My latest endo appointment

[Guest guest]

So it was a nsh endo reffered to by my gp to talk about insulin resistane. 20

minute slots and i was in there for 1 hour 30 mins!

We talk about thyroid for 1 hour diabates for 20 minutes the total opposite of

what i wanted.

Typically wanted me to reduce T3 and add in some T4, i just said to him im not

doing that and in the end we agreed to reduce my T3 from 125 to to 75-100 and

monitor bloods (i know they dont show much when on T3 but he insited but then it

opened the opportunity for more blood tests)

When i asked about RT3 he said its bollocks his exact words lol

All the usual crap do you even need to be on thyroid hormone your blood tests

were normal before hand same with adrenal support was there any need in the past

ect ect needless to say we discussed this for a long time.

The amount of times i made a massive point of saying im going to go off how im

feeling and not blood tests he hopefully he got the picture.

Onto the insulin resistance side of things straight away hes just like yeh you

dont have it, cant test insuluin or c-peptide unless your blood sugar levels are

out of range (i explained to him i dont eat sugars or carbs to raise my blood

sugar as they make me feel rubbish, he was having non of it) When i told him

that the metformin(typical drug for diabates and insulin resitance) was clearing

up the yeast in my body when i gave myself a trial he then said well naturaally

things can just get better, then i said well they came back when i stopped, not

much he could say.

So yeh i wont be reccommending this doctor for sure but he is quite thorough i

will give him that, he has agreed to put me in for a load of blood tests and a

funny thing, i said there is no point in fasting glucose as it will be normal

due to my diet and he just said ok we will still call it a fasting but you can

eat whatever you want 1 hour before the test, pretty much asking me to prove the

spikes which i see after carbs so i will try.

The difference in the doctors knowledge between NHS doctors and the likes of

dr.peatfield or a doc i saw of the good doc list is unreal.

We agreed for

9am cortisol

TSH FT3 FT4

Fasting glucose

And in 5 weeks another thyroid panel one week before my follow appointment. He

has also put me in for some heart scans as my pulse was a little fast (due to T3

dose taken not that long before appointment) pretty much trying to scare me off

T3 saying my bones ect and my heart ect, i know and accept the risks of too much

T3. Also going to give me presciption for anti-fungal, and thinks i mite be due

to low white blood cells instead of insulin restiance.

So im going for all the blood tests wednesday then im going to up my metformin

dose and see how i go on over the next couple of weeks, if my yeast starts to

clear up and im feeling well then i see no point to see this doctor again. If

the yeast isnt clearing or things arent too good i guess i will go to the follow

up appointment.

Steve

[Guest guest]

Sorry for ranting a bit, just really annoys me when doctors/endos are saying

stuff like people need T4 and RT3 is bollocks when im living proof he is wrong.

You can tell if they have not suffered from the illness themselves. But if i had

not suffered from RT3 myself and feel a huge benefit from T3 then you would

believe the doctors bullsh*t.

Just makes me want to be an endo even more so that i can actually help people!

and if the NHS want to just stick to T4 only then screw them ill go private

[Guest guest]

Hi Steve

This does sound quite a disappointing appointment. I think it would have been

helpful for the doctor to check your fasting insulin levels etc

Did he give any reasons why he felt there was no such thing as Rt3 dominance?

Or was he just dismissive?

>

> All the usual crap do you even need to be on thyroid hormone your blood tests

were normal before hand same with adrenal support was there any need in the past

ect ect needless to say we discussed this for a long time.

Did you tell him how you are dosing with T3 now - ie early in the morning and

that's helped, or was he not at all interested? You'd think even if he

disagreed he would explain why ?

> Onto the insulin resistance side of things straight away hes just like yeh you

dont have it, cant test insuluin or c-peptide unless your blood sugar levels are

out of range (i explained to him i dont eat sugars or carbs to raise my blood

sugar as they make me feel rubbish, he was having non of it) When i told him

that the metformin(typical drug for diabates and insulin resitance) was clearing

up the yeast in my body when i gave myself a trial he then said well naturaally

things can just get better, then i said well they came back when i stopped, not

much he could say.

is he going to check B12 for you? I have read that metformin can lower b12 (i

think possibly folate, too?). That is interesting that metformin is lowering

your yeast, do you have any ideas why that might be? Is it because it could be

lowering sugar that yeast could be feeding off?

