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Need an Endocrinologist Who Takes AHCCCS, Mercy Care

By June 19, 2009 - 9:07am
 
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I was diagnosed with hypthothyroidism in October 2008 by my GP. She prescribed 25 mcg of levothyroxine and did bloodwork two months later in December 2008. She did not change my dose then. Recently, however, I had an additional thyroid panel done because of an increase in symptoms. In May, for example, I had a heavy period for three weeks. Shortly thereafter, I had an additional heavy period for a week. I have also been sleeping about 10-12 hours per day, have gained a lot of weight, have gotten a puffy face, have lost hair, have incredibly dry skin, have water retention problems, and have developed other symptoms like short term memory loss. A week ago a full thyroid panel produced the following results: T3 82, T4 .91, and TSH 10.13. A staffer from the doctor's office left a voice mail when the results of this bloodwork came back in which she noted that I should call the doctor's office with a pharmacy number so the doctor could call in a higher dose of levothyroxine. The staffer further noted that I should come back in eight weeks for more bloodwork. I have decided that it is time to get a referral to a good endocrinologist, and need one who takes AHCCCS. I would appreciate doctors' names and any other suggestions.

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The nurse just called with my lab results at almost the six week mark of taking a higher dose of levoxyl. Here are my results: T3 34.2, T4 8.9, TSH 1.44. My blood pressure was 118/80. My pulse was 59. And for the first time ever, my cholesterol was high. My cholesterol was 228, with high density cholesterol at 76 and low density cholesterol at 143. This represents a more than 30 point gain since I became hypothyroid and put on forty pounds over the course of being incorrectly treated. I was not surprised to get the results back, because when I saw Dr. Friedman and reported to him that I did not think I had a cholesterol issue, he seemed surprised. He noted that it is very, very common for hypothyroidism to produce cholesterol issues. Last August my total cholesterol was 195. I am making lifestyle adjustments for the cholesterol hike and look forward to getting Dr. Friedman's feedback on the new blood results. Over the course of the past six weeks to two months, I have had enough energy to take an hour long walk per day. Especially since I have been in Dr. Friedman's care, the walk is more and more enjoyable because my energy is really improving. I am now at the point where I can add thirty minutes or so of a cardio activity at least several times per week with light hand weights, something like step aerobics. I have pretty much already cut out red meat, butter, and other products that aren't great for the heart. I will take more care to eat chicken without the skin. I went out and bought myself some tuna to marinate and grill after I got the lab results. I needed to go shopping for groceries, and realize that I must educate myself about eating with the goal of lowering my cholesterol in mind. I know a lot of the obvious points, but need to know more. In any case, I would not have made the choice to buy fresh tuna before. I would have had a healthy choice, but probably not--"Got to watch my cholesterol, let's grill some fish." I have to really start shopping cholesterol-smart! I don't know if I can eat all of the vegetables that Dr. Friedman recommends on the diet posted on his site, but I can certainly eat more fruit and vegetables. What supplements should I consider to help with the cholesterol? A tablespoon or two of a high grade olive oil? More fish oil? (I take 1000-2000 mg. per day.) What have readers working with their cholesterol found in the way of important lifestyle changes to make? I am looking forward to taking off what I call my thyroid weight, and getting the news about the cholesterol is certainly an impetus to do that.

