Another rant about Doctors who know almost nothing....
Over the past few years I suspected I was having trouble with my thyroid. To cut a long story short I have been diagnosed with Hashimotos.
I have moved countries and have finally found a doctor who is on the same page as me - as in optimising my thyroid through nutrition/supplements - but also looking at my adrenals and other hormone levels.
This all got me thinking and researching about Hashimotos in children. I was a "roundish" 10 and 11 year old girl at school but ate the same as my sisters and was active on my horses etc. I am 5 cms shorter than them. I also read that Hashimotos occurs most commonly in 10 and 11 year old girls due to changing hormones.
My daughter is the spitting image of me at 11 years old. So I decided to get her tested for Hasimotos. I didn't take her to my doctor because it takes ages to get to see him and I knew what bloods for thyroid testing to ask for (TSH, Free T3 and T4, TGA and TPO antibodies).
So I walk into this doctors office and explained I'm gluten intolerant and gluten is the reason my thyroid is being attacked (auto immune issues) - she just looks at me blankly and says "oh so you are a coeliac". I said No. I'm gluten intolerant and I believe my daughter is too.
So we went around and around - Doctor "well we will take a blood test for Coeliac". I said "No - she has no coeliac symptoms except constipation sometimes - which is probably due to her thyroid - it will be negative. I would like her gene tested for gluten intolerance". She called 3 doctors in the practice to ask what the gene tests are - and they all knew nothing (I couldn't remember the exact name of them but have since looked it up on google and found they look for two genes called HLA-DQ2 and HLA-DQ8).
Sure enough she put the wrong test on the form and surprise, surprise my daughter has no antibodies showing for coeliacs. But there was no gene testing done!!
So sure enough I get the blood tests results back and she has some TGA antibodies showing - not high - but they are still there. Her TSH is 1.5 which regular thinking is considered OK - her free T3 and T4 are also in the range - but I KNOW there is something wrong.
So I go back and ask the doctor what she recommends as because my daughter has antibodies present means her thyroid is under some sort of attack - even though the number is lowish. She said "Oh we wont do anything at the moment - just keep an eye on it - come back in a few years". So I said "So you can't give me any advice to stop her immune system attacking her own body". And she just looked at me blankly... So I advised her that she should be recommending a gluten free diet, with supplementation of vitamin D and Selenium, zinc and magnesium - at the very least, and that the advise would be the same for any one of her patients with an auto-immune issue. I advised her only about a third of gluten intolerant people are coeliacs and she should be learning more about it. She got all defensive after that but I don;t care. These people are incompetent.
So I am off with her results to see my doctor because I have an appointment next week anyway. I don't need the gene tests done - the fact that I have the genes and she is showing TGA antibodies is enough evidence for me... Gluten free for her as well (and in black and white for her father to see so he won't continue to feed her gluten because "a little bit is ok" grrrr).
I am just so amazed that here is a young girl struggling with her weight and the pressures from peers that come with that - and they are just going to let me walk out the door telling me nothing is wrong and to do nothing except the watch what you eat and exercise more. (Shes a kid FFS - plays hockey, we eat well - she is doing nothing different to her brothers).
So I'm going to me more diligent with getting vitamin D and the other supplements into her (her bloods show she is slightly low in D) and see what my doctor says next week. Everything I have read said a healthy thyroid TSH should be under 1 - and shes higher than that.
But when are these incompetents with a medical degree going to get with the program?? I'm just so bloody angry.
Last edited by Rueben; 12-07-2012 at 07:49 AM.
This is the reason why I prefer Nurse Practitioners over doctors they seem to listen more. I am a nurse and I truly understand your frustration level. The medical field walks around with blinders on and they don't see the forest for the trees. I am not saying all doctors are like this but a good majority are including Dr. Oz! Don't get me started on him I think he is a money hungry pathetic excuse for a doctor. Everyday in my career I have to hear nonsense about low fat and whole grains and yet our patients are still battling the same diseases over and over again. I have to be very careful in what I say to my patients if I want to keep my job but I present it to them in such a way even the doctors agree. I wish you luck and keep searching for the right one, there has to be a medical professional that is willing to listen and understand that we are a whole body and not just parts. I too have Hashimoto's and have been put on Synthroid but I am doing my best to take care of my autoimmune disorder and I make sure I am the one in charge of my body because I don't trust the medical field with my life!!!
