Fat, Mad, Middle Aged, Menopausal Women??!

There is still so much we don't understand about our thyroid and how it's related to menopause. The symptoms are so similar so in this forum we can talk and learn about each other's experiences and research.

Fat, Mad, Middle Aged, Menopausal Women??!

Postby Seventeen_At_Heart » Fri Jun 06, 2008 6:28 am

Just read the following, referred from this
http://thyroid.about.com/b/2008/05/22/b ... -girls.htm
...I am sure some here can relate to being labelled this way [even if it not spoken directly and aloud] by medical practioners...and, in this case, when enquiring about details of results for thyroid function..

http://www.onmedica.com/BlogView.aspx?b ... 9a5b4806e5

The Evolving Patient
Joanne Shaw (22/05/2008 10:08:31)
Fat, mad, middle aged, menopausal women

I had a surprising encounter yesterday with two cheerful and competent women who run support groups for patients with thyroid disease. Here’s their view of the hot issues for thyroid patients:

not being taken seriously and being talked down to by GPs
having test results withheld by receptionists - being told they are allowed to know that they are normal, but not the detail
being charged £50 for special consultations if they want to know their full results.
I was truly amazed.

The ladies reassured me that these problems are far from universal. For example, some practices are happy routinely to fax full results to patients without charge, which is much appreciated. But people ringing patient support groups to ask for advice regularly report negative experiences of this kind.

This is an anecdote, not evidence, and hopefully it’s not a fair reflection of most people’s experience. I may be naïve but surely care like this is incompatible with an NHS that works in partnership with patients and encourages them to take responsibility for their own health.

Dan Brett Posted: 22/05/2008 12:06:28

Joanne - tell the "goitre girls" to find a new hobby! Here are some facts to save an unecessary fax Under-active thyroid disease (which nearly all our thyroid patients are) doesn't need support - It's very simple - keep taking the tablets - if you do, you will have a normal blood test once a year - no GP consulatation required - end of story! If you don't believe me got to: http://www.btf-thyroid.org Don't make an issue of something that's not - we've got PCTs to do that job... PS I like the £50 fining system for ridiculous consultation requests, though I'm not sure its currently strictly kosher under our terms of service

J Jones Posted: 23/05/2008 01:27:18

But the question here Dan Brett (though perhaps it only arises for GPs with critical faculties intact) is what exactly constitutes a normal range for TSH? Since 2003, the American Assoc. of Clin. Endocrinologists has stated that the normal range for TSH should be 0.3-3.04. Britain (supposedly a developed country) is retrogressive in having its patients wait until their TSH hits 10 before commencing treatment. (Cf. the BTF's recommendations). US researchers had the good sense to use a valid methodological approach and screen 'normal range study' participants for occult thyroid dysfunction. A shame the BTF and UK doctors can't learn from those with more advanced research skills. The fact is, defining the normal TSH so broadly saves GPs lots of money but leaves lots of patients suffering.

J Jones Posted: 23/05/2008 02:11:22

Dan Brett's post is a great example of the uneducated and ill-mannered treatment of thyroid patients (the majority of whom are female) by many UK medics. Can we expect to see Brett posting on blogs about male impotence telling the 'impotent idiot brigade' to find a new hobby? In what way is asking for one's full results a 'ridiculous consultation request' that deserves a £50 fine? Perhaps Brett should be mindful of the GMC's guidance to 'give patients the information they want or need'. Note to Brett's appraiser - it seems Brett has missed out on some basic training in the areas of respect for patients, information provision, diversity and equality. Perhaps you could organise for him to attend his Trust's next course in Equality and Diversity for Beginners.

Dan Brett Posted: 23/05/2008 07:38:34

Excellent! The goitre girls have a new champion in Dr J 'Indiana' Jones! As a sequel to Ms Shaw's "101 ways to waste GPs time" we have "J Indiana Jones and the Last Crusade for the Missing Thyroxine". Between them, with their bullwhips, they are able to turn simple monitoring into a wimmin's occult, cult issue - fantastic! As long as the Trust Equality and Diversity Police don't get to me I will continue to give my patients what they need, using our local normal ranges for TSH, free T3 / T4 and thyroid autoantibodies, and if my patients want more than that they can discuss it with an endocrinologist - privately... in America if necessary...

John Squire Posted: 23/05/2008 11:45:40

Are Goitre Girls a girl band?

Mary Shomon Posted: 23/05/2008 16:47:22

It's no surprise to hear how contemptuous some NHS doctors are toward patients. It's worlwide common knowledge that NHS docs are inadequate in thyroid care. A clear example is the willful ignorance evident in Brett's commentary. While many NHS doctors may have an appalling lack of knowledge of proper thyroid diagnosis and treatment, that can eventually be addressed through education. Sadly, however, there's little to be done about contemptuous, misoygnistic doctors who deride patients as "fat, mad, middle-aged, and menopausal" or "goitre girls." These are fundamental character and personality defects; no amount of continuing education will ever improve. No patient deserves to suffer this sort of incompetence. Here's a fact: NHS doctors use outdated TSH reference ranges. Perhaps Brett and colleagues should spend less time offering uninformed opinion on blogs, and more time boning up on Endocrinology 101, so they can learn the basics. Mary Shomon Thyroid Patient Advocate

Talia Newman Posted: 23/05/2008 16:58:39

So you actually run the free T3/T4 and autoantibodies test at your practise? Well,at least thats an improvement from the usual current practise of running the TSH only. Your other comments are deplorable.What about that Hippocratic oath you undertook? For Gods sake,show some compassion for your fellow man (albeit)woman. And try to back up scientifically what the hell you are talking about.In cases of Central Hypothyroidism and problems with the Pituitary gland the TSH 'normal' level is skewed and the patient can still be hypothyroid.If your patients have to resort to paying privately to see an Endocrinoligist it is a bad reflection on yourself and makes clear you dont know enough about Thyroid disease. Inadvertently,youve just admitted this. Perhaps a change of career is in order.How about a comic?

