new doctor search--long

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Hi everyone. This is long, as short as I was trying to be. I'm not

bothered by it if no one reads it all the way through, or does and

can't make sense of it. I'm just plugging away as usual trying to

find a thread to grab and follow as I try to get myself well. The

main thing is that I could use some doctor suggestions. I'm turning

out to be a difficult hypothyroid case under the care of Ron

Manzanero in Austin. It's touch and go with him, and I pretty much

feel like I'm the one coming up with all the ideas. I never know if

I'll be able to continue with him or not. I just called Dr.

's office in Lubbock and can't possibly afford it--no

insurance, for one thing, and the fact that the labs cost between one

and two thousand dollars makes it impossible for me. I don't really

get that. I asked if I could go through Healthcheck USA instead and

they said no. So I had to eliminate him.

I'll try to give as short a case history as I can. Diagnosed hypo not

quite two years ago with a TSH of 3.1, but I had started asking my

doctors about it back in 1986. (I'm 40.) I was cold all the time,

gained weight and couldn't lose it, alternated between months-long

periods of sleeping too much and then having the worst kind of

neverending torturous insomnia, depressed since puberty. The doctors

would test me and tell me I was fine.

Manzanero put me on a quarter grain of Armour a day back in August

2001. I felt slightly better, which, on my scale, felt pretty

dramatic, and unfortunately that has colored everything with him. He

won't listen to me now. " But you felt so much better when I put you

on just a quarter grain! " (ly, I've always had strong placebo

responses, which isn't unusual for soemone who wants very badly to

feel better.) Since then I've experimented with dosages--with his

blessing--and have taken as much as 3 grains a day. I went back down

to 2 when my free T3 levels were above range back in February. The

weird thing is that I have never felt any hyper symptoms WHATSOEVER

from increasing my Armour dosage. Coffee doesn't even speed me up or

make me feel hyper. In fact the reason he let me go so high on the

Armour was that I had no hyper symptoms from it.

I believe that this could be indicative of a conversion problem, but

unfortunately when I finally had my reverse T3 tested back in

February, it was when I had been taking 3gr of Armour, and Manzanero

attributed the above range reverse T3 results to the fact that I was

taking too much Armour and he pointed out that my free T3 results

were high too. I posted about this in the about.com thyroid forums

and everyone concurred. But I still disagree. My free T4 was still

middle normal, so the T4 was converting to something. Nor does it

make sense to me that an above range FT3 completely explains away an

above range RT3. This assumes that back when I was taking less Armour

and the FT3 test was in range, that if I had had my RT3 levels tested

then, they would've been in range as well. But what if that hadn't

been the case?

I've never had an easy time expressing this, and never did it

successfully in the about.com thyroid forum. I doubt I'm managing to

make it clear this time either. I understand that the expected thing

when your RT3 is elevated is that your FT3 will be low, because the

idea is that the T4 in your system isn't converting to T3, it's

converting to RT3. But what if you're taking too much Armour? The

Armour is going to put a lot of straight, non-converted T3 into your

blood stream. It makes perfect sense to me that the reason I was able

to go so high on my Armour dose without any hyper symptoms is that my

T3 receptors were already clogged with RT3, so all that T3 I was

getting from the Armour never had a chance to connect with the

receptors, and therefore never performed any action on my organs and

therefore I never felt any hyper symptoms.

So I want to try 's protocol, the time release T3 with no T4

approach. Manzanero wouldn't go for it last time I saw him. He

doesn't believe that I eat like a bird. This is so unbelievably

frustrating, since he is so proud of what a good listener he

is. " It's not that I don't believe you, " he said, " but you need to

keep a food diary for me. " That just makes me dig in my heels. It's

not my job to make him believe me, since clearly he's not going to.

If he was going to believe a food diary, he'd believe the detailed

reports I give him of what I eat on a daily basis. He looked at my

194 lbs. and assumed I wasn't telling him everything I eat.

What's happened that has changed things somewhat is that I developed

another major depressive episode about three months ago that seemed

to come out of nowhere, and I lost my appetite entirely. This is not

an exaggeration. I stopped eating altogether for two weeks, whether

anyone believes me or not. I managed to get out of the house and get

some saltines to eat with my Glucophage (2000mg/day for insulin

resistance), but didn't manage to eat more than a couple, and didn't

manage to take my full dosage of Glucophage for those two weeks.

After that I started being able to eat a few crackers a day, and then

later worked in some fruit, and slowly over time I've come back to

something approaching a normal appetite, but it's still less than

1000 calories a day, and while I have lost about 10 lbs over the last

three months, that's still not normal. The " starvation mode " doesn't

explain it either, because normal caloric intake for me is around

1200 calories a day, at which I slowly gain weight--if I increase

calories to even just 1400, I rapidly gain weight (all this

regardless of how much Armour I'm taking). That's a metabolism that's

broken.

The depression was so severe that I again pursued an anti-depressant.

Two years ago, before I started Armour, a psychiatrist prescribed

Effexor for me and I went really nutso on it. It was very bad, almost

hallucinatory. Two nights in a row the only solution seemed to be to

drive my car into a tree. I'm lucky I survived it. This time another

psychiatrist prescribed Lexapro. I had horrible diarrhea that put me

in bed for a week, and I ended up stopping it after only two weeks.

The psychiatrist said this time that my severe loss of appetite with

no weight loss along with my nebulous thyroid disorder along with my

recurrent major depressive history probably did call for T3

treatment, but he wsn't going to do it. I'd have to see an

endocrinologist.

Great. So I'm in the process of trying to get Manzanero to try the

's protocol on me. He's always said that there's no harm in

trying most of these treatments to see if they work, so I don't know

why he's balking now except for his ego--I'm the one who thought of

the T3/no T4 approach, not him. I still don't know if he's going to

go for it, even though I told his receptionist that I was at a point

where I needed to find a doctor who would try a T3/no T4 treatment,

and that I would prefer to stay with Manzanero but I would find

someone else if I needed to.

One more possibly relevant fact for anyone who reads this far (thank

you) is that I started taking cortef a year and a half ago for

adrenal fatigue, and sometimes wonder if that's what started all the

trouble to begin with. I had a very high anxiety childhood. The

cortef has absolutely been the one thing I've taken that has made a

big difference. It instantly cured allergies, insomnia, and asthma,

and the insonia being cured was what elevated me from ongoing severe

depression to ongoing mild depression with major episodes. I started

on 20-30mg a day and am now down to 5 or 10, depending on how I feel.

I do hope I can stop it eventually, since I think it's probably what

sent my blood sugar up and caused mild insulin resistance (my ha1c

was 5.3 a few months ago).

What I'm hoping to find here is maybe someone with a similar history

who can recommend a doctor who can handle a difficlut case who

doesn't charge an arm and a leg. I'm unemployed and trying to find

work but I'm in the horrible catch 22 of being too depressed to be

able to make a good impression. People who know me and can throw me

work are doing their best, and it's helping and they are goddesses

and they haven't regretted it either because at least I'm able to

still do high quality work on time, but I am extremely financially

strapped.

Many thanks to anyone who can help--or who has read this whole thing.

It is a help just to feel listened to.

Sandy