About Karen Brawner Expertise I will answer any questions you have regarding the thyroid whether it be cancer, cysts (types), hyperthyroidism, hypothyroidism, blood tests for thyroid problems, surgery, fine needle biopsies etc...
Experience My complex cysts on my right thyroid gland and the isthmus were found my accident when my doctor thought I was having a TIA. The ultrasound found a complex cysts the size of a golf ball (which turned out to be the size of a tennis ball when it was surgically remove). Doctors were totally surprised because for 5 years, including the day I went to surgery, all of my thyroid blood work was "within the normal range". So much for blood work being conclusive..
Thyroid Problems - How do I get someone to diagnose me correctly?
Expert: Karen Brawner - 2/3/2006
Question I began to put on a lot of weight in the last four years despite eating
fairly normally. (65 lbs.) I suspected thyroid problems two years ago
when I couldn't lose weight despite great effort with diet and exercise.
I went to an internist for bloodwork and asked for the TSH(?) test. He
sent me results that were "normal" and advised me to just lose weight
by eating less and exercising more!
I then went to an endocrinologist who performed the test again
and did a suppression test. He suspected that my symptoms
were thyroid-related until the results came back--"normal"
again. There was no follow-up advise from him.
I have been working with a dietician and trainer for 16 weeks
and have only lost 9.5 lbs. This is withan increase to five days per
week of intense 1 hour workouts and a well-monitored diet.
Previously, in the months before, I only worked out once or twice every
other week.
I am on meds for high blood pressure, depression and
perimenopausal issues. I also have a very stressful family life. I
still believe that my cortisol level may be elevated no matter
what the thyroid tests have said in the past. I believe that stress,
the menopausal transition and, in particular, meds have really
messed me up. I believe these factors are playing a role in my
metabolism not functioning properly.
What can I do to get someone to diagnose me properly and who
should I see for this? I don't think my internist is the answer.
Thanks for any advise you can provide.
Answer Dear Cate, It is possible for your cortisol level to be elevated since it really has nothing to do with the thyroid or thyroid blood tests.... Cortisol level are actually controlled by the pituitary and adrenal glands.. Stress IS the MAJOR cause of cortisol problems...
If your internist and the endocrinologist ONLY took a TSH test, then you need to find some one who will do ALL of the thyroid blood work that is necessary to rule out a thyroid problem... The TSH test is one of the most unreliable blood tests there are since most all labs say that a reading of 2-6 is within the normal range, when infact that is like saying "one size fits all" and that is simply not true.... There can be many problems with the thyroid (nodules, cysts, masses etc) and these do NOT effect the TSH and often the only way to know anything about these problems is to have an ultrasound of the thyroid to see if anything can be seen... An enlarged thyroid can also be overlooked, cause thyroid symptoms, but yet still give a normal TSH reading....
You are simply going to have to find an endocrinologist or a thyroidologist who will LISTEN to what you are telling them about your life-style, your stress levels, etc, do ALL of the proper blood work for thyroid and cortisol blood levels, even do an ultrasound to rule out nodules or masses on the thyroid gland etc....
Keep exercising and dieting as loosing 9.5 pounds in 16 weeks is really good since you are not loosing too much too fast.... Remember, it took you 4 YEARS to put on 65 pounds, so it will take at least 1-2 years to take this weight off safely so you can keep it off.... You MUST exercise and diet even if you find out you have a thyroid problem, because medication alone will NOT cause weight loss when using thyroid medication... Infact, if you done diet and exercise the chances are you WON'T loose weight, but actually GAIN weight....
As we age, out body metabolism changes, and when menopause starts, that even adds more change and people normally gain weight if they do not eat healthy, diet and exercise..