I don't see how he can say you don't have insulin resistance if he doesn't check

your fasting insulin levels?

>

> We agreed for

> 9am cortisol

> TSH FT3 FT4

> Fasting glucose

Did he also add in CBG? cortisol binding globulin - it'd be interesting to see

what that level was, as well as ACTH.

is he checking any minerals or vitamins too? like vitamin D3?

are you feeling better now or do you still have lingering symptoms?

chris

[Guest guest]

He was very dismissive over RT3 chris just said its bollocks, but im going to

give him the Rt3 website on my next visit as he seems the sort of doctor that

would atleast read over it, wether it changes his mind is another story.

I dont think he is expeirneced in the T3 department i was close this appointment

but i will wait to next to ask him " how many people have you treated with T3 " as

obviously he just quoted the bta reference at me, " 40-60mcg " is what we

reccommend and he couldnt believe i was on 100mcg....

B12 is good, but i will keep a check on it since i satrted metformin now i have

read that also, i didnt mention specifically my early morning dosing but i asked

him if he knew of the cardiah rhythm about tsh peaking midnight and FT3 a few

hours later for the main cortisol production. Ye you guessed it he looked

baffled lol.

Ye chris im very disapointed he didnt test them also (peptide and insulin), i

think i need to inform myself with info to get them tested, as im quite new to

insulin resitance i felt i had no argument to what he was saying. He said you

would have other symptoms if you had sinulin resitance along with being obese.

All my minerals and vits and within range, not had CBG tested, what would this

show, its something i could ask for. (main reason im staying with the doc now is

that i can get alot of tests done for free)

Im feeling pretty good!

Cheers

Steve

>

> Hi Steve

>

[Guest guest]

I also think metformin helPed as it makes your tissues absorb less sugar.

Steve

[Guest guest]

Hello Steve

Well it'd been nice if he explain why he didn't agree with Rt3 " i don't agree

because of x, y, z " . I am not sure if there is any scientific literature on it

- if there is, could you show him, is it covered under euthyroid sick syndrome?

Has Dr Lowe written about it? I forget now which doctors believe or don't

believe in certain theories.

You have the lab results too don't you, which back up what you said about having

high rt3 and feeling bad, and now having low rt3 and feeling better on T3? it

is a pity he wasn't at least willing to let you explain and look at your lab

results of high rt3 /low rt3 and your experiences? (i assume this is what

happened). or how he can explain why you now feel better on this higher dose of

t3?

> B12 is good, but i will keep a check on it since i satrted metformin now i

have read that also, i didnt mention specifically my early morning dosing but i

asked him if he knew of the cardiah rhythm about tsh peaking midnight and FT3 a

few hours later for the main cortisol production. Ye you guessed it he looked

baffled lol.

I am not sure what they do or do not know - i've had a similar baffled look too.

I can't remember whether it was cortisol or testosterone but one of these drops

in winter i believe, and when i said that to the endo last year i could tell he

thought i was mental but i' m sure i read it from a reputable source. it makes

you lose faith when they don't know what you consider to be 'basic' information.

if i was an endo, i would want to know when testosterone and thyroid (for

instance) peak. the endo i saw didn't seem to know much about the connection

between testosterone and metabolic syndrome.

If your endo measured fasting insulin then he could have compared it in say 6

months to see if it got better or worse? but they don't do this kind of thing,

do they. they assume you're well or ill, i think. 'not insulin resistant' or

'ok': all or nothing. At least if he had done the tests he could have proved

to you that you weren't insulin resistant, or you could have proved him wrong.

NHS testing leaves a lot to be desired.

I read that insulin resistance precedes obesity though it seems to be debated

which comes first?

is he going to do 24 hr urinary free cortisol, so you can check your adrenals

are ok? i think mentioned this in his posts? The CBG is cortisol

binding globulin. I think, but may be wrong, that if you have high CBG the

cortisol you do have is not very effective because i'ts all bound up to CBG. I

do wonder if that's why we can have normal serum cortisol tests but low saliva

cortisol.

