1. Believe Everything You Read on the InternetWith many millions of thyroid patients around the world struggling to feel well and understand their conditions, many of us turn to the internet. But it's important to realize that any time there is a condition like thyroid disease, where it's not taken seriously enough by doctors, or it's even stigmatized, opportunists will see a marketing niche, and view your illness as an opportunity for them to make money. There are now hundreds of ebooks, videos, webinars, ongoing programs, and practitioners promising cures for everything thyroid-related that ails you, and they are being aggressively advertised all over Google, Facebook, and on websites. Let's face it: we all want there to be a magic thyroid cure, or a secret supplement that miraculously and safely causes rapid weight loss, or an amazing over-the-counter pill that shrinks nodules, The sales pitches can be very slick and compelling. Even I find myself thinking, hmm, I wonder what secrets, miracles, hidden truths, or steps to wellness they know that I don't?! Don't think you're susceptible to a sales pitch? I heard from many dissatisfied readers who bought the Secret Cure for Hypothyroidism ebook, but when thyroid patients finally learned what was going on, the ebook was taken off the market. Bottom line: When I hear about products and programs that actually work -- meaning that there is underlying science evidence, as well as reliable reports from patients who are honestly having success -- you will hear about it here. Otherwise, caveat emptor...buyer beware.
2. Talk to Your Doctor Like He/She is Your Best FriendMany of us have done it. You walk into the doctor, and when he/she says, "so, how are you feeling," you start to complain about your legitimate symptoms. "I can't lose an ounce...every time I look at a donut I gain five pounds!" Or, "I'm so tired, you can't believe it, I'm dragging myself around, and it's just...."
In today's world, where you probably have less than 10 minutes to communicate with your doctor, you have a limited amount of time to communicate your symptoms to your doctor in a way he or she will understand. When we express symptoms emotionally, we run the risk of the doctor seeing the symptoms as emotional in nature. Instead of tests or treatments, you run the risk of walking out of the doctor's office with a prescription for an antidepressant medication, and advice to "get some more exercise." So my advice is to do something similar to what we're told to do in job interviews. Quantify, quantify, quantify!
"Doctor, I've been doing an intense cardio routine for 3 one-hour sessions a week, and I'm eating a 1,500 calorie a day low-glycemic, low-fat diet, and I'm gaining 2 pounds a week." Or "I've been making sure to get at least 8 hours of sleep per night, and I'm still so tired that I have to take a 30-minute nap before I can even make dinner, and even then, I'm needing a 3-hour nap on Saturdays and Sundays as well, just to function."
When you don't feel well, you have a right to whine, complain, feel frustrated, or otherwise discouraged. But those conversations are best to have with sympathetic family and friends. With even the most compassionate doctors, try shifting to a less emotional, but more factual, quantifiable discussion of your symptoms with your doctor, and your doctor may be more likely to take your symptoms seriously, and take action.
And if you have a "difficult" doctor, it may be even more important to keep things unemotional.
3. Assume All Your Symptoms Are Thyroid-RelatedOnce diagnosed with a thyroid condition, some of us have a tendency to assume that every ache, pain, and symptom is thyroid-related. This can pose some challenges. First, by assuming every symptom is your thyroid, you may end up gauging the success of your thyroid treatment based on resolution of symptoms that may have nothing to do with your thyroid. Second, you may end up overlooking other conditions that can be diagnosed and treated, apart from your thyroid condition.
I remember a women who contacted me, insisting that the pain in her abdomen was clearly something related to her thyroid, as it had begun around the time she was diagnosed with hypothyroidism. She kept trying various supplements and self-help remedies, until she had a full-scale gall bladder attack. The problem was her gall bladder, not her thyroid condition. I also heard from a man who had mild hypothyroidism that was being treated, but extremely high cholesterol, and was expecting his thyroid treatment to resolve it thoroughly. But it turned out, despite them all being slender and having a healthy diet, he, his father and brother all had this genetic tendency toward very high cholesterol. In this case, the cholesterol was likely not a direct result of his hypothyroidism.
Even symptoms that can be related to the thyroid may not be a symptom of your thyroid condition, but rather, could show up as separate conditions. For example, some people have the autoimmune disease alopecia, and as a stand-alone condition, it can result in hair loss. While hair loss is a common thyroid symptom, if you also have alopecia, even the best, most optimized thyroid treatment may not impact the alopecia.
