Guest guest Posted September 5, 2011 Report Share Posted September 5, 2011 I'm new around here - could you please elaborate on what is a " non-insurance " doc? My GP referred me to an endocrinologist in Bedford, Dr. Vani Kotha, because my enlarged thyroid isn't big enough for surgical removal and both the ENT who did the surgical consult and my GP believe the endocrinologist is the appropriate next step - both for the enlarged gland and my continually rising TSH. My endo appointment is still two weeks away, been working on a " plan B " if that doesn't work out in my favor and I have to admit, I've never heard of that reference before. > > > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her name by > > > Margaret Christiansen¹s office, since Dr C is full and taking no new > > > patients. Dr Harsh has recently moved here, was a traditionally > > > gynecologist for many years, but has been training in alt/comp world as > > well > > > as anti aging for the past few years. Sounds interesting, at least a > > > possibility. She offers a free phone consultation before making the first > > > appointment, probably to make sure there is a fit. I spoke with her > > > regarding est/prog stuff and asked a little about thyroid. Her hormonal > > > input seemed quite good, her thyroid perspective seems flexible but she > > has > > > more experience using synth/cytomel. I cannot tolerate NT, so I did not > > > pursue that with her much, but she did seem open about many options, in > > > general. > > > > > > I have seen Spurlock for my dd¹s many issues. While I appreciate him, > > he¹s > > > so hard to get in with for a follow up, and has not returned 2 phone > > calls > > > with specific questions. I really need someone more accessible, which is > > > why I did a phone hunt recently and found this possible new name. > > > > > > Wondering if anyone has met her yet? > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 5, 2011 Report Share Posted September 5, 2011 Most of the better thyroid docs do not take insurance or Medicare, so you have to pay for their services yourself. Has any attempt been made to shrink your gland with a suppressive dose of thyroid hormone? That would be a dose that lowers your TSH to below the bottom of the range. Sometimes that works to shrink an enlarged gland along with any nodules that maybe present. Do you have any pain, difficulty swallowing or difficulty breathing? > > > >> > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her name by> > > > Margaret Christiansen¹s office, since Dr C is full and taking no new> > > > patients. Dr Harsh has recently moved here, was a traditionally> > > > gynecologist for many years, but has been training in alt/comp world as> > > well> > > > as anti aging for the past few years. Sounds interesting, at least a> > > > possibility. She offers a free phone consultation before making the first> > > > appointment, probably to make sure there is a fit. I spoke with her> > > > regarding est/prog stuff and asked a little about thyroid. Her hormonal> > > > input seemed quite good, her thyroid perspective seems flexible but she> > > has> > > > more experience using synth/cytomel. I cannot tolerate NT, so I did not> > > > pursue that with her much, but she did seem open about many options, in> > > > general.> > > >> > > > I have seen Spurlock for my dd¹s many issues. While I appreciate him,> > > he¹s> > > > so hard to get in with for a follow up, and has not returned 2 phone> > > calls> > > > with specific questions. I really need someone more accessible, which is> > > > why I did a phone hunt recently and found this possible new name.> > > >> > > > Wondering if anyone has met her yet?> > > >> > > > > > > >> > >> > > > > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 18, 2011 Report Share Posted September 18, 2011 Thanks for the clarification - didn't know there were doctors that didn't take private insurance - had heard about issues with Medicare. No attempt has been made to treat my thyroid at all - other than referring me to specialists. I was being checked out by a cardioelectrophysiologist for a racing heart - echo and 2-weeks of event monitoring were normal, but the ecg noted " low voltage QRS complex in precordial (chest) leads " which is apparently associated with hypothyroidism and he was the one that suggested I get my thyroid checked out, because it looked enlarged to him. My new PCP ordered an ultrasound which confirmed the enlargement and found 2 nodules and she sent me to the ENT. He said it was only mildly enlarged and since the nodules are both less than 1 cm in all dimensions that I'd benefit from seeing an endocrinologist. I was hoping the PCP would put me on thyroid meds after the ENT didn't think surgery was necessary, as she initially mentioned suppressive therapy before getting the US results, but she agreed with sending me to an endo. I've been in the queue for six weeks - finally seeing endocrinologist tomorrow. No breathing or swallowing difficulties - I really just feel like I've been running on empty since May - unfortunately, my labs are all technically normal, though my TSH went from 0.967 in 2005 to 2.20 last Sept and was 2.90 in July. I have anti-TPO antibodies, though within range (barely) and my free T4 and T3 are within range, but on the lower end of it. I'm just worried that I'm going to get on the " wait and see " list; I'm barely functional at this point, just tired and apathetic, and