The answer may lie in the inexact nature of the blood test most commonly used to make the diagnosis. In 2003 the American Association of Clinical Endocrinologists formulated new guidelines for the interpretation of thyroid blood tests. They stated that the blood tests as traditionally interpreted left many patients undiagnosed. The suggestion was that the actual normal ranges for thyroid blood tests be changed. This would help doctors across the country to easily make the diagnosis in their patients. Despite the fact that this was suggested over 5 1/2 years ago, the lab reports your doctor consults have not been changed. Although some doctors are aware of, the new interpretation, many are not. This leaves many people being told by their doctor’s that their thyroid function is normal. A closer look at your lab report might bring that into question.
There are a number of signs and symptoms that people need to be made aware of so that the problem can be understood and brought to the attention of their doctors. If the doctor is, however, unresponsive to these concerns, the patient may be best served by seeing a doctor who is already aware of this issue.
The following paints a picture of what many people may notice about themselves that might cause them to have this looked in to. If a person’s thyroid has become underactive, which is quite common and even more so in women over 40, they will frequently feel fatigued, and may notice that they have gained weight despite not having changed their dietary habits. If the person goes on a diet, they may see that despite following the weight loss plan they still can’t seem to lose weight.
There are other physical signs to be aware of. Dry skin, and a tendency to bruise more easily may be noticed. Constipation is a very common sign. Along with feeling generally tired, a person might also feel that they are sensing a feeling of weakness. They may feel cold, more than others who they are in the company of, in the same environment.
Facial appearance may change, and the changes may be subtle and occur slowly over time, and thus the patients themselves may be the best to judge that the changes are occurring. The hair and nails may be affected. If a person notices hair falling out at a greater rate than normal, again think thyroid. Other physical sign has to do with hair loss other than on the scalp. A particular well-known sign of hypothyroidism is the loss of the outer 1/3 of the eyebrows. Loss of hair on the arms and legs and under the arms can also bring into question whether thyroid function may be involved. Another facial characteristic is puffiness of the eyelids and face. Some patients report hoarseness and some difficulty swallowing.
Depression is common in hypothyroidism. As a resident in Internal Medicine in the 1980’s I remember our chief of staff an elderly doctor nearing retirement at the time, describing how in the days before the blood tests were used to diagnose a thyroid condition doctors had to use their knowledge of the signs and symptoms to make the diagnosis. He observed visits to hospital wards where severe depression was being treated. He saw cases of depression resolved with the diagnosis and treatment of their hypothyroidism.
The effect on the body of thyroid hormone involves so many functions that there are many other symptoms, as well as the ones mentioned above, that may also occur.
Menstrual problems, such as irregular periods, PMS, and/or infertility, may be a consequence of hypothyroidism. Is your cholesterol elevated? This, too, may be a sign of an underactive thyroid. Before taking medication to control cholesterol it may be wise to more carefully consider whether it might relate to an underactive thyroid.
Environmental toxins affect the thyroid. One reason given for the rise of hypothyroidism is that we live in a world polluted by many chemicals, which the human being had never been previously exposed to. Along with these new chemicals is the influence of the class of elements called "heavy metals" such as mercury, lead, and arsenic. All of these substances interfere with proper hormonal functioning in the body.
Most doctors do not screen their patients for the presence of these elements, which may be having a profound influence not only on the person’s current health but on their long term risks of health problems.
If the heavy metals are present in excessive amounts, there are effective treatments to remove them.
In summary, it is important that the underdiagnosis of hypothyroidism be understood and acted upon. Since thyroid hormone plays a part in overall body metabolism and so many functions of the body, there is a very wide array of signs and symptoms that may alert a patient to the possibility that this may be an important disorder to be checked by their doctors. Furthermore, for a person to be properly empowered so that they may act upon this knowledge, it should be recognized that many doctors may simply not be responsive to the ideas in this article if they rely entirely on the usual screening test for hypothryroidism (the TSH blood test), and declare to their patients that they do not have a thyroid problem based on that test being within the normal range. In that case the patient must be assertive enough to find a physician who recognizes these developments in the diagnosis and treatment of this problem.
Article #3: Morbid Obesity- Effective Treatment Changes Lives
Morbid obesity affects approximately 9 million Americans, and it is on the rise, and is an increasing problem for our society. It negatively affects those that suffer from it medically, emotionally, and even socio-economically.
If you are over 100 lbs overweight or have a BMI (body Mass index) of over 40, you are considered morbidly obese. The chances of premature death are quite high in comparison to those of normal weight. This has been shown to be the case statistically, but it is also a logical outcome of its association with so many medical conditions.
If there is any good news here, it is that effective treatment for a morbidly obese person can lessen these risks dramatically.
