The about.thyroid.com website, for alternative medical information has reached a new low. Patients with thyroid disease should NOT see an endocrinologist or thyroidologist. The post claims that "thyroid friendly" alternative types will listen to the patient and give them therapy based on symptoms, rather than hard thyroid hormone blood studies. The patients with cancer or needing radiation for Graves' disease are the exception, and need to see a thyroidologist. This is a very way out idea. Here is why. First, hypothyroid patients need to see a specialist at the first sign of disease. The careful examination of the neck by an expert will be able to feel a firm nodular surface of an early Hashimoto's thyroiditis. That will trigger an ultrasound. The ultrasound done real time by the endocrinologist could reveal a cancer nodule, goiter,or nodular goiter years before it can be troublesome to the patient. Waiting until the patient has cancer,or nodules that can result in a surgery is a poor concept,and is the major reason not to consider anyone other than an endocrinologist. Every patient with subclinical hypothyroidism with TSH >3.0 and slowly climbing yearly needs to see an endocrinologist,or thyroidologist PERIOD. Hashimoto's thyroiditis with progressively increasing TSH from 2.5 to 10 over 10-20 years, or has positive antibodies needs a complete endocrine/thyroid evaluation. TSH is a risk factor for thyroid cancer in patients with Hashimoto's thyroiditis. Also TSH causes nodules to grow that are not cancer but look bad on a thyroid biopsy, and can result is surgery.Early detection of Hashimoto's can save surgeries and find cancer when it is small and curable. Also, in 35 years of practice,I have seen goiters melt away, and the antibodies disappear on T4 therapy. The disease will destroy the thyroid if you prevent the regrowth due to TSH. Failure to visit an endocrinologist to get an early diagnosis of possible troubles is a major mistake that will happen to some of those who read the posts on thyroid.about.com. Finally, that leaves only the few percent of all thyroid patients who are still complaining about symptoms when their T4, and TSH are normal, to seek those physicians, that prey on the patients ignorance and give them Armour, T3, Combo T4/T3, and compounded products, to treat symptoms totally unrelated to the thyroid disease. The impossible dream is that just treating thyroid problems will correct all the symptoms the patient have. That is not only a dream, but a pipe dream. They may feel better for a while due to the effect of T3 on the brain, but will suffer in the long run.
I challenge the website managers to allow comments, without deleting those that have a contrary opinion to it's alternative views. My comments given here in my last few blogs were sent as comments to the website. They were clearly received, but disappeared by the next day. The only comments that were allowed to appear were the "yes, I agree" type. The alternative thyroid audience will not like what I have to say, but there will be a few among them that will rethink their position. Good Luck, Dr.G.
Does that mean anyone with hypothyroid should be seeing an endocrinologist? I have tried to see one, but they'll only let me make an appointment with a referral, and my primary care physician won't give me a referral because they say my TSH is within the right levels (I'm on 150mcg levothyroxin).
Also, I have had a few friends make comments about my "goiter" which I've always just thought of as my "big esophagus" that protrudes when I'm thin. No doctor has ever mentioned it, and I had one exam where my physician felt my neck around that area and said my thyroid wasn't enlarged. I was complaining about always feeling a lump in my throat but she said everything felt fine, and that it was just anxiety. I've tried googling for "goiter" but most of the images are the crazy pictures where it looks like they're about to birth twins out of their neck, not like how my neck looks at all! lol. Your nontoxic goiter pic actually looks a lot like mine, and is how I arrived at your site.
Anyway - I guess to sum it up, I'm wondering:
1. if it sounds like time for a new primary care physician,
2. if I need an endocrinologist even if my hypothyroid is supposedly under control, and
3. what a less than guinness book of world records goiter looks like.
I have been doing research on thyroidectomy for the last two months and keep running across information you have provided online, and am curious as to your thoughts on the following:
I had thyroid nodules for the last 8 years and have had biopsies every other year, to which they were found benign, until my last one which showed a solid nodule. They did a biopsy on it and it turned out to be Papillary Carcinoma with Hurtle Cell changes. Two weeks later I was scheduled for a total thyroidectomy, to which I had done one week ago and am now recovering. My endocrinologist and surgeon are telling me that I have to have radioactive iodine to kill off the rest of the thyroid and any cancer cells that may still be in my body. I am reluctant to take the radioactive iodine as for someone my age (51 years) they said that it could reoccur in 10 years. However, I read that if I am a low risk, which I think I am, I can avoid the radioactive iodine and avoid reoccurrence for 20 years. This is where you opinion comes in to help me in my decision as to whether I should do the therapy or avoid it.
Today, seven days after my surgery, I met with my surgeon, and I was told that the cancer site was 1.3 cm, my lymph nodes were benign (they took two for tests), they tested 1/3 of a parathyroid gland, which was also benign, and left the others in place, and there was no extension of cancer beyond the capsule of the thyroid gland. I have no family history of thyroid cancer, no direct radiation other than a few chest xrays and one low thyroid update for a scan about 8 years ago.
Does this make me low risk and someone that can avoid radioactive iodine? My concern is the reoccurrence later in life. My endo and surgeon both say is necessary for me to have the treatment to kill off the existing thyroid and make sure all the cancer cells are killed.
Thank you for taking the time to respond in advance. I only have 1 week before they are going to set up the therapy and I would like to know that I am making the right decision.
I have had a enlarged thyroid all my life with no meds cause no one really noticed it but I could tell something wasn't right with my neck....I am now 31 years old had two kids (one in 2000 and 2002) and tubes tied. and I just recently went to the doctors and they said I had really low thyroid..so they put me on levothyroxine 25mg. I asked about my bulge in my neck so I got the sonagram and concerned what they saw and found a nodule on my thyroid...got a needlepoint biopsy. the nodule was benign (thankfully) and they said that I have Hashimotos thyroiditis...my thyroid after blood tests was still sorta low but not bad like before so they increased it to 50mg. but taking it actually made me HAVE the symtoms of low thyroid losing hiar,sluggish ,sleeping ALOT..so my doctor took me off the meds and I feel like myself again.....thing is I now want to get a tubal reversal done will that affect me at all??????????? and what can help with hashimotos if the eds aren't working