Appropriate Thyroid Tests?
I've been following PB fairly strictly for 4 months now and have been in a continuous state of ketosis for three and a half months but have had only a six pound weight loss, as well as ongoing symptoms such as fatigue, muscle cramps, thinning hair, etc. So, yesterday I went to an endocrinologist to see if I could get some thyroid tests done. He ordered:
TSH w/ reflex to T-4
The guy spent all of two minutes talking to me, and really didn't explain any of the tests he ordered or why. I was his last appt. of the day, and it was obvious he was just trying to get rid of me. I'm wondering if anyone in here knows: Are those the most appropriate tests for thyroid? Should I get anything else tested? I'm contemplating whether to have the tests done or to make an appointment w/ another doc that I feel more comfortable with.
Thanks for any info.
Those tests are all good, however keep in mind if the cortisol test is a single blood test it is pretty much useless unless you have full-out Cushing's or Addison's disease. A four-point salivary cortisol test is better for determining sub-clinical adrenal problems, which can affect the thyroid.
Additionally, if nothing turns up with those and you're feeling frazzled, I'd suggest getting Free T3 and Reverse T3 checked as well to rule out conversion problems, and Ferritin to rule out anemia. Finding a better doctor who will work with you to order appropriate tests and will listen to your input is a good idea.
Hope that helps!
It's important to have an endo you are comfortable with, but I would not make a change based on one visit. (My current primary bought the practice of my former doc when he retired, and it took me about 4 visits to feel comfortable with the 'new guy.' but that was years ago, and I'm glad I didn't make a change too quickly.)
Yes, the tests are fine. Most docs check only T4 for diagnostic purposes, but if you are diagnosed as hypothyroid, he should be checking T3 on a regular basis. If he doesn't (and many don't), then you need to look for another doctor.
Also, what's important is how he interprets these tests. When you get the results, be sure to get a copy for yourself (it's your right, and you cannot be denied). If you have any questions, post your numbers here.
Most good endos will treat based on both symptoms and blood values, so consider whether this guy is interested in your symptoms, too. I'm hypothyroid, and I've had my meds adjusted sometimes on symptoms alone (when the lab values didn't indicate a change was needed) because my endo is very responsive. My first endo told me that with thyroid issues, it's often more important how the patient feels than what the lab values are.
It's tricky because when you're dealing with thyroid hormones, it's important to be optimized to feel your best, but too much is dangerous, as overmedication can lead to cardiac problems. That's why many doctors are extremely conservative in treating thyroid and why it's important to have a good relationship with your doctor.
If you have a thyroid problem, you should read the blog stopthethyroidmadness.com. I learnt a lot there.
Thanks for the info. I'm going to get the tests tomorrow and will post results when I get them. I'm really hoping to find something that can be fixed. It doesn't seem normal to need a nap every afternoon after a full night's sleep, and the lack of weight loss is a bit depressing.
I just want to report back on the results of these tests: I was told over the phone that "everything was normal", but I requested to have the report sent to me in the mail. It turns out that one thing wasn't quite normal, and that was my vitam b-12 level. On a range of 200-1,100, I scored a 312. I researched b-12 deficiency and discovered that many of the symptoms I experience are, in fact, related to b-12 deficiency. I'm glad I asked to have the report sent, or I wouldn't even know that my vitamin b-12 was low.
I've gotten some sub-lingual methylcobalamine supplements and am starting to use them... Does anyone have a recommendation about the best supplements to use to up vitamin b-12? (I can only imagine that my b-12 must have been even lower four months ago before I started the PB. Before going primal, I ate hardly any meat and was mostly vegetarian, and from what I've read, meats and fish are the best sources for getting this vitamin.)