I would love some help preparing for my first Doctor visit
On Monday the 3rd I have my first doctor's appointment on my new, fairly awful medicaid based, insurance. The first and last time I had insurance, a couple of years ago, I ended up with a disdainful, dismissive doctor who ran a standard blood test (blood sugar, cholesterol, the most basic thyroid, etc, all within "acceptable" parameters, not necessarily ideal) and then said there was nothing wrong with me, and said she could just put me on antidepressants. O__O I wanted to cry.
This time, I want to be prepared, rather than asking the doctor to figure it out, I want to be armed with the knowledge to do it myself, with her help.
I would really love and appreciate any suggestions you guys can give me. I've searched the forums, so I have a basic idea of the tests I need to ask for, but I don't want to miss anything.
So, to start with, I need to find out my vitamin D levels, the full thyroid panel, something to check my adrenals? Check again for PCOS? other hormone related issues I can test for? Are there other vitamin levels I can/should test for? Potassium maybe?
Some background to help with recommendations:
I'm a 28 year old woman, 5'9 and 185lbs, I haven't been under 160 since I was 14. I lost 10 pounds in the first three weeks of going primal in April, but I guess it was mostly water weight, I haven't lost any more since then. I still LOVE living primal and it feels right and I still feel way better than I did before. I have celiac disease and some mean fibromyalgia. I was told when I was a teenager that I was pre diabetic and probably had PCOS, though the last doctor said I didn't have PCOS because my hormones were "acceptable". I had the Mirena IUD at the time, vile little device that it was! The ultrasound saw all sorts of cysts on my ovaries, so wtf? And I lost my, already irregular, period after I got the IUD, it's occurred twice in the last year and half. Had the Mirena removed after a year of feeling sick, crampy and horrible all of the time, like 24/7 PMS from hell, gaining 20 pounds, and going from having a small waist no matter how much I weighed to having a gut!
I'm pretty concerned right now that I'm having thyroid and/or adrenal problems and I keep coming across the idea that fibromyalgia may be related to untreated thyroid problems. On top of the muscle pain and soreness, I sleep terribly, restlessly, I wake up with puffy hands, feet and face, I look like a newborn kitten, my eyes won't even open! I'm terribly cold sensitive, and my hands and feet are always cold (much to the consternation of the PunkGrokBoy who must suffer the icy appendages under the covers), I heal soooo slowly (and my system is slow in other ways, tmi there), and working out leaves me with a week's worth of crippling DOMS.
Sorry for the info dump, but this whole thing is pretty overwhelming and I have a fair bit of doctor anxiety. Help me arm myself with knowledge, grokstars, so I can kick these health problems in the ass and get on with having a happy and (finally!) healthy life!
Last edited by punkgrokgirl; 09-30-2010 at 07:00 PM.
Reason: Monday is the 3rd, not the 6th, oh zombie brain!
I don't have good news for you! Let me explain--based on my experience and participation on some thyroid boards.
Yes, fibro has been shown to be related to untreated thyroid. You mention celiac. If you have the auto-immune thyroiditis (Hashimoto's) there's a strong correlation there as well.
Untreated thyroid can also raise cholesterol and BP and cause depression. In fact, most doctors will proclaim patients 'normal' and then just prescribe an anti-depressant and/or statins!
Here's the problem. I was undiagnosed for 5 years, despite having increasingly severe symptoms of hypothyroid because most primary doctors go entirely by 'lab ranges,' but the thyroid hormones have to be read differently. It's where you are in the range rather than the number itself that's significant. Even when I was finally medicated, the endo told me that many of her patients come with 'normal' lab ranges because you can be hypothyoid for some time before the low hormone level shows in the blood. Most good endos treat with a combination of bloodwork and symptoms. But many endos and most primary physicians are clueless.
What to ask for. For your thyroid, you need to ask them to run the tests--TSH, free T4 and free T3. If the doctor says that 1) he only checks TSH OR 2) he never checks T3, then you know you have a doctor who 'doesn't get it' and won't be any help.
Don't ask about the PCOS--tell him that you were previously diagnosed but not treated and ask for help. My understanding that a lot of doctors will prescribe Metformin to help with weight loss in PCOS patients.
If the adrenals are low, then they need to be treated before the thyroid, so you should ask for a test for "adrenal insufficiency."
I hope this helps.
Last edited by emmie; 09-29-2010 at 02:19 PM.
Thanks kindly for the reply, emmie! Don't worry, it's not bad news at all, just giving me more tools to deal with all of this, so it's much appreciated. Hashimoto's is something I've suspected ever since I found out about the celiac disease and started researching auto immune disorders. I'm definitely going to make sure I get my TSH, free T4 and T3 tested, as well as adrenal insufficiency testing (I googled it, it looks very helpful).
Just another tip about Hashimoto's--my own diagnosis came via a biopsy of one of my thyroid nodules.
When the pathologist's report came back indicating a finding of Hashimoto's (from the fluid extracted from the thyroid), my endo commented that this was really helpful because he could not diagnose Hashi's from my blood test because the antibody level was too low for a definitive diagnosis. I've since read that unless the antibodies happen to be actively attacking at the time of the blood draw, you can easily get a negative report but still have Hashi's.
I suspect that's why a lot of doctors don't bother with the antibodies test, since they are primarily concerned with treatment, and the treatment is the same for any form of hypo.
So if you should get a negative report based on a blood test, you could still have Hashi's--I've read that this issue of false negatives is fairly common.
Oh jeeze, biopsy, owch! But at least you got your confirmation. Do you mind my asking what your symptoms were/are? And what kind of treatment have you been using, and does it work in helping to alleviate them? I'm near giddy at the thought of NOT being in pain for the first time in ten years, but it seems like everyone reacts differently to different treatments, and there are soooo many extenuating circumstances, adrenals, other auto immune disorders, etc, etc. Thanks again for all your help, by the way, it really goes a long way toward making this next leg of my mission to heal much less stressful.