Honolulu: Borderline Thyroid Tests: When Should You Take Thyroid Medication?

Honolulu,

A recent study found that many people have untreated thyroid disease.  The study, published in the Journal of Medical Screening assessed over 4000 people between the ages of 50 and 65 and found about 8% have low thyroid levels.  When weight goes up, many people suspect a low thyroid.  But when they go to the doctor, they get the routine “TSH” test and are told “it is borderline” and probably not the problem.  As an endocrinologist, I see this frequently.  There are so many cases with borderline thyroid testing where the thyroid really was to blame.  Once treated, thyroid patients lose a lot of weight without a major change in their diet or exercise routine.

Thyroid experts recognize the TSH test as the test of choice when thyroid disease is suspected.  An elevated TSH test diagnoses hypothyroidism.  TSH is more sensitive than other thyroid tests because it begins to rise before thyroid hormones drop.  As such, it’s a better indicator of early thyroid dysfunction.

When the TSH test is “high normal,” in the range of 2.5-4.5, deciding to take thyroid medication can be a difficult decision.  I’ve seen many patients with this situation.  Frequently, thyroid tests in this range will normalize within a few months, other times, they progress to overt hypothyroidism.   The first step is to repeat the test.  I never make a treatment decision based on a single blood test.  Experts recommend waiting 3 months to repeat a borderline abnormal TSH test, but if you have a lot of symptoms it is better to do it sooner.

In my opinion, many doctors take the easy way out and prescribe a low dose of thyroid medication when the thyroid is really normal.   If you take low dose thyroid hormone and your thyroid is normal, it will make fewer hormones to maintain normal levels.  So taking a low dose of thyroid hormone, even if you don’t need it may not do much.  I’ve seen so many patients who have tried this approach and then come to me still complaining of symptoms.  Some of these patients stopped thyroid hormone replacement and felt better.  Others do feel better, but I have always wondered how much of this was placebo effect?  A study was done to determine if treatment with thyroid hormone could improve the symptoms of hypothyroidism in people with normal thyroid function tests.  The results, published in the British Medical Journal, showed that thyroid hormone was no more effective than placebo for relieving symptoms.

On the other hand, some people with borderline tests have early thyroid disease that is certain to progress.  Diagnosing hypothyroidism in the early stages can be tricky.  That’s because when the thyroid starts to fail, tests can remain in the normal range for a period of time.  The first thing that indicates low thyroid is an elevated TSH level.  A change from a low normal TSH to a high normal TSH over a period of a few months may mean early thyroid failure.  If thyroid antibodies are positive or if the thyroid gland is enlarged the risk for thyroid failure is extremely high.  If the thyroid antibodies are normal and the thyroid is not enlarged, the risk is much lower.

The bottom line is that many times there is no easy answer.  If the thyroid is truly to blame, tests will become more clearly defined as time goes on.  There is usually no harm in waiting a few months to make a decision about treatment.

Source by Scott Isaacs M.D.

Borderline Thyroid Tests: When Should You Take Thyroid Medication?

Honolulu: Hypothyroidism Levels - 5 Most Useful Tips on Interpreting Your TSH Test Result

Honolulu,

Till early 1970s, doctors all around the world used various symptoms and signs of hypothyroidism to detect issues with the thyroid gland. After 1975, TSH test became the standard test for determining the T4 hormone production levels. Almost all the laboratories across the globe started doing this test to analyze the presence of thyroid gland issues and possible hypothyroidism levels. Even now, this test is considered as the most accurate test to analyze hypothyroidism levels. Hence, it is important to learn the various aspects of this test before going for a diagnosis. Following are some useful tips on how to interpret TSH test and analyze your hypothyroidism levels.

1. A great number of laboratories consider the range of 0.4 mU/L to 4.0 mU/L as a TSH production indicating normal functioning of the thyroid gland.


2. If your TSH test results are above 2.5mU/L, your doctor may ask you to do a blood test for anti-thyroid peroxidase (anti-TPO) antibodies.


3. You should repeat TSH tests every year, if you are having a TSH level above 2.5 mU/L.


4. If you have a low TSH level, and still having symptoms of hypothyroid, you should go for other tests such as T4 and free T3 tests


5. The TSH test may not be accurate if your pituitary gland is not functioning well. If your pituitary gland does not produce enough TSH, your thyroid gland will also reduce production of T4. This is known as secondary hypothyroidism, which is a very rare case most of the time.