For instance, look at my cortisol blood test, it doesn't look too bad, does it:

Cortisol (8h) 14.4 µg/dL 7-25

but, if you take into account high levels of Transcortine (CBG), which binds the

cortisol:

Transcortine + 51 mg/L 20-50

My actual serum *free* cortisol is low:

Cortisol free (8 AM) - 6.7 ng/mL 10-30

And what good is that?

but most people looking at just that cortisol test would say it seems ok?

Some links on this, if you are interested:

http://www.addisons-network.co.uk/high_cbg_ad.html

CBG is raised, and SHBG lowered in hypothyroidism:

http://www.ncbi.nlm.nih.gov/pubmed/7749500

I don't know why - when they test 9am cortisol levels- they don't test CBG, too?

It seems a bit of an oversight really. What if someone has normal cortisol but

high CBG?

Mind you, 'they' sometimes do this with testosterone - they just check the

levels of testsoterone, without checking testing SHBG (binding globulin). I've

read the SHBG can rise in older men so they can have a normal level of

testosterone, but a very low free level. (Low shbg can also be indicative of

other things too eg high insulin levels - that's a good point actually: if he

won't measure your insulin ask him to check SHBG, it may give you some

indication about your insulin levels:

http://en.wikipedia.org/wiki/Sex_hormone-binding_globulin#Control)

If i was you'd I'd ask for the 24 hr urine test, DHEA, CBG, Testosterone+ SHBG,

FSH, LH, prolactin, Vit D3 - just to make sure there's nothing else wrong with

you. Can you also ask for IGF-1 (growth hormone testing) but also ask for

IGFBP-3 to be done with the IGF-1 as this is the binding protein that makes

IGF-1 less usable, just like CBG and SHBG do to cortisol and testosterone,

respectively. I had 'normal' IGF-1, but high IGFBP-3: didn't find this out of

course until I had private tests done. I do wonder if they don't test

things just in case they don't find anything wrong.

Chris

>

> He was very dismissive over RT3 chris just said its bollocks, but im going to

give him the Rt3 website on my next visit as he seems the sort of doctor that

would atleast read over it, wether it changes his mind is another story.

>

[Guest guest]

I read it worked a bit differently to that ?

http://www.diabeticlivingonline.com/medication/oral/metformin/

Its main action is to decrease the overproduction of glucose by the liver. This

action helps lower blood glucose levels particularly after fasting but also

after meals. Metformin also increases the uptake of glucose by your muscles. All

in all, metformin decreases insulin resistance and improves insulin sensitivity,

thereby helping the insulin your body still makes work more effectively.

>

> I also think metformin helPed as it makes your tissues absorb less sugar.

>

> Steve

>

[Guest guest]

what is the significance of the IGF 1 test as my mine was very low at 60, range 90-252 and not even been mentioned by Endocrinologist. How important is it ? Thanks Dawn

[Guest guest]

Hello Dawn

I would say it may be very significant. IGF-1 is released in response to Growth

Hormone (GH). So it may be you have a deficiency of Growth hormone, but you'd

need proper testing of course. But I don't think they treat adult growth

hormone deficiency properly in this country and you may have to have an insulin

tolerance test, which i gather isn't very nice. GH deficiency impacts quality

of life greatly, I believe.

http://en.wikipedia.org/wiki/Growth_hormone_deficiency#In_adulthood

Treatment in adulthoodGH supplementation is not recommended medically for the

physiologic age-related decline in GH/IGF secretion.[5][8] It may be appropriate

in diagnosed adult-onset deficiency, where a weekly dose approximately 25% of

that given to children is given. Lower doses again are called for in the elderly

to reduce the incidence of side effects and maintain age-dependent normal levels

of IGF-I.[11]

In many countries, including the UK, the majority view among endocrinologists is

that the failure of treatment to provide any demonstrable, measurable benefits

in terms of outcomes means treatment is not recommended for all adults with

severe GHD,[4] and national guidelines in the UK as set out by NICE suggest

three criteria which all need to be met for treatment to be indicated:

1.Severe GH deficiency, defined as a peak GH response of <9mU/litre during an

insulin tolerance test

**2.Perceived impairment of quality of life, as assessed by questionnaire**

3.They are already treated for other pituitary hormone disorders

Where treatment is indicated, duration is dependent upon indication.