September 15, 2009 - 9:27am

I am looking forward to getting lab tests this week to see how my blood levels are since I started on Dr. Friedman's increased dose of levoxyl. I am wondering whether to switch GPs owing to my GP's "care" of my hypothyroidism, and thought that I would post to elicit comments. I asked Dr. Friedman if he thought that I should switch GP's. In my case, my GP treated me with a way too low dose of levoxyl for almost a year and did not ever try to refer me to an endocrinologist. She discounted my symptoms even when my bloodwork showed that I had every reason for concern; and she refused to make telephone calls to try to help me get in more quickly to an endocrinologist. (I would have had to wait about four months to see an endocrinologist in Phoenix had I not gone to Dr. Friedman.) Dr. Friedman was very dipolomatic and told me that, unfortunately, he sees general practitioners prescribing way too low doses of thyroid hormone and not referring patients who should see specialists to specialists quite often. I asked him if there was any sort of philosophy that would merit my having been put on such a low dose of levoxyl. He told me that doctors can be hesitant to put older people and people with heart disease on a treatment-merited dose of thyroid hormone. However, as I was neither older, nor did I have heart disease, such considerations would not apply in my case. He told me that I should consider whether the GP is a good doctor for the other things that I see her for. The fact of the matter is that I have nothing else to assess her ability as a doctor on. She did have me get a full pelvic ultrasound when I had really heavy and long periods owing to what turned out to be my hypothyroidism this Spring. Still, she suggested that I might want to consider taking a diuretic and also taking hormones to regulate my period while I got my hypothyroidism under control. I told her that I understood that water retention from hypothyroidism does not respond well to treatment with diuretics, and that I thought that it would be prudent to see how my menses fared as my hypothyroidism improved. My reasoning was sort of that too many cooks spoil the broth. In other words, to really treat my hypothyroidism, I would have to see which symptoms would resolve with appropriate therapy. Taking hormones for menstrual irregularities owing to hypothyroidism might regulate my period, but might also mask my hypothyroidism. I am inclined to think that I should look for another GP owing to this doctor's discounting my symptoms and to her unwillingness to make any sort of effort to get me in to see a doctor in Phoenix. Moreover, her willingness to treat symptoms of hypothyroidism while the hypothyroidism itself has not been properly treated just seems like bad medical practice and, to be quite frank, bad science. One wants to hold as many things constant while getting one thing under control, and then move on to the next thing. That just seems like good medicine based on good science. What do you folks think?

September 14, 2009 - 9:37am

Here's an update on how important it is to get early care that is correct. Last year I taught part-time. Today I was offered a research position that begins in about a month that is almost full-time. I have been taking the increased dose of levoxyl for almost three weeks and many of my symptoms have started to abate. In addition, I can tell a big difference in my energy level from taking B-12, which I began doing per Dr. Friedman a week ago owing to my lab results. I confidently accepted the job offer because I really do trust that I will see even more improvement over the coming weeks. I will have had the benefit of almost seven weeks of Dr. Friedman's treatment prescriptions as far as thyroid hormone dose goes when I start, and about a month with all of the vitamins that he told me to take. Had I waited to see Dr. Knecht at the end of October, I could not have accepted my new position at all, much less with confidence. I really don't think that I would be in any condition to start a new job at the end of September if I were still getting treated by my G.P. and waiting to be seen in late October. So ladies, as soon as you are diagnosed, it bears emphasis, get in to see a specialist! And a good one!

August 24, 2009 - 1:13pm

As I note above, my appointment with Dr. Knecht here in Phoenix is in late October. Not wanting to wait to be seen until then, which would mean waiting until mid-December, probably, to see the benefit of any changes Dr. Knecht would make to my treatment regimen, I saw Dr. Theodore Friedman in Los Angeles on August 5. I am really glad that I did.

Dr. Friedman has doubled my levoxyl to 100 mcg daily and does not want me to take generic synthroid. He also ran lab tests to see if I had enough testosterone, Vitamin D, Vitamin B12, and iron. He also tested me for the Hashimoto's antibody. He also observed, contrary to what my GP, who physically examined my neck area about a month ago reported, that I have a goiter with a nodule.

My labs showed that my testosterone level is OK. However, I am low to low-normal with the vitamins tested, and so am now going to begin taking supplements that Dr. Friedman has recommended at doses that he has suggested based on my lab tests.

Dr. Friedman suspects that I may have low aldosterone levels, and so wants my GP or the endo here in Phoenix to run aldosterone tests. He has advised me to add salt to my diet. This has been hard to do, as I had become so used to a saltless diet, given my family's history of hypertension and heart disease. In my case, my blood pressure and pulse tend to be low, and have, at times, been really, really low. (Last summer, for example, right before my blood levels showed that I was hypothyroid, my pulse was regularly in the low forties.) My low pulse and blood pressure stem from hypothyroidism; and increasing my salt intake, if I can just do so, will increase my energy level.

Thankfully, I don't appear to have Hashimoto's; for I don't have the antibody.

Dr. Friedman underscored the role that genetics played in my case. My mother had a goiter; and my father is hypothyroid.

He said that it will take about six weeks for symptoms to start resolving.

It may be just placebo, but some symptoms have started to resolve. I have no idea if this is because the higher dose of levoxyl is taking effect or if it is the lifestyle changes that I have implemented for the past month or so.

