Wednesday, April 01, 2009

My new doctor.

Why did your doctor run that test? Have you had symptoms?

Dr. S sat in front of me, typing my answers into a computer. I don't know why my GP ran that test, I said. I think he does certain tests when you reach a certain age, so maybe that was it. I have had some symptoms, but I thought it was just menopause.

He started going through a list of symptoms.

Had I notice any hair falling out? Well, I didn't think so. I mean, I have LOT of hair. I haven't seen any in the drain, or on my pillow. But then, this past weekend, I turned our vacume over - the little new one we bought for the new house - and I was stunned at how many much blonde hair was wrapped around the beater brush. There was a lot. My hair stylist, meanwhile, had commented that I had "course" hair, which nobody had ever told me before. At the time, I chalked that up to her not having a good chairside manner.

Weight gain? I explained my lifestyle to him. When I got to the point where the only time in the past seven years that I've been in the "normal" range for my height was when I was training for an Ironman, his eyebrows went up, and he typed into the computer.

Family history. "Is your mother still alive?" I told him she died of heart failure at 61, as a complication of cardiomyopathy. His lips tightened, and he typed into the computer.


"Suicide," I said simply. "About 3 years ago. He was the second in his family to do that; there's a lot of depression and alcoholism there."
He continued down a list of symptoms, and asked about fatigue. "The thing is, doc, I do a lot. I work full time, and besides that, I'm usually either doing another part-time gig, or taking classes, or both." But lately, I told him, I'd complained to Sweet Baboo that I just felt old.

"What did you mean by old," he probed.

"I don't know. Just--old. Like time is running out."

He smiled a little, and typed into his computer. He's about 65, I think. Sharp as a tack--he was familiar with the psychopharmacology research that I'm coordinating at my job. But at 65, it must be ironic to hear a 44-year-old marathoner say that she feels like time is running out.

All together, he spent probably about 45 minutes with me, listened to my heart, breathing, explained things to me, answered the questions I could remember (because I forgot my list of questions) and then explained to me why he was going to prescribe what he was going to prescribe.

He told me that generic medications are allowed to deviate from their name-brand counter part by as much as 20%. He also told me that "natural" drugs, like dessicated pig thyroid, are allowed to deviate in potency even more than generics, because they are classified as "natural" and are not subject to the same guidelines by the FDA.

He checked off the "no substitution" box on my prescription. Synthroid, .5 mg

I assured him he didn't need to sell me on that point. "To be honest, doc, snake venom is natural. Spinal meningitis natural. I've also been reading up on all this, and I know that the "natural" thyroid is not bioidentical to human thyroid hormone. I'll take the stuff that's been formulated to exactly duplicate human thyroid hormone, thanks."

It pays to be educated about your condition. When I went to the pharmacy to pick up my new prescription, I glanced at the label. Hesitated. "Is this generic? I'm pretty sure my doctor said no generics."

The pharamcist went to check that the doctor had indeed checked that box, and then called out to me that it would need to be refilled again, if I didn't mind waiting a couple minutes. I went in search of an Oil of Olay product that Oil of Olay makes but nobody seems to carry. That's another story.

When I came back for the right prescriptions, I hesitated again. "How many is in here?"

"Ninetey," I was told. "It's a three-month supply."

I struggled to be my own advocate while still being a good girl. "Gosh, ninety!" I said brightly, giving my biggest Dixie Girl smile. "It sure doesn't look like ninety. These must be tiny pills." The pharmacist looked a bit put out, but then when she took the bottle I handed her, her eyes widened a bit. "I'll be right back," she said.

I finally arrived home with ninety of the right medication, and I started taking it today. "How soon will it start working? What sorts of things might I expect," was one of the questions I remembered to ask. Sweet Baboo wanted to know that, too.

The doctor had smiled, and said, "you know, that's an interesting question. Like you, a lot of people tell me they're only been feeling kind of bad for the past couple months. But then when they get on the medication, and their level is adjusted properly, they realize they've felt crappy for years."

So, I took my new pill for the first time this morning. It has to be taken with water, on an empty stomach, at least an hour before I eat. This morning at 5 am, I took my pill. But I can't help but wonder: I love my life. It's a fantasy life, in my opinion. How much better could it possibly be?



  1. Anonymous9:08 AM

    What a great report. I want to bring you with me next time I have to go to the doctor.

  2. Anonymous9:30 AM

    I like that last line :)

  3. Nice handling of the pharmacist.

    Maybe in some sense your life can't be much better, but with more energy maybe you'd enjoy it even more!

  4. Ok, I love reading your blog! If there was a favorites to check this would be one of them. The top one. I almost got teary-eyed, like I'm sensitive or something like that!