Cost of adult treatment in the UK is UKP 3000-4000 annually.[4]

Please note that I've read that if you get all the other hormones optimised and

follow a good diet, you don't need to take as much Gh, meaning treatment can

cost as 'little' as 600 pounds a year.

I would research this and see if any of the symptoms fit. Dr hertoghe's book

is a good place to start:

http://www.amazon.co.uk/Hormone-Solution-Dr-Thierry-Hertoghe/dp/1400080851/ref=s\

r_1_1?ie=UTF8 & qid=1320395688 & sr=8-1

The TPA library may have a copy of it? ( if so i think you just pay for

postage?)

Do any of these symptoms, from Dr Hertoghe's book - fit?

Growth Hormone

My hair is thinning

My cheeks sag

My gums are receding

My abdomen is flabby/I've got a " spare tire "

My muscle are slack

My skin is thin and/or dry

It's hard to recover after physical activity

I feel exhausted

I don't like the world (I tend to isolate myself)

I feel contineously anxious and worried

GH is another thing that affects T4 > T3 conversion. Ie, growth hormone

increases the conversion I believe.

Could you ask your endo more about this, and ask about IGFBP3 binding too? May

be that you very low IGF-1 as well as high IGFBP3, making what little IGF-1 you

do have unusuable?

what units were your lab results in? My range is different to yours:

Somatomedin-C (IGF-1) 388 ng/mL 190-490

IGFBP-3 + 8.26 mg/L 2.96-4.96

IGFBP-3/IGF1 + 5.62 mol/mol 0-4.5

>

> what is the significance of the IGF 1 test as my mine was very low at

60,  range 90-252 and not even been mentioned by Endocrinologist. 

>  

> How important is it ?

>

> Thanks

>

> Dawn

>

[Guest guest]

I've read a bit different to that, maybe not so much it absorbs less sugar in

the tissues, but defintely less in the gut which would have a knock on affect on

the rest of the body if someone has systematic candida.

http://diabetes.emedtv.com/metformin/metformin.html

" It can also decrease the amount of sugar absorbed into the body (from the diet)

and can make insulin receptors more sensitive, helping the body respond better

to its own insulin. All of these effects cause a decrease in blood sugar

levels. "

http://en.wikipedia.org/wiki/Metformin#Mechanism_of_action

and decreases absorption of glucose from the gastrointestinal tract.

Either way its working some how lol, i have been having terrible leaky gut since

taking it i dont know why. But a theory is that the yeast in my gut is getting

disturbed leaving gaps for food to pass through the intesial tract, so i have

just started to hammer pro-biotics if this is the case to try get some good

bacteria int he place of the yeast which is disutrbed on the tract. - I could be

really wrong but this is my and sorry for the pun lol " my gut instinct "

>

> I read it worked a bit differently to that ?

[Guest guest]

l-glutamine is important for gut repair, do you take this?

> Either way its working some how lol, i have been having terrible leaky gut

since taking it i dont know why. But a theory is that the yeast in my gut is

getting disturbed leaving gaps for food to pass through the intesial tract, so i

have just started to hammer pro-biotics if this is the case to try get some good

bacteria int he place of the yeast which is disutrbed on the tract. - I could be

really wrong but this is my and sorry for the pun lol " my gut instinct "

>

[Guest guest]

A couple of times i felt like walking out, when he said RT3 was bollocks was one

of them, im glad i stayed tho.

I am guessing any doctor that believes in T3 only must believe in RT3 and/or

cell resistance. I know Dr wilson does. My endo did not give any reason but i

will give him some reason to believe next appointment.

I do have the lab results but i didnt have them to hand, also they were from

genova which most NHS doctors dismiss but yet they will not test rt3 on the nsh,

cache 22.

He cannont explain how i feel better on T3 only...

He said he cannont test insulin levels unless my fasting glucose is either under

3mnol or over into the diabetic range, as the test costs £1000's , i dont see

that as a good enough reason but i dont know what i could say to get it done, he

was adamant saying that he coudlnt do it unless i fell into those catergories.

Depending on the cortisol results depends if he will let me have 24 hour urine,

i think on this part i can pursuade him regadless of cortisol results.

I will get him to test CBH next appointment for sure. and also some of the other

tests, i dont want to go overboard tho and im pretty sure if i couldnt give a

good reason he would not do some of them.