Be familiar with the symptoms and conditions that are thyroid-related, but make sure that when you talk with your doctor, you're leaving open the possibility
4. Smoke CigarettesCigarettes contain a variety of chemicals that are specifically detrimental to the thyroid. For Graves' disease patients, smoking increases their chance of developing thyroid eye disease, and makes the treatments for thyroid eye disease less effective. We know about the many other reasons not to smoke, but thyroid patients have their own unique reasons to stay away from cigarettes.
Note: Are you a smoker thinking about quitting? Visit About.com's site to help you quit smoking.
5. Accept "The Tests Were Normal" as a Test ResultI hear from many thyroid patients who say, "My thyroid tests were 'normal' but I still think I have a thyroid problem." And my first question is, what was normal according to your doctor? As a thyroid patient who wants to feel well, you're going to have to accept -- and I know this can be frustrating-- that you will have to become more knowledgeable, assertive and empowered when it comes to your health. And one of the most important steps is no longer relying on the phone call from the doctor's office saying "Your thyroid tests came back normal." Or the "Blood Test Results Summary" form letter in the mail that has "Thyroid, Urinalysis, Cholesterol, etc." with little check marks indicating "OK" next to them. You need to know the actual numbers -- actually, you need to have a hard copy of the actual lab results, and keep a file of them* -- and you need to know what those numbers mean. Many people are not aware that for 10 years, physicians have not even been able to agree as to what is considered "normal" for the thyroid stimulating hormone - TSH - test. And beyond that, there are other issues, including normal TSH but abnormal T4/T3 -- these are the actual thyroid hormones in the bloodstream -- or normal TSH/T4/T3 but elevated antibodies -- that can diagnose thyroid conditions.
* Remember that you have the right to copies of all your bloodwork. Some doctors will give you a copy at your appointment, or fax, email, or mail a copy to you reliably. But to make it easier, leave some self-addressed, stamped envelopes with the office staff to put in your file, along with a note that says "Patient requests hard copy mailed of all lab results."
6. Hide the Supplements/Unprescribed Medications You're Taking From Your DoctorI frequently hear from thyroid patients who are taking over-the-counter glandular supplements, or "thyroid support" combination formulas, or who have even taken it upon themselves to self-medicate -- order and take prescription medications without a prescription. And when they see their doctor, and are asked, "what else are you taking," they are afraid to tell the doctor. Then, when thyroid results come back skewed, or symptoms crop up, the doctor does not have the information needed to make the right kinds of decisions about treatments. In some cases, patients have even ended up overmedicating themselves into serious health crises, including emergency room visits to the hospital for atrial fibrillation or uncontrolled tachycardia (high heart rate), as a result of taking unprescribed medications.
If you are going to self-medicate with supplements and/or prescription drugs -- and this is not something I recommend -- at least make sure that you are keeping your doctor informed about everything you are taking. And if you can't talk to your doctor about it, it's time for a new doctor.
7. Assume that Products Labeled "All-Natural" or Available Over-the-Counter Are Universally Safe and Good for YouThere's a temptation to believe that if something is labeled "all-natural," or it's available without a prescription, it must be totally safe. But that is a mistake, especially for thyroid patients. Some of the "thyroid support" formula supplements are loaded with iodine and kelp, which may actually aggravate your thyroid condition. After nuclear accidents, some people rush to needlessly take potassium iodide, which can actually trigger or worsen thyroid conditions when not needed.
And a study reported on by Dr. Kang at the 2011 American Thyroid Association meeting demonstrated that t10 of the most popular over-the-counter health supplements marketed as "thyroid support" contain varying levels of active thyroid hormone, in some cases levels that exceed typical doses of prescription medication. And because the levels of active hormone in these supplements is essentially unknown from batch to batch, it's easy to become overmedicated or undermedicated.
Again, it's wise to be careful, and ideally, to work with a knowledgeable practitioner to help determine the best supplements for you.
8. Ignore the Warning Signs that You Need a New DoctorYou may have a warm, fuzzy relationship with your doctor, but notice that he/she doesn't seem too savvy when it comes to thyroid and hormone health issues, even repeating some of the old misinformation like, "natural thyroid is off the market" or "all you need is a TSH test." Or, you may be running into one of the more disdainful practitioners whose answer to your concerns is to tell you you're stressed, depressed, PMSing, hormonal, lazy, not taking your medical properly, or that you need to "get off the couch." These are just a few of the many signs you need a new thyroid doctor.
You've heard the hold adage about teaching old dogs new tricks -- don't waste time trying to educate a doctor who isn't staying current and willing to keep an open mind.