[edited out some disgustingly condescending comments from two male doctors, which can be viewed by going to the link]

Mary Shomon Posted: 25/05/2008 17:38:38

Re: TSH Worship: Lab values in the UK and the US have consistently had similar parameters, so arguing that there are different reference populations is specious. Labs in both areas have used 0.5 to 5.0 (approximate) for years. But many US endos now view levels above 3.0 as evidence of thyroid disease, and treat these levels. Peer-reviewed journal research has shown that high-normal subclinical hypothyroidism contributes to heart disease risk and infertility. TSH is known to be unreliable during pregnancy; FT4 is considered more accurate for maternal and fetal safety. There is evidence that treating high antibody levels and normal TSH may resolve symptoms and prevent progression to overt hypothyroidism. If SR and DB and their NHS colleagues are relying on TSH to the exclusion of clinical evidence and patient symptoms, shouldn't the reference range at least be reliable, and not outdated?

Mary Shomon Posted: 25/05/2008 17:51:49

SR says that letting patients know their actual test results "would be a huge waste of time." SR argues that thyroid problems are not predominantly female -- despite the fact that they are, by a ratio of some 7 to 1. In terms of diagnosis, it is intellectually and professionally lazy to dismiss symptoms as due to "purely lack of exercise, poor diet, and dissatisfaction with home/work/family life" and that "attempting to treat these with a tablet is mostly a waste of time."

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Re: Fat, Mad, Middle Aged, Menopausal Women??!

Postby psexypsychic » Wed Jun 11, 2008 3:56 pm

being told they are allowed to know that they are normal, but not the detail

I was told for nearly two years that my "thyroid numbers" were completely normal. A few times it was worded as: "in the normal range".

When the student doctor cycle came around, the new guy said, "Yes, the numbers are normal, but they've been going up over the last year or so..." then proceeded to show me on my record how they've gone up. Now that I have a new doctor again (dang student doctor cycle), I ask specifically to see the results. But then, my doc visits don't cost me anything other than my time and gas money to get to the hospital, 64 miles away.

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Re: Fat, Mad, Middle Aged, Menopausal Women??!

Postby Seventeen_At_Heart » Sat Jun 28, 2008 3:10 pm

psexypsychic wrote:
I was told for nearly two years that my "thyroid numbers" were completely normal....
a doc told me yesterday that my last 3 were...
I can hardly speak of it because of what he was implying and the patronising...and he was one of the better ones :(
[had to call him to my home...emergency leg stuff...never do that- and yet there was an unspoken nuisance thing]

very peed off.

if I get serious probs that lead to who knows what, will that change anything for others?
who knows.
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Re: Fat, Mad, Middle Aged, Menopausal Women??!

Postby GrandmaGreathouse » Sun Jun 29, 2008 11:25 am

I've got to add something about that "normal range".

Years ago, I heard an endocrinologist talk about the NORMAL ranges for women with hormonal issues that resulted in hair growth. I am an electrologist and attend LOTS of continuing education. This endocrinologist said that the "range" is found by studies where they advertise the study and people participate because they hope to get some information about themselves regarding something that is already bothering them. SO, the people participating in particular studies are very likely to have "problems" in the area to be studied. She said that she believed the normal range is often actually HIGH and for women (with excess hair issues anyway) the normal range really does mean that there are excess hormones causing the hair growth.

Now, this was back in the 1980's so MAYBE they have improved on the way they find their "normal ranges" - or maybe not! And, she was talking about one particular type of endo problem.
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Re: Fat, Mad, Middle Aged, Menopausal Women??!

Postby RacerWife7 » Sat Aug 16, 2008 5:19 pm

:banghead: Doctors and thyroid issues. UGH! I was on either Synthroid or Levoxyl for TWENTY years (ages: 22 - 42) before finding this website: stopthethyroidmadness.com . However crazy the title may sound, the information there was completely valid for me. For years I had complained to every doctor I had: my endocrinologist, my OB/GYN, my general practitioner. Not ONE of them did ANYTHING for me. I was 38 and starting to have hot flashes, inexplicable weight gain (to the tune of 10 lbs in one month at one time), my periods were getting shorter, I was depressed, I was exhausted, Oh, and the PMS??? OMG! It was HORRIBLE. But, every one of them told me I was "FINE". :x Oh, it was SO frustrating. ...Until I found Stopthethyroidmadness.com . The one change I made? I changed from synthetic thyroid hormones to Armour Thyroid (natural dessicated thyroid hormones which are derived from pig's thyroid which is the closest to human thyroid that there is). I can't even BEGIN to tell you the difference! Omg!

I no longer see an endocrinologist - especially after what he said when I asked to be switched from Levoxyl to Armour. He told me, "well, I can change you over if you really want to try it. But, your thyroid numbers are fine. You won't see any difference." I took that prescription right to the pharmacy, had it filled, then found a NEW doctor. I see a doctor of internal medicine now who manages my thyroid 1,000% better than ANY endocrinologist EVER did. ...And he takes HOW I FEEL into consideration and ASKS me how I feel every single time I see him.

So, if you're having issues with hypothyroidism symptoms that don't seem to go away, I recommend the website above and Armour Thyroid or some other brand of natural, dessicated thyroid hormone. I guarantee you'll feel MUCH better! (((HUGS!)))
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