Thursday, January 10, 2013

10 years of doctors, more doctors, and more doctors....


My problems with my thyroid started in my teenage years. At 18, my parents took my to a well renown endocrinologist we will call Dr. K. Not all of Dr. K’s tests were covered, and my parents dished out a lot of cash to have various tests done. The results came back that I had several issues. One of them was my thyroid, which would explain the tiredness and sluggish metabolism among other things. The other issues I didn’t understand; not everything was explained to me and a variety of medicines were prescribed. We couldn’t afford them all. As I reached my twenties, I didn’t have health insurance. My PCP’s were unable to help me other than to refill the generic brand for Synthroid called Levothyroxine. As my thyroid spun out of control, I gained more weight, and only had been told by my first doctor the tip of the iceberg of my issues. I sought out another endocrinologist, one that some of my other family members regularly saw.

 

The second endocrinologist, while more forthcoming with my issues than my first doctor, would only add to my weight gain. He told me (looking at the records from the first doctor, who just clearly choose not to tell me everything) that I had Hashimoto’s disease. This is a severe thyroid disease classified as an autoimmune disease because the thyroid gland is attacked by in a “variety of cell- and antibody-mediated immune processes.” (Wikipedia). It results in weight gain, depression, mania, sensitivity to heat and cold, fatigue, migraines, hair loss and much more, all symptoms of which that I experienced. It might interest you to know that family members on both sides of my family, living and deceased, have Hashimoto’s thyroid disease. It is strongly possible that my Hashimoto’s disease is caused by wheat consumption. I have discussed this in previous posts, but I will reiterate that one of the symptoms of having gluten sensitivity is having autoimmune disorders such as Crohn’s disease, Hashimoto’s disease, and even rheumatoid arthritis. This is because in some people, the gluten can not be properly processed in the bowels, and has the ability to sneak out into the blood stream and wreak havoc including causing the production of antibodies that will attack the thyroid. My recent blood tests not only cleared me of my insulin resistance, but my thyroid is functioning better than ever. Time will tell as I lose more weight, and have my dosage reduced, if wheat was the cause of this disease. Meanwhile, not only was Hashimoto’s disease one of my issues, but I heard for the first time “insulin resistance.” I didn’t know what it meant, or how to fix it. Dr. B, the second endocrinologist prescribed metaformin and told me I couldn’t eat anything with sugar in it. “Why are you gaining weight?” I remember him saying “you understand you can’t eat anything with sugar in it right?” Well, no I didn’t understand that. There was never any explanation of what insulin resistance was or how to eat properly with it. And it was more than sugar. I would only find out recently that sugar was more than what caused insulin levels to spike. It was wheat based foods and starchy carbs.

 

I had several more trips to the second doctor. Metaformin disagreed with me and resulted in many trips to the bathroom! He tried Actos, which made me gain even more weight; among other medicines for the “insulin resistance” I still didn’t understand. My thyroid medicine kept being increased, but the Levothyroxine didn’t seem to have any affect. I felt the same: tired and depressed. Due to the sudden weight gain, my gall bladder was affected and I had to have it removed. I was about 22 when that happened. I remember clearly one day wondering if I would ever stop gaining weight. would I be 400 pounds? I didn't know. Would my husband still love me? Desperate, and not seeing results, and frankly tired of being treated like shit, I went back to the first doctor, Dr. K, which again cost me and my parents a lot of money out of pocket.

 

Dr. K said that Actos and some of the other medicines that the first doctor prescribed were ridiculous and known for their weight gain. My thyroid still not stable, he prescribed a higher dose of the generic for Synthroid and also gave me some samples of liquid metaformin which was supposed to be gentler on the body. It did work somewhat, but without insurance was impossible to maintain. I went to my regular PCPs for many years trying to do something about my thyroid, which still wasn’t functioning properly. In between trying to deal with that, I went to see a gynecologist in Monroeville who told me (while wearing nothing but a hospital gown on a table, mind you, because she had just examined me) that “having thyroid issues was no excuse for my weight gain and that I needed to eat better and exercise.” I pointed out to her that she herself had some weight to lose. (She was overweight, criticizing me!! That takes some balls don’t you think???) She agreed that she had her own issues, but this was about me. Oh, how caring. Gee, you shouldn’t have.  Not knowing my traumatic issues from childhood (see my very first blog) related to being forced to exercise when I was younger, and basically growing up thinking I was ugly and fat already, this pretty much was the worst thing that she could have said to me. It would be many, many, years before I went back to a gynecologist due to the depression that set in. No one could help me. I would give up trying. This is just how I was and I was doomed to have Hashimoto’s disease that would never get better.

