Wednesday, April 18, 2012

Dr. Phil's perspective...

(I don't really call him doctor Phil, but his first name is Phillip. I think he's a pretty cool guy, and he's been my dcotor for 12 years.)

I saw my doctor today. I had blood work done a couple weeks back and this was a follow-up appointment.
I was somewhat anxious to see what he would choose to do about my irregular TSH reading. I called his office shortly after my lab work and asked the nurse if he would want any more labs done related to my thyroid function. I was thinking T3, T4, Reverse T3, anitibodies.... He didn't.

So, today he told me that he wasn't wanting to "jump to treat" the thyroid situation because he wanted to see that my levels were progressively climbing. The tricky bit, is the fact that adjusting my thyroid activity might impact my heart arrhythmia. Personally, I think it's all mixed together, because taking beta-blockers can be a factor in hypothyroidism. I've developed this irregular TSH reading since being diagnosed with atrial fibrillation and taking beta-blockers. Hmm...

During the time that I was waiting to see him I ordered a supplement that is highly reviewed for supporting thyroid function and balancing metabolic activity. I have been taking it for about a week and I think it has helped. I know it's effecting me in some way because I'm noticing that my energy is better and I noticed a few more brief episodes of arrhythmia in the first couple days I was taking it. Those have tapered off, and I'm feeling fine.  I'm taking less than the recommended dose because I don't want to take more iodine than necessary. Selenium is also included and it has been shown to reduce the presence of thyroid antibodies.

So, on other fronts... Dr. Phil was happy with my a1C (6.3), but mostly because we reviewed the sensor's standard deviation for the past 2 weeks. My sensor data showed an average of 125 mg/dl with a standard deviation of 28. This means that my general pattern has me between 111 and 139 mg/dl. With no hypos, we were both happy with it. He said he didn't think there would be much benefit to getting my A1C any lower. But, if I can do it, I'd rather get it as close to normal as possible.

I asked him to prescribe Symilin and he did.

He said he has had about 3 other patients who have tried it, but all of them didn't like it and went off of it. He said they had been proactive and asked for it, but the side-effects didn't agree with them. I'll see how I do with it. I also got an Rx for a glucagon emergency kit. It was recommended as a precaution when using Symilin. I haven't had any serious lows, but it's good to be prepared if you do have one. Especially, if you are trying something new.


  1. I will be really interested in hearing your experience with Symilin. When will you get started on it?
    Do you feel pretty good about Dr. P's wait and see approach with your thyroid issues? Do you feel the same way? Maybe the supplement will give you the push you need...

    1. I think it will be special ordered through my pharmacy, so maybe by the weekend I'll be trying it.

      I'm not sure about the "wait and see", because it's clearly a clinical level test result. Maybe he has seen variability in his patients and wants to see it really develop. I think he considers me asymptomatic, but with my lipids higher, and some lethargy... I feel like it's enough to do something.

      Since I'm not feeling overly tired these days, I am okay with doing nothing besides taking that supplement. He thought that any tiredness I was feeling could be related to the beta blocker. I don't really love this relationship between hypothyroidism vs. beta-blocker vs. tiredness vs. heart arrhythmia... right now I'm feeling like I kind of have a handle on the diabetes side of things, but this other stuff...sheesh.

      I wish making some shrewd nutritional choices could cancel my need for beta blockers... but, that's not an option.

  2. The main ingredient in that supplement that would affect the thyroid is iodine. Iodine overdose is potentially fatal. I had subacute thyroiditis three years ago, which was seriously awful (weight loss of 22 pounds, anxiety panic attacks, heart rate about 30 beats per minute higher than my normal, full body tremor all of the time, painful flushing especially during and after eating, diarrhea - you name it). My iodine uptake scan showed the same kind of thyroid problem that shows up in people who overdose on iodine; the note from the radiologist to my endocrinologist said to consider the possibility that I was taking iodine supplements. Which I wasn't.

    The supplement you are taking has 225 mcg iodine per "serving" which is 112.5 per capsule. For a normal adult about 1100 mcg per day to cause toxicity. But in people with autoimmune thyroid disease, iodine can be toxic at lower levels. In fact, it's thought that the high levels of iodine consumption in the United States (which prevent all kind of nasty things, like congenital hypothyroidism- a leading cause of mental retardation in some parts of the world and an unknown cause here) is part of why we have such high rates of autoimmune thyroid disease.

    1. Thanks for the info, Jonah. I read a review about the supplement in which one person's Endo recommended that they only take 1 capsule a day. That's where I'm headed.

      I doubt my issues are much related to low-iodine intake, but probably more with the recent addition of beta blockers to my regimen, or just plain genetic auto-immune status. I have read several places that taking excess iodine can have a rather negative effect (hyperthyroidism) for people with auto-immune thyroidism.

  3. I'll be interested to hear how you do on symlin and the supplement. Though my doc won't prescribe it to any type 1's...not sure why?