I genuinely miss being an active participant in my own life. Keeping my fingers crossed. > > > > > > > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her > name by > > > > > Margaret Christiansen¹s office, since Dr C is full and taking > no new > > > > > patients. Dr Harsh has recently moved here, was a traditionally > > > > > gynecologist for many years, but has been training in alt/comp > world as > > > > well > > > > > as anti aging for the past few years. Sounds interesting, at > least a > > > > > possibility. She offers a free phone consultation before making > the first > > > > > appointment, probably to make sure there is a fit. I spoke with > her > > > > > regarding est/prog stuff and asked a little about thyroid. Her > hormonal > > > > > input seemed quite good, her thyroid perspective seems flexible > but she > > > > has > > > > > more experience using synth/cytomel. I cannot tolerate NT, so I > did not > > > > > pursue that with her much, but she did seem open about many > options, in > > > > > general. > > > > > > > > > > I have seen Spurlock for my dd¹s many issues. While I > appreciate him, > > > > he¹s > > > > > so hard to get in with for a follow up, and has not returned 2 > phone > > > > calls > > > > > with specific questions. I really need someone more accessible, > which is > > > > > why I did a phone hunt recently and found this possible new > name. > > > > > > > > > > Wondering if anyone has met her yet? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 18, 2011 Report Share Posted September 18, 2011 If you have an out-of-network benefit, you can submit a claim. Your insurance will pay a lower percentage than for in-network. If you have an HMO, you will have to pay the entire amount. > > > > > >> > > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her> > name by> > > > > > Margaret Christiansen¹s office, since Dr C is full and taking> > no new> > > > > > patients. Dr Harsh has recently moved here, was a traditionally> > > > > > gynecologist for many years, but has been training in alt/comp> > world as> > > > > well> > > > > > as anti aging for the past few years. Sounds interesting, at> > least a> > > > > > possibility. She offers a free phone consultation before making> > the first> > > > > > appointment, probably to make sure there is a fit. I spoke with> > her> > > > > > regarding est/prog stuff and asked a little about thyroid. Her> > hormonal> > > > > > input seemed quite good, her thyroid perspective seems flexible> > but she> > > > > has> > > > > > more experience using synth/cytomel. I cannot tolerate NT, so I> > did not> > > > > > pursue that with her much, but she did seem open about many> > options, in> > > > > > general.> > > > > >> > > > > > I have seen Spurlock for my dd¹s many issues. While I> > appreciate him,> > > > > he¹s> > > > > > so hard to get in with for a follow up, and has not returned 2> > phone> > > > > calls> > > > > > with specific questions. I really need someone more accessible,> > which is> > > > > > why I did a phone hunt recently and found this possible new> > name.> > > > > >> > > > > > Wondering if anyone has met her yet?> > > > > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 2011 Report Share Posted September 19, 2011 There is research out there that shows that taking replacement thyroid hormone to get your TSH to around 1.0 can help the nodules shrink. I can dig up the article if you'd like. It's also possible that you have adrenal fatigue that can cause these issues. There's also underlying infections and issues with toxins, as well as gluten intolerance that contributes to this lack of get up and go. When I was trying to figure out what was going on with me 8 years ago, I made a table with list of symptoms along with columns with all the possible problems and the symptom overlap is >90%. In the end, I actually had *all* the problems. The only way to figure out is to do the testing for each and then treat the issues one at a time. B. Thanks for the clarification - didn't know there were doctors that didn't take private insurance - had heard about issues with Medicare. No attempt has been made to treat my thyroid at all - other than referring me to specialists. I was being checked out by a cardioelectrophysiologist for a racing heart - echo and 2-weeks of event monitoring were normal, but the ecg noted " low voltage QRS complex in precordial (chest) leads " which is apparently associated with hypothyroidism and he was the one that suggested I get my thyroid checked out, because it looked enlarged to him. My new PCP ordered an ultrasound which confirmed the enlargement and found 2 nodules and she sent me to the ENT. He said it was only mildly enlarged and since the nodules are both less than 1 cm in all dimensions that I'd benefit from seeing an endocrinologist. I was hoping the PCP would put me on thyroid meds after the ENT didn't think surgery was necessary, as she initially mentioned suppressive therapy before getting the US results, but she agreed with sending me to an endo. I've been in the queue for six weeks - finally seeing endocrinologist tomorrow. No breathing or swallowing difficulties - I really just feel like I've been running on empty since May - unfortunately, my labs are all technically normal, though my TSH went from 0.967 in 2005 to 2.20 last Sept and was 2.90 in July. I have anti-TPO antibodies, though within range (barely) and my free T4 and T3 are within range, but on the