Lastly something i forgot to mention which he is looking into, i have low white

blood cells and swollen lymth glands and he could see the yeast on my

chest/feet, so he will give me some anti fungals a few months on max dose he

said but will also look into it more.

Cheers

Steve

>

> Hello Steve

>

[Guest guest]

>> He said he cannont test insulin levels unless my fasting glucose is either

under 3mnol or over into the diabetic range, as the test costs £1000's , i dont

see that as a good enough reason but i dont know what i could say to get it

done, he was adamant saying that he coudlnt do it unless i fell into those

catergories.

I had it done in Belgium for a few euros, along with glucose. It sure wasn't

thousands of euros or pounds....

[Guest guest]

>I will get him to test CBH next appointment for sure. and also some of the

other

tests, i dont want to go overboard tho and im pretty sure if i couldnt give a

good reason he would not do some of them.

If it were me i'd ask for everything to be sure that there are no other

problems. Not everything is thyroid related....

chris

[Guest guest]

I know little about growth hormones chris. Would me looking about 5-6 years

younger than i actually am and also having alot less body hair than a normal man

account for anything, or is this just natural occurance.

Cheers

Steve

>

> >I will get him to test CBH next appointment for sure. and also some of the

other

> tests, i dont want to go overboard tho and im pretty sure if i couldnt give a

> good reason he would not do some of them.

>

>

> If it were me i'd ask for everything to be sure that there are no other

problems. Not everything is thyroid related....

>

> chris

>

[Guest guest]

I couldn't say sorry but I@m just wondering if it's worth getting all this

checked while you have the referral so the tests are free to you? just to be

sure?

Chris

>

> I know little about growth hormones chris. Would me looking about 5-6 years

younger than i actually am and also having alot less body hair than a normal man

account for anything, or is this just natural occurance.

>

> Cheers

[Guest guest]

How can i get my endo to agree to them when i am unsure what a couple even are?

they may be free to me but the endo has to agree and print the form off.

Cheers

Steve

>

> I couldn't say sorry but I@m just wondering if it's worth getting all this

checked while you have the referral so the tests are free to you? just to be

sure?

>

> Chris

>

[Guest guest]

hi steph

are you taking digestive enzymes as well? ...also, what about FOS ?

(fructo-olio-saccharides)

http://www.breakingtheviciouscycle.info/knowledge_base/kb/fos_fructooligosacchar\

ides.htm

do yo know this one? (does anyone know this one?)

Lactobacillus Rhamnosus Gg

http://www.everydayhealth.com/drugs/lactobacillus-rhamnosus-gg

http://www.crohns.net/Miva/education/leakygut.shtml

trish

>

> I've read a bit different to that, maybe not so much it absorbs less sugar in

the tissues, but defintely less in the gut which would have a knock on affect on

the rest of the body if someone has systematic candida.

>

> http://diabetes.emedtv.com/metformin/metformin.html

>

> " It can also decrease the amount of sugar absorbed into the body (from the

diet) and can make insulin receptors more sensitive, helping the body respond

better to its own insulin. All of these effects cause a decrease in blood sugar

levels. "

>

[Guest guest]

sorry i wrote *steph* ..i knew it wasn't quite right but for some reason that's

the way my brain always interprets " stehendie " !!! it's a kind of dyslexia on

my part

[Guest guest]

Hi trish, you are not the only person to call me steph on the forums. Not sure

why but a few people read my name as steph hehe.

I've just had a read of the leaky gut link thanks, i wonder if my endo would be

able to order any of the tests or even if we have a similar test on the NHS... a

question to ask him anyway.

