having, and most need a raise at that point.

[Hidden]

Bad news about Dr P and do wish him a successful recovery.  Obviously disappointing for you and hope you can find some answers.

[LtAngua52]

Would sending an email to Louise warvill help? She has lists of doctors recommended by members on this forum. 

Can you explain the blood pressure test, sitting and standing up. I get palpitations when I stand up so it's been suggested I check this. How? Good luck with your new meds.

[Rainbow100 in reply to LtAngua52]

I think the b.p. test is one of Dr. P's actually. You take BP sitting and then stand up and take BP again. If adrenals are fine there will be a slight increase, if not BP actually falls slightly.

Any idea how I can get Louis Warvill's email ? Should I have heard of him/her ?

[LtAngua52 in reply to Rainbow100]

She is the administrator on here and deals with the advertising and membership of thyroid uk. Her email is [e-mail] 

Do you use a bp monitor or just count your pulse? 

[Rainbow100 in reply to LtAngua52]

Thanks ltangua52

I used an electronic monitor, easy to use.

[Jazzw in reply to Rainbow100]

No, he didn't invent it. It's a test for postural hypotension, which just so happens to show up in cases where there's adrenal insufficiency (amongst other conditions). See patient.info/doctor/adrenal...

[Lisaveta2006]

Hi. Woud suggest to try dr. Liam Chapman. CIM clinic.

[Rainbow100 in reply to Lisaveta2006]

Hi Lisaveta 2006, may I ask why you suggest him ? 

[SilverAvocado in reply to Lisaveta2006]

Lisaveta, Recently there have been a few negative threads about Dr C. I've seen him and I would say he's no substitute for Dr Peatfield. Especially if you don't have adrenal problems, as he seems to always treat them. 

Rainbow100, I suggest you get hold of the list and study the notes on there and try to find someone who suits you. I doubt any will be as fantastic as Dr P

[Lisaveta2006 in reply to SilverAvocado]

Oh. I didn't know he has bad reviews. I'm his patient. Chose him over dr. P. Entirely because he can do prescriptions. Can't say that i improved dramatically but it's only 6 weeks as started his plan. And a week of  NDT. So can't expect a lot. But from what he suggests it looks very similar to dr P.'s book. But will check the threads. It's a pity I thought I can relay on him.

[SilverAvocado in reply to Lisaveta2006]

No really sure how much we're allowed to say on the forums, so a mod please delete if this is too much: 

I saw him for about a year, and recommended him to a friend. At first I was pleased, particularly the first few appointments where he listened to me, explained the possible causes of my symptoms, and did tests to start ruling things out. 

But later he never really followed through with any of those sets of explanations (and didn't interpret all the tests we paid for me either. I had some that looked quite dodgy), for either me or my friend. He refused me NDT because my blood results 'looked fine', and refused my friend T3 because he thought he could sort out his adrenals, after that treatment my friends blood results also became 'normal', although his symptoms didn't improve. Both of us have no thyroid, him congenital, me TT. 

My advice to someone in your position, based on what I know, is to carry on with him as long as he's helping you, but be prepared to sack him if he gets into a rut and stops really thinking about your treatment. I was great for the first 6 months or so, I did actually get a decent improvement in symptoms in that time. Just not sure a new patient can't do better. For example I spent around £1,000 on Dr C, but Dr P as good as refused to make a new appointment with me saying I'd be wasting my money, though he wants me to write. 

[SilverAvocado]

Rainbow100, I saw Dr P before Christmas. Although he gave me the peace of mind of giving me a couple of pointers to start on NDT, he told me I didn't need to see him again, and could just figure things out for myself! I have read his book, and keep an eye on this forum for advise on how to take it. 

In fact I ended up a bit clueless, as Dr P told me I'd been overdosed from the start by my current doctor, but we were only together for half an hour or so, so there weren't many details. Because my blood tests and symptoms hadn't clearly shown I was overdosed, and I'd thought I was basically still hypo, I've been fearful I'll get into that state again, so I started lower and increased slower than either Dr P or other experts suggest. So in fact I'm pretty much making it all up as I go. But I'm still pleased with the results, I'm far better off than I was before I self medicated. 

I think from the OP you haven't had any treatment so far? In that case, if I were you, i wouldn't worry too much about getting everything perfect. In 6 months or a year you may take stock and decide to change your approach and that you didn't get things right in your first attempt. But that's just what getting treated for hypothyroid is, the same as if you did get some joy from the Endo. Treatments are not written in stone, it's always trial and error. Just because I'm trying NDT now it doesn't mean I won't go back to try pure T3 or something else this time next year. 

[Rainbow100 in reply to SilverAvocado]

Hi Silveravocado,

You're right in that i've never had any treatment before apart from taking raw glandular supplement for approx 1 week and then decided to stop purely because I was about to start on proper NDT after seeing Dr P (which didn't happen). I noticed no effect from the supplements which is no surprise because 1 week isn't very long but in any case I decided it's not worth proceeding with a treatment which does not guarantee the presence of any thyroid hormones in it at all.

Thank you for your opinion on going it alone. In fact what I did was to read STTM and Dr. P's book at least twice (stupid hypo brain doesn't retain much, duh !) and got myself to the point where I am ready to go it alone, but held off actually starting the dosage because I only had a matter of 3 weeks to wait to see Dr. P. I'm pretty confident that adrenals are not a problem and I am going to start with .25 grain WP twice a day and self-review every 2-3 weeks as per recommendations.

I do get hung up on getting things perfect (destructive habit that !) as well as fears over going it alone but I think i've done my homework and there's nothing else to do now but take the leap. I've long been praying for an end to this shitty nightmare, think i'll make tomorrow my D-Day (or should I say my NDT-Day) :o)

Hope you're in great health !

[SilverAvocado in reply to Rainbow100]

Thanks Rainbow100, it sounds like you're very prepared! The other thing I meant to say is that as soon as you try something, you'll be getting more and more information - how you thrive on the medication, changes in your temperatures, BP, etc. It all adds to the pool of knowledge you have to use in the future. It's amazing how fast it all adds up! 

[Rainbow100 in reply to SilverAvocado]

Agreed SilverAvocado. For the last 2 weeks I have been logging temps thru day in an excel sheet and just in the last few days I got the BP & pulse rate monitor so I have the full "before" picture and I will continue to do so. This should help me to form the full picture along with the all important symptoms log, as well as kicking ideas around here and picking up real life usr feedback.