I had a similar experience with DS when he was 7, I suspected a genetic disease that my sister was diagnosed with in her 50s (highly unusual) and mentioned it to DS's doctor and he said oh, it can't be that he just has allergies. Months later and many tests later sure enough DS was diagnosed with the disease. The good news is that once he was diagnosed we were funneled into the specialists. I have every confidence they know what they are doing and they are always available to answer my questions. DS is now a thriving 14 yr old, very healthy for some one with his condition and even compared to the general population. I listen to what the specialists say but we also do our own research. BTW DS takes all the supplement you mentioned.
You are right to trust your instincts.
If you've moved to a country with socialised medicine, I've noticed a big difference between the offices that "bulk bill" and those where you still pay a certain amount. The doctors in the Medicare offices were great, but there was a big uptick in knowledge about the system once I switched to an office where I had to pay.
You know what they call someone who graduated at the bottom of his/her medical class? Doctor.
As a fellow Hashimoto's sufferer, I definitely understand the frustration. My Hashi's was set off my a dairy allergy.
It's frustrating that one of the most important glands in the body is so little understood by most in the medical profession, and that the generally only treat TSH labs and not symptoms and also don't typically test FT4, FT3 and TPOAB.
I've been fortunate in that Naturopathic Doctors (ND's) are actually better versed (generally) than Allopathic docs like MD's, DO's. I suffered from thyroid failure for 9 years and had all the symptoms but my GP would not do anything about it because my TSH wasn't over the lab value of 5.5. My new doc, an ND, said she would have begun treating me when I went over 2.5, 9 years previous, and she believes that a dietary change at that point might have turned it around. As it is, I do have to take supplemental thyroid hormone now. But my ND listens to my symptoms and adjusts my dosage based on symptoms with labs to back it up, rather than basing everything on labs alone.
"Everything I have read said a healthy thyroid TSH should be under 1 - and shes higher than that."
THIS is incorrect. A TSH of between 1.0 and 3.0 is considered evidence of a healthy thyroid provided the actual hormone levels (T4 and T3) are in range.
The TSH of 1.0 is what most doctors aim for with patients who are taking Rx for thyroid. Those supplemental hormones automatically suppress the TSH, and the 1.0 level is considered evidence that the patient is optimally medicated.
I have Hashimoto's, and I'm sure I had it long before I was diagnosed--I was severely symptomatic for about 5 years before diagnosis because it's true that most doctors are clueless about how to read the lab results, etc. I finally self-referred to an endo who diagnosed me immediately on symptoms alone, but I was a mess by that time.
However, it's also untrue that Hashi's "occurs most commonly in 10 and 11 year old girls." It is a disease more common in women, and it tends to develop at times of hormonal shifts--puberty, childbirth, menopause--with menopause being perhaps the most common time. That's why it's especially difficult to get a diagnosis, since the symptoms are usually dismissed by primary doctors as 'normal aging.'
I have a friend who developed Hashi's when she had her first child. That child, a daughter, developed Hashi's with puberty, which for her was age 14. I developed Hashi's at menopause.
I don't want to seem to defend doctors, but the OP was asking for nutritional recommendations--and in the U.S. doctors are NOT trained in nutrition. If there isn't a medical solution, it's a rare doctor who would advise nutritionally, and if they do, it's usually the conventional wisdom, which is nutritional stupidity.
This doctor's attitude of doing nothing for the child at this time is EXACTLY what almost every endo would advise. Hashi's is a disease; hypothyroidism is a condition. It's unusual for someone to be diagnosed with Hashi's before the thyroid is damaged enough to produce hypothyroidism, so that's why treatment is almost always begun immediately. It's the hypothyroidism that's treated; there is no medical treatment for Hashi's. If someone is diagnosed with Hashi's but isn't yet hypothyroid, the doctor will ALWAYS advise no treatment but regular testing for the eventual hypothyroidism as the Hashi's damages the thyroid.
Yes, there is evidence that some efforts at eliminating gluten, etc. may be helpful with this auto-immune disease, but there are no scientific studies to support these beliefs--mainly anecdotal reports on the Internet.
Personally, I feel much better since I've eliminated gluten, but there's no evidence that it's improved my thyroid issues at all.
Doctors, like all professionals, may be flawed, but they usually don't know 'almost nothing.'