 

Every doctor and person around me thought I just couldn’t put down the fork. This was never my problem. Not that I ate healthy mind you, but I wasn’t one of those people on the “Biggest Loser” who didn’t want to give up their gallon of ice cream every day. In fact, one of the symptoms of having such a severe thyroid disorder is having a complete loss of appetite. I never felt hungry, just tired. I could sleep in until 2pm wake up, and still not be hungry. I might eat once a day. So someone explain to me, please, how, if your thyroid causes you to gain weight, you are tired all of the time, and doctor after doctor is not able to even stabilize my thyroid, how I was supposed to lose weight even if I found the energy to work out????  

 
I saw my regular doctor for many years. At various times, he would encourage me to see an endocrinologist because my problems were out of his specialty. I still see him today; he always listened to me and did his best to help me, even at my worse, darkest times.  There were a few other endocrinologists or specialists I tried during this years, whom I only saw once, who usually either told me my thyroid was fine, or that I needed to take metaformin. It was the same old stuff.  For my PCP, treating my thyroid was out of his realm of specialties, but I begged him to help me anyway, having told him about all of my misadventures with endocrinologists. He himself was unable to recommend a good endocrinologist in the area. (Great. They are all clearly a bunch of asshats who don’t know what the F@$# they are doing, I thought to myself).   He tried me on Armour, a synthetic thyroid drug made from the thyroid of pigs. I tried this for many years, without any success.

 

About 26 or 27 years old at this point, and at 330 pounds, and with the encouragement of my PCP, who was unable to stabilize my thyroid so far, I decided to try the market again and see if I could find a decent endocrinologist again, who could help me. I sought out a woman and UPMC in downtown Pittsburgh. Having a huge endocrinology department and being one of the best hospitals in the area, I tried my luck there. After seeing Dr. B one time, within the first five minutes, she informed me that “there was nothing she could really do to help me. I would need bariatric surgery, and even then it would be difficult for me to reach a normal weight.” She also told me it was highly unlikely that both my T3 and T4 needed medicine. I explained to her that I had tried Levothyroxine for many years, without any success and begged her, (in tears at this point because she had just told me there was no help for me basically), to give me something to address the T3. She quoted me some statistics about the number of patients that actually need a T3 drug, but with tears in my eyes I convinced her to try to treat me on cytomel also which addresses T3 production.  She put me on 250 mg of regular Synthroid, not the generic. The generic she said (Levothyroxine) did not work the same in all people. She also put my cytomel 5mgs twice a day. I had some blood drawn and went down to the cafĂ© to call my mother, in tears, yet again. She did not address the insulin resistance nor did she explain it, prescribe anything for it, or discuss it at all. Would there be any help for me?

 

I looked online for reviews of endocrinologists. I wouldn’t be fooled again, I thought. I found reviews for a Dr. E that had good reviews. He was a doctor that would listen. Again I traveled downtown to an area that was supposed to be known for its good health care and quality doctors. He spoke to me for an hour, discussing my long history and my various symptoms. He wanted to see current blood tests before addressing anything else, but it seemed promising. Two weeks went by and I hadn’t heard anything from their office. I would spend the next two weeks further trying to obtain some answers from someone in his office. They would continuously refuse to let me leave a message for or allow me to speak to him. Finally someone agreed to check my results and said that my results were fine, and that if the doctor wanted to see me he would call to have me schedule an appointment. I was completely jerked around by his many (no less than 6 different secretaries and nurses) and no phone calls every came. A few months later I received a letter saying that his office had been trying to contact me to make an appointment. (What the F#@!) By that time I was completely in despair and had given up on endocrinologists again. I still have not seen another endocrinologist since then. I was 28/29 when I saw my last endocrinologist. I will be 31 in march.

