pregnancy, good, thyroid doc in Austin? newbie.

April 7, 2012

Hi all, I'm brand new to this group, and to thyroid issues in general. I am currently 21 weeks pregnant with my first baby, following a successful round of IVF. Despite having normal TSH levels pre-pregnancy, I found out at 12 weeks my numbers had risen to around 3.0. Because of my experience with IVF, I knew that was no good for pregnancy. I fought my OB for a referral to an endo , and was started on 50mcg synthroid. My TSH levels are now arond 2.0, however my Free T4s have dropped slightly to just below the midrange of normal. The endo I am seeing at Texas Diabetes and Endocrinology, is happy with those numbers, and is refusing to bump my meds. She insists that TSH is the best measure of thyroid function, and because it is below the desired 2.5 mark for pregnancy, no changes. I wish she would dose based on Free T4, as from my research, that is the better indicator. Anybody have thoughts on that, am I off base??? I know thyroid panels can be difficult to read in pregnancy?

I'm hoping to find a new doc, or at least get a 2nd opinion. Can anybody recommend somebody in the Austin area who is good at dealing with thyroid and pregnancy? Even better, somebody who is up to date, and will look at my Free T4, and not just TSH???

Thanks in advance for any suggestions. Prather

April 7, 2012

In Austin, there is no endo that we recommend. Most of the better thyroid docs are in primary care, usually in an alternative/integrative/wellness/environmental/anti-aging type practice. Find our Texas Armour docs list in Files for our recommended doctors. Also read the Database for reviews of docs by various members.

Ron Manzanero and his PA Debi Winder come highly recommended. They do not take any insurance.

If there is a doc you are thinking of seeing, make a post with their name in the subject line to get the attention of folks who may know something.

>> Hi all,> > I'm brand new to this group, and to thyroid issues in general. I am> currently 21 weeks pregnant with my first baby, following a successful> round of IVF. Despite having normal TSH levels pre-pregnancy, I found out> at 12 weeks my numbers had risen to around 3.0. Because of my experience> with IVF, I knew that was no good for pregnancy. I fought my OB for a> referral to an endo , and was started on 50mcg synthroid. My TSH levels are> now arond 2.0, however my Free T4s have dropped slightly to just below the> midrange of normal. The endo I am seeing at Texas Diabetes and> Endocrinology, is happy with those numbers, and is refusing to bump my> meds. She insists that TSH is the best measure of thyroid function, and> because it is below the desired 2.5 mark for pregnancy, no changes. I wish> she would dose based on Free T4, as from my research, that is the better> indicator. Anybody have thoughts on that, am I off base??? I know thyroid> panels can be difficult to read in pregnancy?> > I'm hoping to find a new doc, or at least get a 2nd opinion. Can anybody> recommend somebody in the Austin area who is good at dealing with thyroid> and pregnancy? Even better, somebody who is up to date, and will look at my> Free T4, and not just TSH???> > Thanks in advance for any suggestions.> > Prather>

April 7, 2012

Thank you, it definitely does not have to be an endo. I just want somebody who

is up to date on thyroids and pregnancy, and will take my concerns seriously. I

looked through the list last night, and Manzanero did stand out to me. Anybody

else?

> >

> > Hi all,

> >

> > I'm brand new to this group, and to thyroid issues in general. I am

> > currently 21 weeks pregnant with my first baby, following a successful

> > round of IVF. Despite having normal TSH levels pre-pregnancy, I found

> out

> > at 12 weeks my numbers had risen to around 3.0. Because of my

> experience

> > with IVF, I knew that was no good for pregnancy. I fought my OB for a

> > referral to an endo , and was started on 50mcg synthroid. My TSH

> levels are

> > now arond 2.0, however my Free T4s have dropped slightly to just below

> the

> > midrange of normal. The endo I am seeing at Texas Diabetes and

> > Endocrinology, is happy with those numbers, and is refusing to bump my

> > meds. She insists that TSH is the best measure of thyroid function,

> and

> > because it is below the desired 2.5 mark for pregnancy, no changes. I

> wish

> > she would dose based on Free T4, as from my research, that is the

> better

> > indicator. Anybody have thoughts on that, am I off base??? I know

> thyroid

> > panels can be difficult to read in pregnancy?

> >

> > I'm hoping to find a new doc, or at least get a 2nd opinion. Can

> anybody

> > recommend somebody in the Austin area who is good at dealing with

> thyroid

> > and pregnancy? Even better, somebody who is up to date, and will look

> at my

> > Free T4, and not just TSH???

> >

> > Thanks in advance for any suggestions.

> >

> > Prather

> >

>

April 11, 2012

Too bad that Dr. Causabon is so booked now. I actually had an encounter with

Espinoza, when I had my last baby Dr Causabon was out and she was taking over

for him. I never met her, but my OBGYN conferred with her right after my labor

while I was still in the hospital. She came up with this screwy plan to fiddle

with my Synthroid that had me taking an extra half a pill on every other weekend

and every other Tuesday or something bizarre like that. I blew her off and just

got in to see Dr. Causabon as soon as I could. I thought Espinoza sounded like a

crackpot.

Just to set your mind at ease, I had big ups and downs with my thyroid during

both pregnancies and my babies were fine. My second pregnancy I even quit taking

my meds for over a month because I got manic and decided I didn't need them. I

was only convinced to go back on them when my TSH went to 27.

What about Dr Edgerton, did anyone recommend him yet? That will cost you a bit

of $$ but he will certainly look at your frees.

Tierney

>

> I was seeing Dr. Espinoza, I've only actually met with her once. She was nice

enough, but even with a TSH of 3 at 12 weeks pregnant, didn't really think I

needed meds, but agrees when I pushed her on it. She doesn't typically even test

Free Ts, I had to push for that as well, but now I'm seeing that was a waste and

she's refusing to look at them to dose me.