The health conditions which are associated are quite varied, and the list of problems that are treated by physicians cross over between numerous medical specialties. Perhaps the most directly associated problem is diabetes mellitus. In fact, effective treatment, as I have seen as a physician, may be dramatic. The dramatic nature of the improvement that can be seen with weight reduction is such that I have been able to tell a gentleman I saw recently that if he visited a new physician who had no knowledge of his having diabetes, that physician would not find diabetes if the standard blood tests he ordered on his new patients were performed.
Cardiovascular problems are also quite prominent with morbid obesity.
High blood pressure is a condition which is known to be associated with the development of heart disease and stroke. Another piece of good news, however, is that with weight reduction, high blood pressure can be effectively treated. The effectiveness of losing weight in treating high blood pressure may be such that, if they had been taking medication for their high blood pressure, the weight loss may normalize the condition so that medication was no longer necessary.
High cholesterol is clearly associated with morbid obesity, and this is yet another condition that can be so effectively treated with weight reduction that it may enable a person to discontinue medication for the condition. Of course, for the discontinuance of medication to be able to be maintained, the person would need to maintain their weight loss and associated lifestyle factors that would go along with keeping the excess weight off.
Morbid obesity has been statistically associated with an increased incidence of cancer, including cancers of the prostate, uterus, colon, and breast. These are some of the most common cancer conditions which afflict our population, and effective treatment of obesity would undoubtedly reduce the incidence of these deadly conditions.
Arthritis and gallbladder disease are two more common problems associated with obesity. Another important condition called thrombophlebitis is associated with potentially fatal condition- pulmonary embolism.
The emotional toll of morbid obesity is well known, as it affects the sufferer socially and via job discrimination. Here again, it is clear that these problems can be ameliorated with weight reduction.
My message for my patients who suffer with obesity is that despite all of the negative current and potential consequences of their problem, treatment will change them both medically and emotionally for the best. It can literally change their lives.
Article #4: The Bioidentical Hormone Solution
Synthetic pharmaceuticals prescribed as "hormone replacement" therapy have for years been among the most widely prescribed medications in our country. They are prescribed most often at menopause for symptoms such as hot flashes and night sweats, but also as a preventive measure for osteoporosis and other problems. There are side effects and concerns about the long-term safety of taking these synthetic pharmaceutical "hormone" replacements. The possibility of the promotion of breast cancer development has caused many doctors to shy away away from prescribing these treatments to their patients. Many women fearing lack of safety of these synthetics refuse therapy they might otherwise benefit from. Along with the move away from these synthetic hormone replacements the field of "Bioidentical" hormone replacement has emerged. A great public awareness of this issue has occurred with the publication of books on the subject by the actress Suzanne Somers who has become an public advocate for natural healing methods. Her appearances on the Oprah Winfrey show, as well as their use by other well-known personalities, have brought this medical question to the forefront of public consciousness.
Hopefully, people can receive the benefits of hormone replacement while trying to mitigate safety issues.
What is "natural" or "bioidentical" hormone replacement? There are some misconceptions about these matters. First, natural hormones are not herbal supplements, and they are not nutrients from plant substances which are meant to mimic the effects of hormones. Bioidentical hormones are made by a compounding pharmacy which produces the same hormonal substance that the body naturally produces. Therefore, when a woman is prescribed these hormones, what she is receiving is a replenishment of something that she naturally produces herself, but which has become deficient, causing the symptoms of menopause, such as hot flashes and night sweats.
The safety concerns regarding hormone replacement therapy have been conducted on women who have been prescribed the synthetic pharmaceuticals. It will take a long time for any differences in the safety profile of bioidentical hormones to be established, but here are some reasons to consider that they may be a smart approach.
First, we have logic. Now, admittedly, logic is not the same thing as statistical proof over years of study, but that doesn’t mean we shouldn’t employ logic in our approaches to caring for patients. It is simply more logical that replenishing a hormone that your body makes itself and has become deficient in, might be accepted by the body, and be safer than a substance which is not known to the body which is in effect trying to "trick" the body into believing it has enough hormones to relieve symptoms.
Also, we have the side effects issues which are listed on the insert to your prescription synthetics. These side effects have also not been established to occur as they do with the synthetics that have been utilized. Isn’t it logical to avoid what has been shown to clearly have these adverse effects?
Also, if symptoms such as night sweats and resulting insomnia, are not relieved, what are the negative health consequences of that? Disturbance in normal sleep patterns has itself been shown to be associated with numerous negative consequences for overall health.
It is worth mentioning that men as well as women can benefit from hormone replacement. The term "andropause" has been used to describe the male "menopause." With the lowering of hormones (primarily testosterone) produced since young adulthood, men’s libido and overall well-being are also compromised. This compromise in functioning occurs, just as happens in women’s lives, when the diminishing of the levels of hormones produced since young adulthood occurs in their forties and beyond.
Finally, hormone replacement has a role in treatment of other problems besides menopause and andropause. For some people they can help with PMS, headaches, vaginal dryness, lack of libido, depression, mood swings, and other problems. To consider whether this may be right for you, consult a physician with experience in Bioidentical Hormone replacement.
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