I would recommend to anyone with thyroid concerns to read Dr. Friedmans book, The Everything Guide to Thyroid Disease. It's a very thorough guide to issues concerning the thyroid. I discovered in it, for example, that alopecia, a disease that produced baldness, which my father suffered from for a few years not too long ago, is related to thyroid problems. When my father had alopecia, I believe that they told him that they thought it was from stress, but that they really had no idea what caused it. I don't believe anyone told him it was related to his hypothyroidism.

Anyone with thyroid disease needs to be seen by an endocrinologist. Don't let your GP treat you! In my case, for example, my GP had me for months on a dose of levoxyl that Dr. Friedman deems to be "homeopathic." She did not diagnose my goiter. She discounted my symptoms, even when my lab tests were not good. She did not make any calls to see if she could help me get in more quickly to see an endocrinologist. So as soon as you are diagnosed with thyroid disease, get yourself to a specialist, and a good one at that!

By the time that I see Dr. Knecht, I will have the benefits of about 2.5 months of treatment with Dr. Friedman. Hopefully, I can go back to work this Fall. If I had taken my GP's course of action and had waited until late October to see Dr. Knecht, I would not be able to work this Fall. Not only would I not be getting better with her"homeopathic" dose, but I may have begun t feel even worse. So if you take one thing away from this post, let it be this: get treated by a specialist!

August 18, 2009 - 11:04am
EmpowHER Guest
Anonymous

Has anyone heard of dr. kaur? she's an endocrinologist in glendale.

July 30, 2009 - 4:11pm

Keyesshia, are you in the Phoenix area? Have you tried calling the doctors in the posts above yours to see if one of them would take Health Choice?

I'm concerned that you think you have "an excellent doctor" but that you don't like what she's doing with your medication. Is there something that makes you think another doctor would treat you differently? Or are you just looking for a second opinion?

July 16, 2009 - 9:22am
EmpowHER Guest
Anonymous

My name is keyesshia I am 26 yrs old i have hyperthyroid. I need help finding a doctor who takes health choice. I first visited a doctor in TN were i was staying. he put me on methimazole 10mg 2 tablets 4 times a day and propranolol 10 mg the same atfirst it startedd working but i came to az and it took me a month to find a doctor. Shes an excellent doctor but i need someone to take action. she droped me down to 3 times a day she said she has to wait until my thyroid to go down before she can take action. It feels like my body is getting use to the pills. She said it can take up to 4 months to 1 year. my heart rate gets to 141 per min. , I have tremors when it does I need help finding a excellent doctor can some one help.

July 15, 2009 - 7:12am

Michelle: I am sorry to hear that you have not been feeling well. Thanks for letting us know about Dr. Bailey's cancellation list. You are right that as a community, we need to share information. I find the information posted on Empowher about the kinds of experiences women have had with physcians to be much more informative than the patients' testimonials and "ratings" that one can find for endocrinologists and other doctors on the web.

July 9, 2009 - 2:14pm
Expert HERWriter

Hi ladies....Can you please help us find some good Endocrinologists in Phoenix and Scottsdale? There are so many of us in need. EmpowHer is doing what we can but we need help from our fabulous community of women.

Thanks so much!
Michelle

July 9, 2009 - 1:48pm
Expert HERWriter

Hi Cheryl,

If you can believe this, I just had my thyroid checked and it's .25. I am now looking for a new doctor. I think I'm going to schedule an appointment with Dr. Theo Friedman and head to LA for him to take a look at me. I'm having the opposite problem from you. My thyroid was up to 7 and is now down to .25. And I've been wondering why I haven't been feeling good??

I also contacted Dr. Bailey's office and was told she's not taking any new patients until September. If I have a doctor refer me to her, I can get in sooner. But, I have to have my primary care physician refer me. I was however, able to get on her cancellation list. This is exactly why I started EmpowHer...who can wait 3 months when your having thyroid issues??? The one good thing, we know she must be a pretty good doctor because we've heard it from so many women and other doctors. I also know when a doctor has a 3 month wait, they have to be pretty good. At least I hope so:) I'll keep you posted.

Does anyone have any other names of great Endocrinologists in the Phoenix, Scottsdale area? There has to be more then one great Endo doc out there.

Best in health,
Michelle

July 9, 2009 - 1:45pm
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