>

> Thanks for the heads up on the other endo there. I may try to call and switch

to him.... Anybody know how that works if you are trying to switch to a

different doc in the same practice? Just the fact that he looks at free Ts is a

start.

>

> Sent from my iPhone

>

April 11, 2012

This should be interesting, my husband and I are going to go in and talk to

Espinoza this afternoon. I'm armed with research from both sides, and we shall

see what she says. I'm skeptical, but i'd willing to listen to her explanation.

I had a good feeling about her at our first meeting, I guess because she did

agree to start me on synthroid, when in reality my TSH was barely high and free

Ts were normal (good end of normal). I looked up Edgerton, he looks like an OB?

Is that correct? I'm more than willing to pay whatever I have to, drive wherever

I have to at this point for good care for this baby and me... but can't change

OBs as i'm high risk and have to see a high risk MFM for the rest of my

pregnancy care. Anybody know if he would see me just for thyroid?

> >

> > I was seeing Dr. Espinoza, I've only actually met with her once. She was

nice enough, but even with a TSH of 3 at 12 weeks pregnant, didn't really think

I needed meds, but agrees when I pushed her on it. She doesn't typically even

test Free Ts, I had to push for that as well, but now I'm seeing that was a

waste and she's refusing to look at them to dose me.

> >

> > Thanks for the heads up on the other endo there. I may try to call and

switch to him.... Anybody know how that works if you are trying to switch to a

different doc in the same practice? Just the fact that he looks at free Ts is a

start.

> >

> > Sent from my iPhone

> >

>

April 11, 2012

Have you had your antibodies tested? If you have above normal levels of

antibodies, then they should be treating you. When my son, who had a TSH of 2.7

and Frees in the " normal " range, started on Armour, his TSH actually went up.

He did not have antibodies but had dozen of nodules that showed up on a

sonogram. You actually might ask them when they sonogram the baby if they would

also look at your thyroid. Research shows that if you have nodules, treating to

the point where the TSH is 1 or less can cause the nodules to shrink. And,

again, anyone with autoimmune thyroid disease should be tested for celiac. There

is a correlation due to the autoimmune genes that predispose one to these

diseases - just google DQ2 (main celiac gene) and hypothyroid or go to pubmed

and search - lots of material on this topic. Research has shown that a GF diet

can cause the antibodies to return to normal.

B.

> > >

> > > I was seeing Dr. Espinoza, I've only actually met with her once. She was

nice enough, but even with a TSH of 3 at 12 weeks pregnant, didn't really think

I needed meds, but agrees when I pushed her on it. She doesn't typically even

test Free Ts, I had to push for that as well, but now I'm seeing that was a

waste and she's refusing to look at them to dose me.

> > >

> > > Thanks for the heads up on the other endo there. I may try to call and

switch to him.... Anybody know how that works if you are trying to switch to a

different doc in the same practice? Just the fact that he looks at free Ts is a

start.

> > >

> > > Sent from my iPhone

> > >

> >

>

April 11, 2012

I'm antibody negative, and the interesting thing, is that pre-pregnancy, my TSH

was normal every time it was tested, around 1.5. I have no idea what my Free Ts

would have been, but i've never felt symptoms, so i'm assuming they weren't

horrible. It seems to be something pregnancy does to my body (which I guess

isn't that abnormal from what i've read).

We met with Dr. Espinoza this afternoon, it definitely confirmed my gut feeling-

she is a QUACK!!! Even my husband could see it. I explained what I had found in

my research, both sides, the opinion of the medical director etc, and she seemed

clueless on all fronts, and had no idea what I was talking about.

In the same appointment she both told me that TSH is very stable, and then

confirmed that if fluctuates greatly when I pushed her on it. Even better, she

insisted that the reason free T4s are not accurate in pregnancy is that they

fluctuate all day long based on what baby needs. She repeatedly told me she

doesnt care about Free Ts, only TSH, because a TSH of under 2.5 during pregnancy

is the guideline set forth by the american academy of endocrinology. I asked her

point blank why there are so many doctors/endos who DO care about it, and her

response was, " I don't know, but I don't care about them " . She suggested I seek

a 2nd opinion if I was concerned, but that she had been " doing this for 20

years " . We had a good laugh when we left, and will continue to try to find a

solid 2nd opinion. In the meantime, she did agree to up my synthroid dose, which

makes me feel better about things for now.

> > > > >

> > > > > I was seeing Dr. Espinoza, I've only actually met with her once. She

> > was nice enough, but even with a TSH of 3 at 12 weeks pregnant, didn't

> > really think I needed meds, but agrees when I pushed her on it. She doesn't

> > typically even test Free Ts, I had to push for that as well, but now I'm

> > seeing that was a waste and she's refusing to look at them to dose me.

> > > > >

> > > > > Thanks for the heads up on the other endo there. I may try to call

> > and switch to him.... Anybody know how that works if you are trying to

> > switch to a different doc in the same practice? Just the fact that he looks

> > at free Ts is a start.

> > > > >

> > > > > Sent from my iPhone

> > > > >

> > > >

> > >

> >

>

April 11, 2012

Dr Edgerton is a GYN who is into Bio-identical hormones, anti-aging and weight

loss. He is very nice and listens well, but for me was too focused on food

allergies and his ALCAT allergy testing. He also sells a lot of expensive

supplements, but he doesn't aggressively push them. You can expect to pay maybe

$300 to see him including a follow-up. Hopefully you will get what you want from

Espinoza today and it won't be necessary!

>

> This should be interesting, my husband and I are going to go in and talk to