Test your own thyroid

134 people responded to the latest Heart Scan Blog poll:


When I ask my doctor to test my thyroid, he/she:

Accommodates me without question 45 (33%)

Questions why, but orders the tests 49 (36%)

Refuses because you seem "healthy" 20 (14%)

Refuses without explanation 4 (2%)

Ridicules your request 16 (11%)



That's better than I anticipated: 69% of physicians complied with this small request. After all, you're not asking for major surgery. You're just asking for a very basic test, as basic as a blood count or electrolytes. 36% of respondents said that their doctor asked why, but still complied; this is simply practicing good medicine--If there is a problem, your doctor would like to know about it.

However, the remainder--31%--were refused in one way or another. Incredibly, 11% were ridiculed.

Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.

Let's say you're tired. Ever since last summer, you've suffered a gradual decline in energy.

So you ask your doctor to assess your thyroid. He refuses. "You're just fine! There's nothing wrong with you."

You disagree. In fact, you are quite convinced that there is something physically wrong. What do you do?

You could:

--Drink more coffee
--Exercise more in the hopes that it will snap you out of your lethargy
--Sleep more
--Take stimulants of various sorts

Or, you could get your thyroid assessed and settle the issue. But how can you get this done when your doctor won't accommodate you, even though you have perfectly fine health insurance and are simply interested in feeling better and preserving your health?

You could test your thyroid yourself. This is why we're making self-testing kits available. Test kits are available here.

This is yet another facet of the powerful revolution that is emerging: Self-directed health.

Comments (15) -

  • Tom

    9/7/2009 2:47:55 PM |

    In addition to home kits we might create drop in health shops where healthy people are given a quick set of automated tests/scans and the results made available to them online.

  • Lincolnb

    9/7/2009 3:26:27 PM |

    This is a great tool as many of my clients mention their thyroids and wonder if there was a way to monitor it.  When will this be available in the UK?

  • Anna

    9/7/2009 4:11:56 PM |

    I'm not sure getting tested is as big of an issue as getting a proper diagnosis and treatment.  I know lots of women who have their their thyroids tested (at least minimally with a TSH) but the results are not properly interpreted or treated.   Usually they end up with anti-depressant meds or are told to eat less and exercise more (or both).

    My thyroid was tested for about ten years (mostly with just the TSH and total T4, not the full complement of thyroid tests) for more than ten years because of two infertility investigations and later, symptoms of fatigue, etc.  I didn't ask for these tests; they were routine as part of a panel or the doctor specified them.  

    My HMO network doctors failed to see that my TSH was slowly slowly rising in that decade because they only looked at the recent result and not the trend (and there was a faster rate of increase after 7-8 years of testing).  They also missed that my results  were always in the "upper end" of the reference range (in late 2002 at least two national medical boards said the upper range was suspicious of development of mild hypothyroidism and the range should be adjusted downward).  Last year when I brought these AACE and NACL recommendations to the attention of the local HMO network lab supervisor, he was unaware of of the new range recommendations and promised to look into it.  I was pleased to note the ref range was somewhat adjusted down a few months later.

    So for me, the lab tests were less an issue; I had numerous TSH and total T4 tests while my symptoms progressively increased, but with little good.  

    The biggest difficulty was getting a correct diagnosis and the proper treatment, instead of attempts to suppress symptoms with other meds (I felt in my gut this was the wrong approach and I mostly resisted it).  

    The best treatment I've tried to date has been desiccated thyroid hormone (I'm now taking 1 grain of Nature-throid daily); to get to this it took a full three years with a continual search to find a local doctor who would use and correctly interpret the right lab tests *and* take into account my symptoms.   I hear similar stories from other hypothyroid people.

  • Dr. William Davis

    9/7/2009 8:43:28 PM |

    Yes, absolutely correct, Anna. Getting tested is just the first step.

    Once tested, understanding what they mean is the next step. But at least you know where you start. It's certainly better than not having any data at all.

    Next hurdle: Getting treatment when you need it. A topic for future discussion!

