Should I get a second opinion?

Discussion in 'Fibromyalgia Main Forum' started by nhz1atc, Apr 15, 2003.

  1. nhz1atc

    nhz1atc New Member

    My Doctor tested me for thyroid, and the results came back with a TSH of 4.89 and a T4 Free of .79. She told me that I was borderline Hypothyroid and that we would just monitor it yearly. I have the symptoms, Fatigue, occasional dizzy spells and vertigo as well as foggy memory etc. Should I see an endocronologist for a second opinion....
  2. Dara

    Dara New Member

    I just had an appointment with an endocrinologist, and I now realize I should have done it years ago. My blood tests for thyroid have always come back in the "normal" range, but I have all the symptoms of thyroid problems. I had a partial thyroidectomy done about twelve years ago and at that time it was decided I did not need thyroid medication because my levels were "normal". Well, now, with only 1/3 of my original thyroid left, I have an enlarged thyroid. As the Endo explained it to me, even though my levels were"normal", without the medication it made my remaining thyroid work "overtime", which now has made it to become enlarged. I also have nodules on my thyroid, which could become cancerious again. Definitely, I would say find a good Endo, this is their specialty. I don't think that many doctors really understand the thyroid and just how bad it can affect you. My niece also had "normal" thyroid function tests, she went to an Endo, and they found she has Hashimito's disease, (don't know if I spelled that right??).

    Dara
  3. dojomo

    dojomo New Member

    ........


    Guidelines for TSH levels CHANGED

    Millions could have thyroid malady
    United Press International
    Wednesday, January 22, 2003
    JACKSONVILLE, Fla., Jan 21, 2003 (United Press International via COMTEX) --

    Millions of Americans once considered to have a normal thyroid should be tested and possibly treated for abnormal thyroid function, according to new guidelines issued by a physician group Tuesday.
    The American Association of Clinical
    Endocrinologists' guidelines double the number of people who have abnormal thyroid function, bringing the total to 27 million, Hossein Gharib, endocrinologist at the Mayo Medical School and president of AACE, said during a teleconference from Jacksonville, Fla.

    This number is roughly equal to the number of people with diabetes and cancer combined, Gharib said.
    The thyroid is a small butterfly shaped gland located in the front of the neck just below the Adam's apple. It produces two hormones that help regulate metabolism. The most common dysfunction of the thyroid is when it does not produce enough hormones, a condition called hypothyroidism.
    "If the thyroid doesn't work properly, neither do you," Gharib said.

    The new guidelines narrow the range for acceptable thyroid function. A test used to determine levels of thyroid stimulating hormone is used to determine whether the thyroid is functioning normally, and the guidelines tighten the acceptable range from 0.5 -- 5.0 microunits per milliliter -- to 0.3 to 3.04 mu/ml.
    The association decided to lower the range because of data suggesting many people may have low-level thyroid problems that could be improved with treatment and a narrower TSH range will give doctors reason to more carefully consider those patients.
    Donald Bergman, an endocrinologist and the president-elect of AACE, said: "If left untreated, thyroid disease can lead to a lot of complications," including high cholesterol, heart rhythm disturbances, bone loss, depression, abnormalities in growth and development in children, and even coma in severe cases.

    Early symptoms of an under-active thyroid include fatigue, being intolerant to cold and dry skin, Bergman said. Symptoms of an overactive thyroid include fatigue, change in weight, mood swings and nervousness. Many of these symptoms are vague and can go unnoticed, meaning some patients might be unaware their thyroid is not functioning properly until they undergo the TSH test.
    The TSH test is an inexpensive simple blood test that all physicians can do, Bergman said. The AACE recommends all women over age 35 and men over age 60 get screened for thyroid function.

    In addition, anybody with a family history of thyroid disease, a family history of autoimmune diseases such as diabetes, arthritis and colitis, should get screened. Women who are thinking about becoming pregnant also should get screened because thyroid problems can lead to complications during pregnancy, Bergman said.

    The new guidelines do not necessarily mean everybody who falls outside the normal range should be treated for thyroid dysfunction, Bergman said. Doctors should consider treatment on an individual basis.

    Treatment for hypothyroidism, the most common thyroid disorder, is synthetic thyroid hormone.
    Thyroid experts said the new guidelines are unlikely to change the way most doctors diagnose and treat thyroid disorders.

    Although some patients with early stages of under-active thyroid do not fall into the old TSH range of 5.0, it is debatable whether they should be treated as the new guidelines would suggest, said Lewis Braverman, chief of endocrinology at Boston University's School of Medicine, who was involved in the study on which the new guidelines are in part based.
    TSH levels increase slightly with age, he noted, so "whether patients with TSH values of 3 to 5, especially in the elderly, should be treated is controversial," Braverman told UPI.
    "I think what happens in most doctor's offices, if the patient is feeling normal, most physicians would not insist patients get treated" even if their TSH level is elevated, Daneil Drucker, an expert on thyroid diseases at Toronto General Hospital, told UPI.

    One problem is there are no large studies to show early treatment of mild TSH elevation provides any benefit, Drucker said.
    Doctors, therefore, likely will evaluate patients on a case-by-case basis to decide if symptoms warrant treatment and will not use the TSH test as their sole reason for initiating medication, he said.
    (Reported by Steve Mitchell, UPI Medical Correspondent, in Washington.)
  4. KayL

    KayL New Member

    to see an endocrinologist. He will order more specific thyroid blood tests and address that for you.

    Karen
  5. Mikie

    Mikie Moderator

    Because I had so many symptoms of hypothyroidism, my doc put me on 25 mcgs. of Synthroid. It has really helped and my labs have even improved.

    More and more, docs are discovering they need to take other things into consideration besides just the lab tests. Many of us have normal amounts in our blood but our bodies are not efficient at using this hormone.

    Love, Mikie
  6. nhz1atc

    nhz1atc New Member

    I went back to the doctors and she has started me on synthroid. Dose is .05 and she says she will gradually increase the dose. How long does it ussually take to start feeling normal again??? Thanks, Alan