These days, more and more medical practitioners are emphasizing on the fact that TSH test results alone, cannot be considered as the measure for hypothyroidism levels, neither it may not provide valid results in most cases. However, the debate still goes on.

Source by Jane Jack Collins

Hypothyroidism Levels - 5 Most Useful Tips on Interpreting Your TSH Test Result

Honolulu: What to Expect When You Are Expecting, Heidi E. Murkoff

Honolulu,

The first thing that my husband did when I told him that I was pregnant was to go to the library and buy the book ‘What to Expect When You Are Expecting’, by Heidi E. Murkoff.

The book dedicates a chapter for each month and explains the changes that you can expect to experience during each month, the tests that you will have done and pretty much everything that you want to know about. It is a great book. I have to say that I read it from the first page to the last one, but it is also very handy for checking a few things along the way. I highly recommend it to anyone who is considering to get pregnant, start reading it before and it will give you a good idea of how to take care of yourself for the pregnancy (the earlier the better).

The book also shows you different exercise that you can practice during the pregnancy and that will help you to have an easier labour. During my pregnancy I found that keeping active helped me a lot. I didn’t suffer any liquid retention or swollen ankles and I think it is because I walked every day until the day that I gave birth. Walking is one of the best exercises that you can do during pregnancy, you do not need any equipment, you are outdoors, you can control the intensity easily, you can do it with friends, you can chat at the same time and even go shopping. And the best part is that it helps to your baby to put himself in the right position for birthing.

After I had my baby a friend bought ‘What to Expect During the First Year’ as a present for me. I have to admit that I haven’t been able to read it as much in detail as I did it with the other one, mainly because once you have the baby it is very difficult to find time to read… so my recommendation is read both during the pregnancy, hehe. It seems very good too, there is one chapter dedicated for each month of the baby’s life.

During my pregnancy I read a lot of book and I found many that I could recommend, but if you have to buy just one then I would suggest to buy ‘What to expect when you are expecting’.

Pregnancy is a magical experience, enjoy it as much as you can.

Source by Natalia Ho

What to Expect When You Are Expecting, Heidi E. Murkoff

Honolulu: Signs Of Gestational Diabetes - What To Watch

Honolulu,

Gestational diabetes is a condition that affects pregnant women.

If you are pregnant, you should be aware of the signs of gestational diabetes so that you can seek medical attention immediately.

Although you may not have diabetes and may never have diabetes over the span of your life, you may be at risk for developing gestational diabetes.

Diabetes is a condition where you body fails to covert sugar properly.

This excess sugar builds up in the body and can be potentially fatal if left unchecked. Although this condition can be caused by genetic disposition, diet, and other outside factors, women who are pregnant are also at risk for a unique form of the disease.

Typically, when the baby is born, the diabetes will disappear and may not appear if you become pregnant with another child.

What Causes Gestational Diabetes?

Approximately one in 25 pregnant women is affected by gestational diabetes.

Typically, this type of diabetes will occur during the last three months of the pregnancy , but may potentially occur before that time.

The surge of hormones that are present while you are pregnant can completely change your body chemistry.

Furthermore, these hormones can make someone who has never had any problems converting sugars in their body suddenly unable to do so properly.

The specific hormones that are believed to be the root cause of the problem come from the placenta.

Although not all women are likely to develop gestational diabetes, you may be more at risk if you are overweight or expecting over the age of 30.

Signs Of Gestational Diabetes

The most common signs associated with gestational diabetes are extreme hunger and thirst .

Although a growling stomach is certainly no stranger to a pregnant woman, any extreme feelings may be signs of a problem.

Associated with the increased liquid intake is an increased urinary output. Again, this is a common complaint for pregnant women, but any extreme urination should be noted.

Other symptoms include blurred vision and excess weight gain.

If you believe that you are suffering from any of these symptoms, contact your obstetrician.

He or she will run a test to see whether or not you have developed gestational diabetes.

What To Do After Diagnosis

If you have been diagnosed with gestational diabetes, consider reading up on the disease itself.

Education is the key to acceptance and can make a condition that seems scary very livable, at least until the birth of your child.

Typically, women with mild cases of gestational diabetes can control the condition with a proper diet that is prescribed by your physician.

Be sure to understand which foods can cause problems with the condition and avoid them if at all possible.