    Lincolb--It is available in the U.K. by ordering.

  • Daddy

    9/7/2009 10:02:24 PM |

    I guess that's how CA and NY can justify putting restrictions on their sale.  Sheesh!  Reminds me of when CA was on the brink of criminalizing home-schooling.

  • Hot Cover Girls Central

    9/8/2009 1:28:17 AM |

    That's great! I will recommend that to my sister and friend who were always complaining that they might have thyroid problem.
    See yah!

    Cathy Young
    http://fashionhotcelebs.blogspot.com/

  • pooklaroux

    9/8/2009 3:18:20 PM |

    I have also been able to get my doctors to do TSH tests, but since my labs ate at the upper end of normal, they also pooh pooh my suggestion  that treating the thyroid might positively impact other issues they care about, like my cholesterol levels and my asthma.  But they would rather give me statins (which I refuse to take) and advair (which I take only because I have to be able to function.)  I think they have it in my notes that I am hypochondriac and uncompliant. So much for being proactive for my own health care! Now they think I am a nutcase!

  • Laura in Arizona

    9/8/2009 3:38:35 PM |

    I agree with Anna. My doc has routinely tested TSH for years. This past check up I told her I wanted more info on the thryoid because of my lack of energy and other symptoms. She ordered T3 and T4 along with TSH but nothing else. My TSH came in at 4.5 on a scale going to 4.5 which is a full point jump since my last test. My T3 is almost abnormal on the low end. However since they are within the lab's normal range, she says I am fine. I am making an appointment with doc #2 in my search for someone that knows what they are doing. I sure hope it does not take the 3 years to find him/her it took Anna!

  • Anna

    9/8/2009 4:06:54 PM |

    Laura,

    I'd also like to add that much of that 3 years looking for better care was also spent educating myself (I must have read every book available on hypothyroidism to get a sense of all the perspectives), so developed a sense of when to seek out another doctor's care and when to settle for "good enough for now".  

    For me, the hardest part was early on -  summoning the inner strength to get over my reluctance to find new care and thyroid hormone options.  I was acutely aware that my tactic might be viewed as "doctor-shopping" or hypochondria.   Each step wasn't always very far forward, but it was still progress in some way and far more therapeutic than stagnating (it didn't always feel like progress at the time, though).

    Good luck in your quest for better care and more thorough assessment of your thyroid function.  Be sure to get tested for anti-thyroid antibodies.

  • Anonymous

    9/8/2009 4:39:45 PM |

    Regular Doctors are always a crap shoot. If you don't mind switching Doctors, it is better to seek out a Doctor that you know will probably be receptive to alternative therapies right from the get go. Life Extension has a list of "Innovative Doctors" here:

    http://www.lef.org/Health-Wellness/InnovativeDoctors/

    Another good source for Doctors that would probably be receptive to taking a patients thyroid concerns more seriously can be found at the A4M site:

    http://www.worldhealth.net/pages/directory

    Likewise, if lipid disorders are your concern, you can find a Lipidologist at the following site:

    http://www.learnyourlipids.com/resources.php

    Hope this helps.

    John M.

  • kris

    9/8/2009 8:13:44 PM |

    here is the site to find thyroid hormones friendly doctors.
    http://www.armourthyroid.com/con_phLocator.aspx

    Dr Davis, I don't think that you are on there? LOL

  • Dennis Mangan

    9/9/2009 4:10:23 PM |

    Another option when faced with uncooperative doctors: order thyroid from an overseas pharmacy.

  • Anonymous

    9/19/2009 5:22:14 PM |

    You forgot the option of saying you look Healthy so the test is unnecessary and Ridiculing you -- but finally ordering the tests, because you wouldn't leave the room till he patronizingly agreed (hey, whatever works)... and it turns out I have multi-nodule goiter!!

  • Anonymous

    1/2/2010 10:25:33 PM |

    Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now keep it up!

  • buy jeans

    11/3/2010 2:31:15 PM |

    Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.

