thyroid updates

So I went to my family doctor recently for a check-up and my thyroid bloodwork.

The bad news is that my thyroid is out of whack again, and the even worse news is that Armour thyroid is no longer producing the natural T3 medications that are so much more effective for me.

What the heck? What I am supposed to do for meds now?

Another frustrating thing is that if your TSH is higher than normal for you....yet still within the range of "normal" the docs go by.....they won't change your prescription.

My NP (nurse-practitioner) listens better than most, and she knows I have a long history of trying to establish the best TSH level for me. She knows I feel best when my TSH is under 1.5 (preferably more like 1.0), and that if it gets up around 2 or more, I start experiencing more symptoms like fatigue, cold, and weight gain...all of which I've been having again.

My level this past test was 2.4, but her hands are tied. She can't up my prescription when my levels are still in the "normal" range.....even though they are not in the range that is optimal for me and which keeps me from gaining weight.

And furthermore, if I stay in her care, I have to be on all levothyroxin, a T4-only medicine, instead of on the combo of T4 and T3 etc. meds that come in Armour. AND in effect I would be getting an even lower dose, because she didn't raise my levothyroxine dose to compensate for the loss of the Armour because my TSH is still within "normal."

Augh. I am so frustrated with this. She really is better than most docs I have had, but it frustrates me no end that they are required to rely on this TSH test so heavily and completely discount symptoms as a guide. My T4 and T3 levels are "normal," but just barely....but that doesn't matter, because they ARE normal, and so is the TSH. Doesn't matter if you are experiencing symptoms and you've experienced a deterioration trend in your levels....you are either normal or not, and that's that.

Here we go again with the binary approach in medicine. You are either normal or abnormal and there's nothing in between. If the cutoff is 140 (pulling a number out of the air for demo purposes), you are normal at 141 and no changes need be made, but you are abnormal at 139 and changes should be made. There's only two points difference, for crying out loud! But one is above an arbitrary cutoff and one is below it, so it doesn't matter.

My test results are clearly trending negatively and I'm experiencing more symptoms.....but because I'm still marginally in the normal range, they aren't going to change my dosage.

This frustrates me so much. If they care so much about my weight (she suggested briefly that perhaps we might think about "carving off a few pounds".....ugh, I am NOT a turkey), then they ought to be LISTENING to me about the one thing which DOES help with my weight.

I don't really lose much weight when my thyroid levels are more well-regulated, but I stop gaining and am more easily able to keep my weight steady. Isn't that a worthy goal? The last thing she wants is for me to gain more weight....but she won't do the one thing which is most effective at preventing that.

Now, I'm making her sound like an ogre, which she really is not. She's been more sympathetic and listened more than a lot of docs I have had, and she's a genuinely nice person. I was unhappy about her bringing up the weight loss thing, but she backed off quickly when I reminded her that my history showed that this was the fastest route for me to actually gain weight and if we wanted to avoid me that, dieting was the worst thing I could be considering. She acknowledged that I was the person who knew my own history best and what was most/least likely to work for my body. So that was something, anyhow.

Also to her credit, she knows I feel strongly about the whole Armour thyroid thing and about titrating my TSH levels more carefully. She said HER hands were tied, but suggested that I might consider going to see a local naturopath for further consultation. There are some alternatives for Armour out there (according to the thyroid websites) but she is not allowed to prescribe them; she thought perhaps the naturopaths might have access to them instead.

So I guess that's what I'm down to. Personally, I'm a bit leery about seeing a naturopath. I think some are okay and have decent training, and I'm okay with considering some alternative modalities of care. I'm not always convinced every alternative modality works, but I'm open to considering some. I figure I can always say no if it sounds too "woo-woo" for me.

[To my surprise, I actually have found a couple of "alternative" modalities -- like chiropractic and acupuncture -- pretty darn useful and effective for me, so I try to at least keep an open mind to considering other forms of "alternative" care.]

On the other hand, I do think there are some nutcase naturopaths out there, and some "alternative" modalities are potentially harmful. Just because one alternative modality works for me doesn't mean they are all going to, nor that they are going to be perfectly safe. And the science part of me squirms a bit when considering some of this stuff. I'd rather have some really good studies showing me what's effective and what's not, what's safe and what's not.

On the other other hand, though, traditional allopathic medicine has been mostly unhelpful for me in dealing with this thyroid stuff, and right now I feel like I'm stuck between a rock and a hard place and don't have many choices left. Stay with my traditional practice and have my thyroid needs undertreated, or go try an alternative practice that might meet my needs better but which might also try to rook me into some bizarro stuff.

After thinking about it, I think I'm going to check out a couple of local naturopaths who are trained in both allopathic and naturopathic medicine and see what they say. I'll be taking along a healthy sense of doubt and ability to say NO, never fear, but I know I need to figure this thyroid thing out better. I know from experience that this thyroid thing is the most important thing to keeping me healthy, so the bottom line is that's just GOT to get addressed better.

Levothyroxine may be the "accepted" med in the allopathic world, but it's not the better med for me, and I know I'm incredibly sensitive to even very small changes in TSH levels. If I have to go to a more "alternative" practitioner to get my needs addressed adequately, then so be it.

I'm just pissed as hell that it's come to this. UGH.