lower end of it. I'm just worried that I'm going to get on the " wait and see " list; I'm barely functional at this point, just tired and apathetic, and I genuinely miss being an active participant in my own life. Keeping my fingers crossed. > > > > >> > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her> name by> > > > > Margaret Christiansen¹s office, since Dr C is full and taking > no new> > > > > patients. Dr Harsh has recently moved here, was a traditionally> > > > > gynecologist for many years, but has been training in alt/comp> world as> > > > well > > > > > as anti aging for the past few years. Sounds interesting, at> least a> > > > > possibility. She offers a free phone consultation before making> the first> > > > > appointment, probably to make sure there is a fit. I spoke with > her> > > > > regarding est/prog stuff and asked a little about thyroid. Her> hormonal> > > > > input seemed quite good, her thyroid perspective seems flexible> but she > > > > has> > > > > more experience using synth/cytomel. I cannot tolerate NT, so I> did not> > > > > pursue that with her much, but she did seem open about many > options, in> > > > > general.> > > > >> > > > > I have seen Spurlock for my dd¹s many issues. While I> appreciate him,> > > > he¹s> > > > > so hard to get in with for a follow up, and has not returned 2 > phone> > > > calls> > > > > with specific questions. I really need someone more accessible,> which is> > > > > why I did a phone hunt recently and found this possible new > name.> > > > >> > > > > Wondering if anyone has met her yet?> > > > >> > > > > > > > > >> > > > > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 2011 Report Share Posted September 19, 2011 Update! The endocrinologist is putting me on a low-dose of synthroid; she doesn't want to try a suppressive dose up-front, because my labs aren't that bad (risks making me hyperthyroid) and my thyroid is only " mildly " enlarged and the nodules are too small to evaluate further. She believes I should have at least some improvement and will evaluate my labs AND symptoms in six weeks (which I've heard is good, treating based on both and not just the labs) and do another ultrasound in 6 months. I know a lot of people have had problems with synthroid, but my mom (almost 20 years) and great aunt (30 or 40 years) both take it and it works for them, hoping it does for me as well! Oh and my fiancee has gluten issues, so I'm pretty sure I don't. The endocrinologist is going to check my electrolytes when I come back in six weeks to determine if it's necessary to check my adrenal function, as I have historical issues with salt, heat, and passing out when under physiological stress... I completely agree that the overlap of symptoms is confusing - don't forget to add vitamin D deficiency to the list, as it causes fatigue, muscle weakness, and constipation. Thanks again for the information! > > > > > > > > > > > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her > > > name by > > > > > > > Margaret Christiansen¹s office, since Dr C is full and taking > > > no new > > > > > > > patients. Dr Harsh has recently moved here, was a traditionally > > > > > > > gynecologist for many years, but has been training in alt/comp > > > world as > > > > > > well > > > > > > > as anti aging for the past few years. Sounds interesting, at > > > least a > > > > > > > possibility. She offers a free phone consultation before making > > > the first > > > > > > > appointment, probably to make sure there is a fit. I spoke with > > > her > > > > > > > regarding est/prog stuff and asked a little about thyroid. Her > > > hormonal > > > > > > > input seemed quite good, her thyroid perspective seems flexible > > > but she > > > > > > has > > > > > > > more experience using synth/cytomel. I cannot tolerate NT, so I > > > did not > > > > > > > pursue that with her much, but she did seem open about many > > > options, in > > > > > > > general. > > > > > > > > > > > > > > I have seen Spurlock for my dd¹s many issues. While I > > > appreciate him, > > > > > > he¹s > > > > > > > so hard to get in with for a follow up, and has not returned 2 > > > phone > > > > > > calls > > > > > > > with specific questions. I really need someone more accessible, > > > which is > > > > > > > why I did a phone hunt recently and found this possible new > > > name. > > > > > > > > > > > > > > Wondering if anyone has met her yet? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 2011 Report Share Posted September 19, 2011 Thanks! That makes sense. > > > > > > > > > > > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given > her > > > name by > > > > > > > Margaret Christiansen¹s office, since Dr C is full and > taking > > > no new > > > > > > > patients. Dr Harsh has recently moved here, was a > traditionally > > > > > > > gynecologist for many years, but has been training in > alt/comp > > > world as > > > > > > well > > > > > > > as anti aging for the past few years. Sounds interesting, at > > > least a > > > > > > > possibility. She offers a free phone consultation before > making > > > the first > > > > > > > appointment, probably to make sure there is a fit. I spoke > with > > > her > > > > > > > regarding est/prog stuff and asked a little about thyroid. > Her > > > hormonal > > > > > > > input seemed quite good, her thyroid perspective seems > flexible > > > but she > > > > > > has > > > > > > > more experience using synth/cytomel. I cannot tolerate