 

I had my PCP obtain my blood results from the last doctor, Dr. E. Before I had seen Dr. E I had been prescribed 250 mgs of Synthroid and 5mgs of cytomel and I had been taking it for several months. This seemed to be the right dose and combination of things, my PCP said, as my thyroid was finally showing improvement. My insulin levels and cortisol levels were still through the roof. I worked on dieting and cutting sugar. I stopped drink any pop. I read a book called the insulin resistance diet that instructed that if I ate a balance of protein with limited carbs in certain proportions that my insulin would improve. I learned from this book at least that when your insulin levels spike due to sugar or carb consumption, that your body stores the sugar/carbs right to fat because it is unable to process it correctly. So I had finally learned what insulin resistance was- or so I thought. I started to lose weight just by dieting, not eating sugary foods, pop, etc. Over a year’s time I lost weight and my thyroid was stabilized for the first time. This was a year and a half ago. I had blood tests done, and my insulin and cortisol levels were still high. I thought I was eating better- so what was the problem? Also, the abnormally high levels of insulin in my blood were causing other problems. High blood pressure, as well as mood issues. My stress levels were through the roof. As you have seen from my previous posts, this is the reason I joined the gym last year. I thought more weight loss would be great, but I really wanted to do some yoga/tai-chi sort of class to relieve the stress. I couldn’t keep going on how I was. The driver’s license picture in my previous posts was taken in July of last year. This is right before I joined the gym. You can see from my face that there is one of me missing!!!! In 2011 I wore a size 26. Early in 2012 I was a 24. After joined the gym in July, I started to lose sizes quickly. First a 22, and then after not eating wheat and training with Brenton (see my last “special dedication post!) I am now currently an 18. These are a little big on me as I am starting to gradually work my way down to another size.

 

The real breakthrough was when I stopped eating wheat. Not only is the Hashimoto’s disease a symptom of wheat or gluten sensitivity, but insulin resistance is commonly related to gluten and wheat. Eating all the gluten and starchy carbs sends insulin through the roof for people like me with insulin resistance. For people with insulin resistance, the body stores that sandwich you just ate or pizza straight to fat. The person is swollen with insulin and unable to lose weight and your blood pressure among other things is affected. It is highly possible that reading the wheat belly in combination with the help of my trainer saved my life. I would have continued to stumble around eating what I thought was healthy, unknowingly sabotaging myself the entire time.

 

There is one more person to whom I owe thanks. My mother was the one who helped pay for the personal trainer, and encouraged me to do it. She is also the one who listened to me in tears, over many years, taking me to doctors when I was younger. She also has consistently been trying with me whatever different health foods, supplements, or lifestyles I have been investigating this whole time, supporting me the whole time. She recently bought me the wheat belly cookbook which is amazing! Readers can look forward to some recipe reviews in the future! Thanks mom, you saved me too.

 

Find your own truth. Educate yourself. The internet is a great resource, but research some books written about a particular subject by doctors/people who have done extensive research and have studied numerous cases of what you are experiencing. The truth is out there. It is up to YOU to find it. No doctor is going to find it for you, and as Brenton said to me once, “there is no magic pill” to make your problems go away or make you lose weight. Never give up and never let anyone, doctor or not, convince you that there is no hope. Have faith. I know some of you out there are not spiritual or religious, but I am telling you that my prayers have been answered. “Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you.” –Matthew 7:7.  God helps those who help themselves. Make the first step and seek the knowledge. I’m willing to help! Whether its blood pressure or depression or whatever, let me know what topics you’re interested in and I’ll try to come up with some books to read and review for you on the subject. Whether you’re a complete stranger or a good friend, leave a comment or facebook me on what you would like to see. Be healthy, have energy, be happy and LIVE!

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