I bit the bullet today and went to see another local doc! Took my thyroid test results for his opinion.
We discussed all my health problems!
His 1st reaction was that my thyroid test results were "definitely" Hyperthyroid! As he explained it, it was unusual to have the TSH, T3 and T4 all low in range? At least 1 of them should have been high? To be more specific, it was subclinical hyperthyroid, but taking all my symptoms into account, he said I was definitely hyperthyroid. He has prescribed 5 mg Carbimazole to be taken 3 times daily.
He then "tested me" for possible Parkinson's, because of the left finger tremor, but immediately ruled that out and diagnosed essential tremor. Prescribed 40 mg Propranolol HCL, to be taken once daily.
He did mention that the essential tremor could be related to the hyperthyroidism though, so this is a trial!
I have noticed that other people have posted that they have been prescribed both thyroid medication and beta blockers, as they seem to work well together?
Anyway! Fingers and toes crossed that I will feel better soon!
Are you sure the patient has subclinical hyperthyroidism?
Subclinical hyperthyroidism (SH) is defined biochemically by a low (or undetectable) thyroid stimulating hormone (TSH) level with a normal serum free T4 and normal serum total T3 levels due to thyroid disease or exogenous excess thyroid hormone administration.
Your TSH wouldn't be classed as low, it's actually normal for someone who doesn't have thyroid disease (it would be about 2 or less in that case).
The doc discussed the possibility of pituitary or Hypothalamus disorder, but with absolutely no symptoms associated with them, he ruled that out.
That link also says : Once persistent SH has been established, then patients should be evaluated in an individual manner to determine treatment. Not all patients with SH require treatment. The decision is based on various factors, including TSH level, age of the patient, and coexisting conditions.
I may yet have to have a CT scan (doc said that depends on how I respond to treatment), and/or referral to an endo!
I did post on here a few years ago, and it was suggested that the TSH levels, (which have remained the same, low TSH), suggested subclinical hypothyroidism. This doc is insistent that it is hyperthyroidism though, taking into account my symptoms!
There are many other "papers" discussing thyroid problems, and we all know that it is very hard to diagnose!
He ruled out pituitary or hypothalamus, because I have zero symptoms of either disorder!
There are lots of "papers" discussing thyroid problems, and I remember reading one that stated "if a thyroid disorder is suspected, from symptoms, even if thyroid test results are in range, then a clinical trial should be administered"?
I know exactly what this doc, who appears to be extremely knowledgeable about thyroid problems, has based his diagnosis on! The extreme tiredness, unexplained weight gain, odema in hot climates, and overheating problems!
Yeah, I know! Hypo can also have the overheating problems, but that is rare! Normally hypo is cold intolerance!
I will add this, from your link?
However, if patients are age 60 or above, have cardiac disease or hyperthyroid symptoms, then treatment can be considered.
That is exactly what this doc is doing. Clinical trials!
You haven't even had any Thyroid Antibodies tested.
You haven't even had an Ultrasound scan of your Thyroid. (Cheaper than a CT and easier, quicker to arrange).
You do not yet have a diagnosis.
I would be very careful.
Those results on other post show no evidence of Hyper - Do you have any other results with ranges to share. Doctor should do his own anyway. Where did you have those few tests done? Was it a reliable lab?
People ask questions so that they can make informed comment - but you don't answer.
Be careful
Edit:
ps
" . . extreme tiredness, weight gain"
These are symptoms of Hypothyroidism and NOT Hyperthyroidism.
I have PA, and manage that quite happily with regular B12 injections. I take folic acid along with that.
I have asked for folate and ferritin levels to be tested but those tests are not available where I live/work, but the folic acid "should" bring those levels up! I also take iron supplements and Vit C supplements.
Vit D? I work in the sun all day, so very unlikely to be vit D deficiency! When I asked for that test, I was told no need, because I get more than enough Vit D from sunshine! Refused the test because of that!
And who are you to say that I have not seen a specialist? Do you know my local doctor personally! How do you know if he is not actually an endo specialist?
Believe me, he knows an awful lot about thyroid problems! That much is certain, because his answers to my well informed questions were 100%!
I do not know how many times that I have to say this, but thyroid antibody tests actually mean nothing! They only show if you have the "possibility" of developing a thyroid problem! Early cancer screening is a good example of what antibody tests are? Doesn't mean you actually have cancer!
Please people, do not confuse other people who may be reading my posts, and also are suffering?
Misleading information is just as bad as "actual" facts, and sharing information is a good thing, if well informed?
Listen to yourselves! Hashimoto's is NOT a thyroid problem! It may eventually develop to a thyroid problem, but it is not in itself a thyroid problem!
Same goes for Grave's! Only a possible "cause", but not in itself an actual thyroid problem!
My thyroid tests showed subclinical thyroid problems. That was confirmed years ago by one of your administrators!
I am getting tired of this now!
Who to believe? My doc, who may actually be an expert endo, or "posts" from "possible trolls" on here?
Hey! All I know is that I am very ill! All my symptoms, are that I have a thyroid problem!
I am not going to post on here for a while now!
I will wait and see how the medication for hyper works, or not, and report back!
This is why I initially got banned from this forum, and that is the very fact that Hashimoto's is only a "possible cause" for a thyroid problem!
Hashimoto's IS NOT a thyroid problem in itself! It is only used to diagnose the "reason" for a thyroid problem!
Same goes for Grave's! Only a reason, or an early warning that you are likely to suffer with a thyroid malfunction!
Why cannot people "actually read" what those links actually say!
Duh!
They are only possible causes of a thyroid problem!
What does it matter what has actually caused a thyroid problem?
Example of what I am trying to get over to people who "look too hard"?
Obesity can lead to diabetes, but not everyone who is obese has diabetes!
Same goes for Hashimoto's or Grave's! It does not mean that you "actually" have a thyroid problem, in exactly the same way as obesity does not always diabetes! It is purely a "risk factor"?
I was horrified to read you are taking Carbimazole. To be needing this very powerful medication that can adversely affect your immune system, your Free T4 and free T3 should be high. Yours are not. Do not follow this doctor’s advice. He will make you very, very ill. He is confused over the test results and sadly this is not unusual. Doctors have a tiny amount of thyroid training and many seem to make up the rest to fill the gaps in their knowledge. We see it every day here. Be very careful. You will quickly become much worse than you are at present.
As I have just said in my latest post, who knows if my doc is not actually an expert endo? He was very knowledgeable about all aspects of thyroid problems!
He was very thorough in inspecting the test results! Circled them all and told me that it was definitely subclinical hyperthyroid!
Treating me accordingly!
Hey! If he is wrong? Then I die!
So what!
All I know is that I am very sick, getting worse, and I suffer with all the symptoms of hyperthyroid!
Patez
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