NT, > so I > > > did not > > > > > > > pursue that with her much, but she did seem open about many > > > options, in > > > > > > > general. > > > > > > > > > > > > > > I have seen Spurlock for my dd¹s many issues. While I > > > appreciate him, > > > > > > he¹s > > > > > > > so hard to get in with for a follow up, and has not returned > 2 > > > phone > > > > > > calls > > > > > > > with specific questions. I really need someone more > accessible, > > > which is > > > > > > > why I did a phone hunt recently and found this possible new > > > name. > > > > > > > > > > > > > > Wondering if anyone has met her yet? > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 20, 2011 Report Share Posted September 20, 2011 Yes, we are all different and synthroid works for some. Although, my ex MIL was on synthroid and believed it worked well for her. But, she could not sit still without falling asleep and she had very poor quality of sleep. My current boyfriend's mother is also on Synthroid and doesn't even consider that her weight issues are due to under treated thyroid disease. But, again YMMV. Based on the electrolyte issues, etc., adrenals certainly could be a problem for you As far as the gluten issue, the symptoms are unique to each person. My two sons each had a different set of symptoms. The younger one had ADHD, constipation and intestinal inflammation but no fatigue. The older one had extreme fatigue and D. One never would have thought they had the same issue. For me, the biggest difference I noticed was a big reduction in inflammation. My boyfriend has the main celiac gene but does not believe he is gluten intolerant dispite having heartburn and lots of cramping before BMs (my younger son also thought that was normal til he went GF). If you have signs of autoimmune thyroid disease (i.e., the nodules), then testing for celiac/gluten intolerance can be very helpful in sifting through the layers. For me, removing that layer was the only way that I was able to really start seeing the other separate issues. If felt better in my 40s than I did in my 20s after going GF (and weighed less). A highly motivated person can try going strictly GF for 2-6 months and see if they notice a difference. It took me 6 months to remove all the hidden sources of gluten (in Rxes in particular generics since it's hard to find inactive ingredients and contamination when eating out). Good luck. Let us know how it goes - everyone's experiences are very helpful, in particular if you have positive results with the Synthroid. I do well on Levoxyl and Cytomel, so it's certainly not a rule that synthetics don't work for some of us. . Update! The endocrinologist is putting me on a low-dose of synthroid; she doesn't want to try a suppressive dose up-front, because my labs aren't that bad (risks making me hyperthyroid) and my thyroid is only " mildly " enlarged and the nodules are too small to evaluate further. She believes I should have at least some improvement and will evaluate my labs AND symptoms in six weeks (which I've heard is good, treating based on both and not just the labs) and do another ultrasound in 6 months. I know a lot of people have had problems with synthroid, but my mom (almost 20 years) and great aunt (30 or 40 years) both take it and it works for them, hoping it does for me as well! Oh and my fiancee has gluten issues, so I'm pretty sure I don't. The endocrinologist is going to check my electrolytes when I come back in six weeks to determine if it's necessary to check my adrenal function, as I have historical issues with salt, heat, and passing out when under physiological stress... I completely agree that the overlap of symptoms is confusing - don't forget to add vitamin D deficiency to the list, as it causes fatigue, muscle weakness, and constipation. Thanks again for the information! > > > > > > > > > > > > > > Has anyone seen Dr Harsh in Dallas yet ? I was given her > > > name by > > > > > > > Margaret Christiansen¹s office, since Dr C is full and taking > > > no new > > > > > > > patients. Dr Harsh has recently moved here, was a traditionally > > > > > > > gynecologist for many years, but has been training in alt/comp > > > world as > > > > > > well > > > > > > > as anti aging for the past few years. Sounds interesting, at > > > least a > > > > > > > possibility. She offers a free phone consultation before making > > > the first > > > > > > > appointment, probably to make sure there is a fit. I spoke with > > > her > > > > > > > regarding est/prog stuff and asked a little about thyroid. Her > > > hormonal > > > > > > > input seemed quite good, her thyroid perspective seems flexible > > > but she > > > > > > has > > > > > > > more experience using synth/cytomel. I cannot tolerate NT, so I > > > did not > > > > > > > pursue that with her much, but she did seem open about many > > > options, in > > > > > > > general. > > > > > > > > > > > > > > I have seen Spurlock for my dd¹s many issues. While I > > > appreciate him, > > > > > > he¹s > > > > > > > so hard to get in with for a follow up, and has not returned 2 > > > phone > > > > > > calls > > > > > > > with specific questions. I really need someone more accessible, > > > which is > > > > > > > why I did a phone hunt recently and found this possible new > > > name. > > > > > > > > > > > > > > Wondering if anyone has met her yet? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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