I agree with this post. And I’m glad, despite the hell that is most modern medicine, when faced with something unusual, I’m glad there is some resolution and relief.
Blessings
This puzzles me. Checking thyroid levels is routine bloodwork, I’ve had it done every year for… well, years. Certain since I start showing signs of perimenopause. (For the record, the doc this year said my levels are down a bit from last year, even if still in normal range right now.)
While lack of thyroid hormone isn’t the sole factor in obesity it really does make it harder to lose weight. I have a sister whose thyroid failed in her teens. One of the signs she needs her medication dose reviewed is inexplicable weight gain. She has kept her weight reasonable most of her life but she really does have to work harder at it than the rest of the family.
I have Hashimotos . Had it for over 30 years, but no name was put on it until recently. Thyroid isn’t the most studied gland about, they are learning new things every day. I’ve only had a complete work up done six or seven times. Most GPs just follow the numbers. I’ve had to do a lot of research on my own( this is before internet) .
I’ve read a couple of econ textbooks that use the AMA as an example of an organization that has the effect of a powerful labor union. Make of that what you will.
The AMA is a lobbying group, sure, but they don’t have control over medical licenses. If you have a gripe about potential malpractice, you need to be the one to take action, and that involves reporting them to their state licensing board.
The OP could have been written almost word for word by my girlfriend, except she managed to find a specialist fairly quickly who did the full workup and diagnosed the Hashimoto’s.
Here’s the thing that many of the posters in this thread who’re saying things like, “Great, take a synthetic hormone, case closed,” are missing, and this goes double for doctors, who I’d hope would know better: WHY is her hormone level off?
When my girlfriend went to the specialist she found, he did a really comprehensive workup, and based on his experience decided that she had a mild insensitivity to both gluten and dairy. Nothing approaching the problem that celiacs have, but enough that her system was fighting itself because of her diet. He put together a 6-month diet plan, starting by phasing out almost everything except meat and vegetables (and even some veggies were out), and then slowly adding things back in. This also included weekly visits to check her levels, and then the visits tapered off over the course of the 6 months.
While she’s not 100%, she’s light-years ahead of where she was. Her weight is down, she’s actually lowered her synthroid dosage, and even had a mild psoriasis on her elbows clear up.
I think the biggest problem with modern medicine, and I’m sure most of this is due to the health insurance industry and its ridiculous lists, is that far too many doctors are only interested in prescribing pills to treat symptoms, instead of finding out what the underlying problem is and treating that. It took my girlfriend doing her own legwork, finding the right doctor, and $7000 out-of-pocket to find out what was actually wrong.
The flip side of all this is that there are too many patients who want, (hell, demand) a quick fix without spending time and money on tests or trial and error. They expect doctors to be all knowing and all seeing when much of medicine is still guesswork, and when patients rarely give all the necessary information (sometimes deliberately). Hindsight, as they say, is always 20/20. What may seem crystal clear now may not actually have been so at the beginning.
If a bazillion tests are ordered there’s bitching because it’s time consuming, boring, sometimes painful, and expensive. If doctors don’t order the tests there’s bitching because not enough is being done. They can’t win. God knows why anyone enters the profession these days.
Oh that’s easy. Money.
Treating Hashimitos is NOT identical to treating other forms of hypothyroidism. Also, having one autoimmune disease, like Hashimitos, puts a person at greater risk of developing other autoimmune diseases… diseases which a doctor will not routinely test for or diagnose quickly unless she knows you have risk factors for it. If I was the OP or his wife, I’d be very upset, too.
That being said, Hashimitos is probably one of the most commonly misdiagnosed conditions out there. So I have no idea if this would rise to the level of “malpractice” or not. I’m not qualified to answer that, but I will validate your right to be pissed off.
No, I teach pre-med students and almost to a person these students enter medicine because they like science and they want to help people. These kids come out saddled with 100s of thousands of dollars of debt, before they begin their residencies that pay virtually nothing.
If they go into pediatrics or general medicine they are paid much lower than other disciplines. If they go into OB/GYN or anesthesia they pay unbelievable malpractice insurance costs.
May do make a really good living, but it’s hardly all doctors and for most, it’s not why they go into the field.
Okay. How is it different?
That’s kind of news to me, as I have Hashimotos and the only treatment I’ve been given or needed is thyroid hormone replacement therapy.
I’ve been very lucky in having doctors who have been willing to suppress my TSH levels much lower than what’s considered normal, in order to treat my symptoms. It’s one thing most docs don’t realize is that the “normal” values for hypothyroid were determined decades ago before they knew how many people had low levels of hypothyroidism. So if normal is generally thought to be below 2.0, I keep my TSH levels at about 0.2.
Sure, but the state licensing boards generally follow care protocols established by the AMA.
Earlier treatment with hormones before the levels are abnormal on a test may delay or prevent hyperthyroidism from developing. Selenium, magnesium and calcium supplementation may help the autoimmune portion of Hashimitos.
Yep.
My husband graduated in 1991, and we’ve still got well over 100k in med school debt. He’s a non-surgical sports med/family doc in an academic program. We aren’t starving by any means, but he drives a Scion with 300,000+ miles on it. He loves WHAT he does, not necessarily the way in which he’s allowed to do it, by law.
More than 20 years later, you guys still have over 100K in debt? Where on earth did he go? My husband graduated from a state school owing about 150 between school and living expenses, and that was a decade of tuition inflation later.
So this AMA has little to no influence on the state licensing boards? Just asking, I don’t have a strong opinion or very specific knowledge about this other than what I previously mentioned.
Well, and numerous, independent subspecialty boards, I’d expect, but did you have an alternative, preferred suggestion?
Frankly, the doctors I know take the threat of malpractice extremely seriously. If you’re applying for privileges at a hospital, etc, you generally have to report any time you’ve ever been even accused of malpractice. It’s not like getting a traffic ticket or something.
Edit: On Googling, I see the Federation of State Medical Boards, which brings together state board members and experts in various medical subjects.
Just mentioning it because lots of people default to “I’ll report this to the AMA!” when they have no disciplinary power.
The study described in the article is interesting, but tiny. And I’m not sure what I’m supposed to do with that information–should I do the Hashi’s antibody tests on everyone who has fatigue, right along with the TSH and T4? That’s a really expensive proposition, especially since their one-year follow up and lack of true clinical outcomes doesn’t really tell us if it makes a lot of difference.
There’s a better argument for doing the antibody tests on those with subclinical hypothyroidism (high TSH and normal T4) because it can help predict which of them will progress to overt hypothyroidism. But those who already have overt disease (high TSH and low T4)? Nearly all of them have Hashimoto’s, and the test is an expensive test that doesn’t change your treatment.
There’s not much in the way of evidence for any of these.