Do I need a new endocrinologist?

[Guest guest]

Hello! I have posted and lurked through the year(s), and I have a

question. I received a letter today that my endocrinolgist is

leaving practice...this will be my third to leave in 5 years...I'm

beginning to think it is me! lol

I have been what I prefer to call " in remission " . The doctor I had

says that I have Graves, and it is not caused by pregnancy, etc. I

disagree at this time, since I have been pregnant or postpartum with

3 consecutive children since 1997. They say it is not possible, but

I have had no symptoms, and nothing on my bloodwork since after my

last child was born in 2001.

I believe that my hyperthyrodism is caused by my pregnancies. I am

not " closed " to my having Graves, but I believe my bloodwork and

current history show differently. I would love to hear your opinons

or experiences regarding this situation.

Also, do I need to even become established with a new endo. or just

continue to get my levels checked with my primary? I'm tired of

going to new doctors and hearing their opinions. The last one,

although she was very nice, was just like the first one, who

immediately said I needed to have my thyroid removed. She told me,

after I told her I didn't want to have it removed, that she would

give me one year, and then she would insist it come out! I'm

actually glad she is leaving the practice since " my year " is out. :l

Obviously, my body has not been " normal " for quiet

some time with being pregnant, having babies and regular post-partum

adjustments for the past 7 years. The only other time I have

been " in remission " is when I was between my 2nd and 3rd child in

this time period and there was a time of 2 years between their

births.

So, what do you think? I value your opinion.

Rhonda

[Guest guest]

Hi Rhonda -

The postpartum period is a very common time to develop Graves' in those that

are genetically susceptible. There's another Graves' board that several of

us here also belong to, and about a year ago there was a poll on how many

people developed Graves' after a pregnancy. The results were really

amazing - there were _a lot_ of women who developed Graves' during their

first year postpartum. I even had a couple medical journal articles that

dicussed how the changes in womens' bodies after pregnancy can trigger

Graves'. So you are definitely not alone!

I developed Graves' in 6/01 after child #3 was born. By 2/02, I was back to

having all thyroid levels " normal " . I wouldn't say that I feel normal for me

yet, but that's a whole different issue

When you were diagnosed, did they do antibody testing to confirm Graves', or

did they just base the diagnosis on thyroid test levels? The antibody

testing would confirm whether it was Graves' , as there are other causes of

hyperthyroidism besides Graves'. On of these is post-partum thyroiditis

(PPTD). It's symptoms are similar to GD, but PPTD is not autoimmune and it

is transient. It usually occurs about 3-12 months after the birth of a child

and can last from a couple weeks to a couple months. Then there can be a

period of hypothyroidism and an eventual return to the euthyroid (normal)

state. Do you know if you ever had a test for thyroid-stimulating antibodies

(TSI)? This would confirm whether it was Graves' or not.

At any rate, no matter what caused it, you are currently normal. If it is

Graves', it can return, so you are right to continue to be monitored to

check to see if it has come back. If you have a primary care physician who

understands about autoimmune thyroid diseases and will run the _proper_

tests, you should be able to go with him/her for the monitoring and not have

to get and endo. There's really nothing the endo could do differently for

you now other than charge you more money (oh, cynicism - bad me!) Make sure

that your primary runs not only a TSH, but a Free T4 as well. The Free T4 is

a more accurate picture of the thyroid's function since the T4 is produced

by the thyroid. And the Free T4 is better than the Total T4 since the Total

T4 can be falsely elevated by other meds, estrogen, etc. and the Free T4 is

the amount available for the cells to use. A Free T3 would be nice if you

can get it, but they may balk at doing that every time. A really excellent

doctor would run an antibody test to see if you were truly in remission and

not producing much in terms of antibodies. If you have a doc like that, be

sure to kiss his/her feet and then tell us where we can find that doctor -

'cuz that would be a gem!

I know what you mean about tired of new doctor's opinions. So far I've gone

from " you must have RAI immediately " 2 years ago to my newest doctor who

says that " I don't have a thyroid problem " . Don't you wish they'd make up

their minds?

Oh, also - don't forget to get actual copies of your lab results. Then you

can see what exactly they're running and what the results are. It's just not

good enough for them to call and tell you everything is " normal " . See it for

yourself. Then you can also check for changes in labs and symptoms. Might

also be a good idea to get copies of all the previous labs you've had done.

Those might show whether or not you do have Graves' or just PPTD.

Good luck!

Do I need a new endocrinologist?

> Hello! I have posted and lurked through the year(s), and I have a

> question. I received a letter today that my endocrinolgist is

> leaving practice...this will be my third to leave in 5 years...I'm

> beginning to think it is me! lol

>

> I have been what I prefer to call " in remission " . The doctor I had

> says that I have Graves, and it is not caused by pregnancy, etc. I

> disagree at this time, since I have been pregnant or postpartum with

> 3 consecutive children since 1997. They say it is not possible, but

> I have had no symptoms, and nothing on my bloodwork since after my

> last child was born in 2001.

>

> I believe that my hyperthyrodism is caused by my pregnancies. I am

> not " closed " to my having Graves, but I believe my bloodwork and

> current history show differently. I would love to hear your opinons

> or experiences regarding this situation.

>

> Also, do I need to even become established with a new endo. or just

> continue to get my levels checked with my primary? I'm tired of

> going to new doctors and hearing their opinions. The last one,

> although she was very nice, was just like the first one, who

> immediately said I needed to have my thyroid removed. She told me,

> after I told her I didn't want to have it removed, that she would

> give me one year, and then she would insist it come out! I'm

> actually glad she is leaving the practice since " my year " is out. :l

>

> Obviously, my body has not been " normal " for quiet

> some time with being pregnant, having babies and regular post-partum

> adjustments for the past 7 years. The only other time I have

> been " in remission " is when I was between my 2nd and 3rd child in

> this time period and there was a time of 2 years between their

> births.

>

> So, what do you think? I value your opinion.

>

> Rhonda

>

>

>

>

> -------------------------------------

> The Graves' list is intended for informational purposes only and is not

intended to replace expert medical care.

> Please consult your doctor before changing or trying new treatments.

> ----------------------------------------

> DISCLAIMER

>

> Advertisments placed on this yahoo groups list do not have the endorsement

of

> the listowner. I have no input as to what ads are attached to emails.

> --------------------------------------------------------------------------

------------

>

>