If you have been diagnosed with a more serious case of gestational diabetes, you may need to have daily injections of insulin and test your blood sugar regularly.

Especially with women who need to use insulin injections, the threat of hypoglycemia or hyperglycemia is especially dangerous.

For this reason, carry the appropriate items, including insulin syringes and sugared candies with you at all times.

If you feel the onset of either hyperglycemia or hypoglycemia, immediately call 911 or head straight to your local hospital.

Source by Mike Herman

Signs Of Gestational Diabetes - What To Watch

Honolulu: Tubal Reversal and Healthy Pregnancy

Honolulu,

Those that have had the tubal reversal surgery to have fertility restored want to have a baby. A large majority of the couples that choose this surgery do so because of the excellent pregnancy success. Although it is thought to be harder to conceive when your fallopian tubes are shorter it still doesn’t stop couples. Each day there are couples totally in awe when they get that positive pregnancy test. These are the same couples that were convinced it would take them so much longer to conceive than the other couples around them. This just goes to prove that the human body is nothing short of a miracle and will compensate when something is just not right.

When a reversal couple becomes pregnant the early pregnancy protocol is a bit different than with other pregnancies. Because there is a slightly higher risk of ectopic pregnancies the pregnancy is followed much closer in the early days. Blood work to track the amount of HCG must be done at certain hourly intervals. Once the HCG level reaches 1500, a vaginal ultrasound can be scheduled to confirm the pregnancy is in the uterus. Once the uterine pregnancy is confirmed the couples breath a bit easier and begin to actually enjoy the pregnancy with less worry. It is common that couples will worry before the uterine pregnancy is confirmed. Although the risk is slight for ectopic pregnancy it can be a very unsettling time.

Healthy pregnancy following reversal surgery has excellent odds. The largest tubal reversal pregnancy success study performed confirms this. Two-thirds of all reversal patients conceive in the first year following surgery. The highest percentage of success follows those having clips and rings reversed. A common factor is also the age of the woman. The younger the patient the higher the pregnancy rate seems to be. If you are reading this and are ‘older’ do not let this discourage you. Women that are 40 and over still conceive and go on to have very healthy pregnancies. The leading reversal center regularly has women 40 and over conceiving as reported in their weekly pregnancy reports. For those couples that are a bit older there are test that can be performed prior to reversal surgery to check fertility. Many do this just to be sure before actually paying and undergoing the procedure.

Tubal reversal surgery is not only less expensive than the alternative fertility treatment offered it also a better pregnancy success. A common question among patients is why they had never heard of this procedure? There seems to be no one perfect answer. Many in the medical field do not know the success rates. Common factor is that most had not even been exposed to this surgery while in medical school. Stories are being told all the time on how a reversal patient will become pregnant and the physicians overseeing the pregnancy are quite shocked. As more in the medical field are exposed to this procedure the higher the demand is for the surgery.

Tubal reversal surgery and pregnancy go hand in hand. If you are a couple seeking to have fertility restored to have a baby together this is one of the best options available. Couples who desire to have more than one child are able to do so without added medical intervention. Couples have gone on to have four and five children to complete their families.

Source by Debra Verville

Tubal Reversal and Healthy Pregnancy

Honolulu: Recognizable Symptoms of Ovarian Cysts

Honolulu,

Woman who are in their childbearing years are commonly prone to having ovarian cysts. The symptoms of ovarian cysts can go undetected because many woman are not aware of what is going on with their bodies and often times the symptoms of an ovarian cyst will mimic other conditions.

Endometriosis and an ectopic pregnancy are a just a few of the conditions that will cause this condition to be misdiagnosed. Pelvic inflammatory disease as well as appendicitis and diverticulitis are other unlined conditions that are often mistaken for the condition when it is actual an ovarian cyst.

To help woman become more aware of how to recognize the symptoms of ovarian cysts before it the problem grows to an uncontrollable level that may cause a rupture of a cyst is present and untreated. Some of the symptoms to be aware of are pelvic pains that may occur in the lower back area before or after the menstrual cycle. Nausea and vomiting that may mimic pregnancy and irregular menstruation.

Since ovarian symptoms are commonly not detected early on, the female may not have knowledge that they have ovarian cysts until after a routine pelvic exam performed by their doctor. What usually happens during the pelvic exam is that the doctor will feel swelling on the ovary or ovaries and from there will order that more tests be perform to identify if there is presence of this condition.