  5. I have tried synthetic thyroid and it did nothing for me. My doc switched me to natural armour which has T3 and I am sooo much better. In fact Armour is better regulated than synthroid which has been recalled several times. Do some more homework. Check out the website

  6. I'm on synthroid. Had to have my thyroid "nuked" after being diagnosed with Graves Disease several years ago (which I'm still convinced was a load of crap). Thyroid medicine SUCKS. What they don't tell you is how crazy fluctuations can be. There are days when I have absolutely no energy... not to mention being "down in the dumps". Losing my thyroid was FAR worse than having a TAH - because it took away my "go juice"

    The absolute worst thing for me is when the doctor messes with the dosage - taking away or adds .25 mcg leaves me feeling horrible for a couple of weeks. Just know that thyroid meds take a long time to get adjusted to. The stuff is the "gas" the keeps the car moving forward, so to speak. So any change can cause a sputter. I'll give you some advice if you care to take it.

    1. Take the med at the same time everyday.
    2. Don't let anyone take you off the real stuff (no generics).. it truly isn't as good (even though the insurance folks say it is!).
    3. Get your TSH/Free T4 test after 3 months... then every 6 months thereafter. Realize that your body will eventually need different doses - and it absolutely sucks when that happens but after a few weeks on the new dose things will be back to "normal".

  7. Good luck, Misty! This sounds like something that could be very helpful to you.

  8. great post - your pharmacy interaction was scary! I am glad you looked out for yourself - it makes me worry about more elderly or disabled persons who can't speak up as clearly.

    Good luck with the meds

  9. You'll be surprised and delighted how nice it is to operate on physical energy instead of willpower :)

  10. Well, here's to finding out!

  11. i like the doc's last comment. sometimes i wonder if i should be checked out (again) and maybe there is something (else) wrong with me and once i get that fixed things will be like night/day. i hope you start seeing positive changes soon!

  12. I am required to show up again in 60 days and have all my levels checked.

  13. You beautiful life will be just a beautiful but you will have more energy to enjoy it. Su-weet!

  14. Another set of stuff to watch for- You may experience a "metallic" taste in your mouth for a while. I don't know why, but it is common for some. It will not last, it will go away.

    Do not eat more than a grapefruit per week. It neutralizes the effects of the drug.

    Try as hard and as often as possible to not take allergy/sinus medications within six hours of taking your synthroid. Sometimes it can't be avoided, but note that you can experience palpatations from time to time as a result. Synthroid can raise your heart rate, as can certain drugs, so learn how to use them together. You can safely take them, but don't be afraid to ask your doc.

    Always, ALWAYS read the drug labels for over-the-counter meds. If they say anything about persons with "thyroid conditions," consider calling your doc.

    Iron also bonds with Synthroid and you will lose the benefits of both drugs, if you use iron supplements. Try to schedule your iron at night or late afternoon to keep them as far away from each other as possible.

    I take four times your dose. It takes a while, but you will feel great once things equalize.

  15. My doc took me off generics too and insists on Synthroid for the very reasons you stated. Good job doing your homework. Make sure you realize all the things that interact and reduce the effectiveness of synthroid: iron, calcium, and SOY to name a few. I've gotten to the point where I take only my sythroid in the morning and everythings else -- multivitamin, calcium, etc. at night.

  16. jumping in a little belatedly to say I'm so glad you're starting SYnthroid. I had thyroid cancer a few years ago, so I had the whole thing removed (and nuked, as one poster said above) and I've been on meds for 4 years now. I'm on 225 and let me tell you, if I'm off by an hour on my dosage, I know it. You're going to feel so much better once you get stabalized.

  17. For what it's worth, I was recently diagnosed too. I'm in my 2nd month of meds, reduced from the 1st month. Only I am on Levoxyl (it's the brand name competitor of Synthroid) I'm post gastric bypass and the Levoxyl is absorbed more quickly than the Synthroid -- in my gut anyway.

    You're pretty educated I can tell you studied up. When you start to feel "normal" let your doctor know and stand your ground. Many doctors will get you into the "normal" range, but that might not be right for you. The high end of normal might be where you feel best, or the low-end.

    I feel better already, for the most part. I'm down about 10 lbs. in the last 2 months, but still have strange, significantly large swings in weight (up to 7 lbs.!). I just did a tri this weekend and it was the first time I didn't "gain" weight the day after.

    Good luck to you and just remember to stand your ground when you get to the point of feeling good.

    Also, many doctors are loyal to certain brands because of the drug companies association with them and they'll tell you many different reasons why... if you find that you can't get regulated on Syntroid, don't hesitate to request Levoxyl. I know several of my friends are successful with Synthroid so I'm sure you'll be fine. I'm just sharing with you what I learned, because there is quite the controversy between Synthroid vs. Levoxyl.

    Hope you feel better soon!


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