Currently taking these they are like sweets and taste really nice and also there

full of the good stuff!

http://affordablesupplements.co.uk/product_info.php?products_id=2741 & utm_source=\

googlebase & utm_medium=feedmanager

Each time i take these i find my leaky gut symptoms (skin itching) ease off, so

i am really hoping that it is the fungs being dislodged or moved from the gut

lining (from metformin, by lass sugar being absorbed into the gut) and then the

good bacteria maybe filling the place. Its only been happening for about 4 days

now but 4 days is too long for one certain food to be causing it so i am just

hoping that my theory may be correct

Steve

>

>

>

> sorry i wrote *steph* ..i knew it wasn't quite right but for some reason

that's the way my brain always interprets " stehendie " !!! it's a kind of

dyslexia on my part

>

[Guest guest]

hi steve

thanks for the link on udo's probiotics specifically for the mouth/gumms, looks

excellent and well worth a try.

re the testing (home stool test shows overgrowth of fungus, bacteria and

parasites)... you should be able to get a test on the nhs ....i was offered this

test in 1982 but i was too " precious " to go through with it ...i was young and

silly lol

i think i see skin itching as being a sign of a liver slightly struggling with

the die-off that the probiotics cause and/or the reduced number of candida.

what do you take to support your liver?

are you tasking digestive enzymes as well ?

trish

>

> Hi trish, you are not the only person to call me steph on the forums. Not sure

why but a few people read my name as steph hehe.

>

> I've just had a read of the leaky gut link thanks, i wonder if my endo would

be able to order any of the tests or even if we have a similar test on the

NHS... a question to ask him anyway.

[Guest guest]

Not at the moment i dont take liver supps or digestive enzyems, i have tried

both in the past without any benefit. Milk thistle for liver and nutrigest for

my digestive enzymes.

Yer i agree on the leaky gut i believe its something to do with the candida

being dislodged and then either candida toxins or food particles passing through

the lining.

I have had a stool test done in the past it showed candida and bacteria, did a

cause of anti biotics for the bacteria and felt no difference, but that was a

while ago so i wouldnt mind to do something similar now its so far away.

Steve

>

>

>

>

>

>

> hi steve

[Guest guest]

> Yer i agree on the leaky gut i believe its something to do with the candida

being dislodged and then either candida toxins or food particles passing through

the lining.

the point is that the liver has to deal with the toxins wherever they emanate

from ...if you *up* the load of toxins then the liver has to do more work and

may be struggling hence the itching skin. skin is the second organ of

detoxification and helps out when the liver is struggling.

> Not at the moment i dont take liver supps or digestive enzyems, i have tried

both in the past without any benefit. Milk thistle for liver and nutrigest for

my digestive enzymes.

milk thistle certainly doesn't suit everyone. you could try artichoke extract.

what about l-glutamine as chris suggested in an ealrier reply? what are you

taking to try and heal the leaky gut?

were you under your doctors care when you did the stool test before and had

antibiotics but didn't feel any different? what did he/she recommend?

trish

> I have had a stool test done in the past it showed candida and bacteria, did a

cause of anti biotics for the bacteria and felt no difference, but that was a

while ago so i wouldnt mind to do something similar now its so far away.

>

> Steve

[Guest guest]

I am going to get some l-glutamine in the week from a health food shop near my

work, the thing is i have tried so many things in the past without any benefit

what so ever and wasted so much money, that im always dishearted before trying

it for the second time. I tried l-glutamine a few years back for over a month it

tasted minging and there was 0 benefit. In the last 5 years of trying to get

better the only two things i have ever felt benefit from is HC and T3.

So i have to decide if something is working and giving me a benefit but that i

just dont feel it, or that i have wasted my money and its hard to decide when

you try something for over a month and feel no good affects from it.

I did a stool test privately from genova took the results to the gut doctor and

he said there a load of rubbish, did a colonscopy and could see a bit of

bacteria in the small intestines, a colonscopy can only just about reach the end

of the small intestines, so if you have problems going on in the middle of the

small intestines would be pretty hard to see. He gave me the antibiotics they

didnt work and i never went back to him he was a REALLY bad doctor. Making

assumptions on my weight and age without doing tests. And in the end tried also

to prescribe me some beta blockers as i was having bad reactions to some foods,

i knew this wasnt the way to go even back about 3-4 years ago.

thanks for your replies

Steve

>

>

>

>

[Guest guest]

You could buy capsules from iherb - you'd probably get a load for not much money

you need to take them last thing at night, i believe

can you get a copy of 'the stress effect' book, the author talks about this in

there

Chris

>

> I am going to get some l-glutamine in the week from a health food shop near my

work, the thing is i have tried so many things in the past without any benefit

what so ever and wasted so much money, that im always dishearted before trying

it for the second time. I tried l-glutamine a few years back for over a month it

tasted minging and there was 0 benefit.