The types of tests that may be ordered by the physician will be for the purposes of identifying the cyst, the cyst size, shape and the location of the cyst. All of this information will help to determine the best possible treatment and necessary steps that will need to be taken. There are a few ways to find out the growth of the cyst and one of them will be to perform an ultrasound on the area of the reproductive system.

The doctor may also order a hormone level test to rule out possible of the growth being hormone related. The doctor may also order a pregnancy test to rule out the possibilities of the the female being pregnant which can cause some swelling on the ovaries.

Depending on some of the preliminary tests the physician may also order a blood test that can measure whether the identified cyst is cancerous or not. The blood test performed will help to measure cancerous antigen levels that will be present in the body if the cyst is cancerous. If the cyst is not cancerous then the blood test levels will indicate this by producing lower numbers showing that the cyst have noncancerous cells.

Since some ovarian cysts does not produce enough detectable cancerous antigen the reading of the levels can be misdiagnosed. This can also happen if the body is harboring another illness such as uterine fibroids or endometriosis.

Source by Lorainne Phyllis

Recognizable Symptoms of Ovarian Cysts

Honolulu: TTC Success Stories With Clomiphene

Honolulu,

Clomid (clomiphene citrate) is one of the most popular oral fertility drugs, and for good reason. Around 25% of women with infertility suffer from some form of ovarian problems and require drugs to stimulate and regulate ovulation. Clomid is easier to use than injectible fertility drugs, is less expensive, and is 80% successful at stimulating ovulation. While this does not necessarily guarantee pregnancy, a number of women have successfully conceived with the help of Clomid. TTC is a common acronym used on blogs and fertility forums that stands for “trying to conceive. You are invited to read these TTC success stories of women who have taken Clomid and ask your doctor if a similar protocol is right for you.

Patricia’s story of victory over her biological clock

On Christmas Eve, Patricia finally discovered that she was pregnant. Her positive pregnancy test finally ended her eight year journey through infertility. Patricia and her husband had been trying to get pregnant ever since they got married, but did not believe in using assisted reproductive technology or fertility drugs. On Patricia’s 37th birthday, she realized she wasn’t getting any younger and if she wanted to get pregnant now, she had to act fast. They saw a doctor who prescribed Clomid to help her ovulate. It took just five cycles before she finally conceived the baby she’s been longing for. As of this writing, Patricia’s baby girl is developing normally and her pregnancy is otherwise uneventful.

Eleanor’s tale of a second try at conception

Eleanor and her boyfriend have been trying to conceive on and off for two years. She tried Clomid for two months but didn’t like it because the drug made her moody, depressed, and gave her the most terrible road rage. A year later, she gave the drug another chance and successfully got pregnant! She is now the proud mother of a three year old son and has no regrets for trying fertility drugs again.

Amy’s story of success with IUI

Amy is 25 years old and married for six years. She and her 27-year old husband delayed pregnancy for this long because they wanted to enjoy their married life with just the two of them for a while before starting a family. But when Amy began getting baby fever, she convinced her husband to start trying to get pregnant. She went off her birth control pills but after six months of trying to conceive, she was still not pregnant. A year passed and Amy grew more frustrated as many of her friends starting bearing children with no problems conceiving. She decided to see an infertility specialist and went on Clomid after the tests revealed nothing abnormal. The first two cycles of Clomid did not seem to make a difference, but she finally got pregnant after doing Clomid with IUI.

Catherine’s TTC achievement with fertility drugs

Like Amy, Catherine married young and delayed pregnancy until her late 20’s. She has been on birth control pills for eight years and got pregnant immediately. Unfortunately, she miscarried at five weeks due to a blighted ovum. Catherine and her husband have been desperately trying to conceive since then. Several months later, Catherine got tested and found out that her progesterone levels are very low. Her doctor suggested Clomid on days 3 – 7 of her cycle. On the 14th day, she returned to the clinic for an ultrasound and learned that she had several large follicles. However, only one of them was a “mature” enough (24mm). Catherine received an HCG shot after ovulation and she and her husband timed sex accordingly. She barely felt the two week wait because she was too busy at work, but one day she woke up and realized that her period was several days late. Catherine wasted no time getting her hands on a pregnancy test and could not believe her eyes when she saw that it was positive! The rest of her pregnancy went by without complications and she gave birth to a baby girl.

Source by Diana Farrell

TTC Success Stories With Clomiphene