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More on ASTEROID

More on ASTEROID

Since we are on the topic of the ASTEROID trial and rosuvastatin, I'd make one more point before I start to sound like I'm plugging this drug (which I definitely am not).

In an informative Roundtable Discussion (open to subscribers to the American Journal of Cardiology; sorry) amongst Dr. Steve Nissen, principal investigator behind ASTEROID; and Drs. Vincent Friedewald, Christie Ballantyne, P. Shah, and William Roberts, Dr. Nissen made some interesting comments:


Dr. Shah: In ASTEROID, was the magnitude of atheroma volume change seen across different levels of LDL-C and HDL-C?

Dr. Nissen: No. There was no plaque regression seen in the 17 persons with LDL-Cs >/= 100 mg/dl, and there was little change in persons with LDL-Cs of 70 to 100 mg/dl. Only in persons with LDLs less than or equal to 70 mg/dl was there significant regression. The study was not powered to look for an HDL-C(which increased by 14.7%)-raising effect.



Interesting. In other words, ASTEROID, in a fairly internally consistent way, suggests that the lower the LDL is reduced, the more likely plaque regression is obtained. This is consistent with the Track Your Plaque experience, in which we've advocated reducing (calculated) LDL cholesterol to 60 mg/dl for the past several years.

Unfortunately, the message that the ASTEROID Trial sponsors, AstraZeneca, as well as the roundtable discussion panel (later in the discussion) try to make is that there is something magical about Crestor, that it yields benefits superior to other statin agents or other means of reducing LDL.

I disagree with this message. In the Track Your Plaque experience, we do aim for a similar LDL target. But we also employ a number of other strategies. We have also succeeded in regressing plaque without use of any statin drugs (though, admittedly, many people do require statin drugs to obtain LDLs in this range). We also witness magnitudes of reversal that often far exceed that seen in ASTEROID.

The Rountable Discussion is unfortunately tainted, as is the ASTEROID Trial itself, with deep drug industry financial involvement of the Roundtable participants. In fact, the discussion begins with a listing of the financial disclosures of the participants, a listing that occupies a full column of a two-column page. The potential biases of the participants doesn't necessarily invalidate the arguments, but to me suggests that participants are more likely to argue in favor of the sponsor's drug, or that participants were chosen because of these biases.

Why bother to even mention the ASTEROID Trial in a venue (the Heart Scan Blog, that is) that purports to seek unvarnished, unbiased truth in coronary plaque reversal? Because useful information can sometimes be found in unlikely places. Just like the four-year old child who blurts out an unexpected pearl of wisdom, so it can happen with the gobbledy-gook that emerges from the drug industry.

Every once in a while, they are worth paying attention to.

Comments (3) -

  • Naruwan

    4/19/2008 11:54:00 AM |

    Dr. Davis, your readers may be interested to listen to a recent BBC Radio 4 program which takes a close look at some impressive-sounding figures obtained from statin drug trials and shows how they are in fact not in the least bit impressive (e.g. a reduction in mortality from 3 in 600 people to 2 in 600 being hyped by statin manufacturers as being an over 33% reduction! Brings to mind Disraeli's adage about damned lies and statistics.

    The take home message is that statins appear to be hugely over-subscribed - the UK is gaining on the US in this regard - and statins are of no benefit for 99% of people taking them for primary prevention of heart disease.

    You can listen to the program online using the BBC Real Player at this link. Click Listen Live at the top right of the screen.

  • Naruwan

    4/19/2008 12:11:00 PM |

    My apologies, it appears that the BBC radio 4 program (The Investigation) about statins is no longer available. I think the show's transcript will be made available in due course.

    If anyone would like me to send them the mp3 file of the show (shhh, don't tell the BBC!), please leave a comment here. It's a worthwhile listen.

  • Anonymous

    8/22/2008 8:41:00 PM |

    I would like to know how long one can expect to lengthen their life by taking a statin How many actual years does it add to your life and what about the risk of cancer from taking statins over a 20-30 year period?

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