Thyroid Disease Blog

People regularly complain to me that the waiting list to see an endocrinologist in their area is three months, six months, sometimes even as long as nine months or more — if you can even get on the new patient waiting list at all. Even then, once you're at your appointment, most of your time is spent waiting, filling out forms, being seen by a nurse or physician's assistant, having blood drawn, and so on. You are lucky if you get more than five to ten minutes of face time with the actual doctor. What is going on? Why is it so hard to see an endocrinologist? And is the medical community doing anything to resolve the problem?

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Apparently, nearly one in four Americans has cut back on visits to the doctor, as a way to save money during the current economic downturn.

According to a San Francisco Chronicle article , "Americans have been paying a greater share of their health care costs over the past several years primarily because employers, who cover nearly 60 percent of insured individuals, have been shifting more of the rising cost burden onto them by requiring them to pay a larger share of the premium, raising co-payments, changing plan designs and reducing benefits...Some of those tactics are designed to make people think twice before running to the doctor...the idea behind such plans is that consumers who have more skin in the game will spend those dollars more wisely."

Are you cutting back on visits to the doctor, and if so, why? Share your thoughts here in the poll, and on the forum. Read more...

Over at the New York Times' "Well" blog, Tara Parker-Pope has recently featured two blog posts on an especially hot topic: patient/doctor relationships. In a day when patients are becoming more empowered (and sometimes obnoxious), and doctors are busier (and sometimes more arrogant) than ever, there are still some basic guidelines that both doctors and patients should keep in mind. Parker-Pope highlights them here.

• Six Ways to Be a Better Patient
• Six Rules Doctors Need to Know

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I happen to be a huge fan of Byron Katie, and her process of self-inquiry, which is known as The Work. Her book, "Loving What Is" was truly a life-changing book for me, and lives on my bedside table.

I was interested to hear that Oprah had done an extended 3-part interview with Katie, as part of her XM radio/online "Soul Series." The Soul Series webcast/podcast is very different than Oprah's TV show, in that here, she's doing on-on-one radio interviews -- which are filmed for webcast as well -- with little fanfare...just a personal, in-depth discussion with various writers and experts.

I've been openly critical of Oprah with regard to her attitude toward her own thyroid condition. (As Katie would say, I'm getting in Oprah's business!) But I felt I needed to applaud Oprah and her Soul Series interview with Katie. It's an amazing hour exploring Katie's "Work" process.

I recommend watching the entire three parts -- it will help you understand what the Work is about. But I'd like to call attention to part 2 of the interview, especially, because Oprah talks very openly and honestly about her recurring weight challenge, and how it may be stemming from her hypothyroidism.

Many of us have noticed that since Oprah discovered she had a thyroid condition more than a year ago, her weight has been increasing. Oprah has been quite vocal that she followed a stress-reduction program as a "treatment" for her hypothyroidism. It's not clear whether Oprah has actually had medical treatment for her thyroid problem -- she has suggested in various places that she is not taking medication. More recently, she followed a 21 day vegan cleanse diet, heavy in soy -- an antithyroid goitrogen.

But whatever Oprah is or is not doing to help her thyroid, that's her journey. (See, I'm trying to stay out of Oprah's business!) But I do recommend you watch this interview, and I applaud her for recognizing the work of Byron Katie.

View or download the videos or MP3s of Byron Katie with Oprah now.

_{Photos: Oprah--Paul Hawthorne/Getty Images, Byron Katie--Pricegrabber.com}

Carrie Bell, owner of Madcapz, a company that makes adorable cotton baseballs caps and visors, mainly for women -- with some cute designs for babies and children, dropped me a line recently, and I'm glad she did. Carrie is a thyroid patient who began her company a few years ago when she was struggling with hair loss (due to Graves' disease). She wanted to find a fun uplifting cap to wear on her walks. She couldn't find a fashionable cap (and come on ladies, some of those sports and trucker caps aren't exactly the most flattering styles!) So Carrie decided to make them herself! Now, two years later, Carrie's business is booming, and she's manufacturing and selling women's and kids' caps to women all across the country. Her caps, which are cotton, washable, and made in the U.S., are being sold through hospital gift shops, oncology boutiques, and hair salons focusing on hair loss and wigs, as well as direct to customers on her website.

A newspaper in New York just featured an article about Carrie and Madcapz, and you can read much more about them there.

Or pop over to the Madcapz website, and check out the wonderful selection of really cute caps!

And truth be told, we may have to adopt Carrie's adorable butterfly caps as our Official Thyroid Patient Hats!!

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Honestly, it's just mind-boggling. Almost six years ago, laboratory experts, and a committee of the nation's top endocrinologists both came out with recommendations to narrow the TSH reference range so that the high is 2.5 to 3.0, versus 5.0 to 5.5. Since then, we have had study after study linking subclinical/mild/borderline hypothyroidism to a host of health risks, including infertility, high cholesterol, and heart disease.

In the meantime, the TSH test range is still up for debate. Should we lower the TSH reference range as recommended, or shouldn't we? Everyone has their opinions, but what's the latest? Sadly, what we get is more evidence of confusion among endocrinologists, in the form of the article and accompanying editorial in the August 2008 issue of Clinical Thyroidology.

The article on "Lowering the thyrotropin reference limit to 2.5..." makes it clear that the mean and median TSH levels of the population without any thyroid dysfunction are under 2.0., and the percentage of the supposedly normal population who have a TSH level less than 2.5 is "only" 80%. Therefore, they reason, if the upper reference limit was lowered to 2.5, Read more...

Do you think the "normal" TSH reference range should be:

• The .3 to 3.0 that AACE and the laboratory experts recommended back in 2002! What are they waiting for already? OR
• Keep it at 0.5 to 5.0. They shouldn't accidentally treat anyone, even if that means they refuse to treat millions.

TAKE THE POLL NOW!

Read more...

If you're one of the many thyroid patients following a gluten-free or wheat-free diet, check out JoAnn Farb's cookbook, "Get Off Gluten." A number of terrific gluten-free recipes, including an especially tasty recipe for a low-carb whole grain bread. Find out more about the cookbook now at JoAnn's Get Off Gluten website.

Also, find out more about the celiac disease/gluten intolerance link to thyroid problems now:

The Celiac/Autoimmune Thyroid Connection

Gluten Intolerance

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Newsweek has a new article discussing problems some thyroid patients are having when they are entering U.S. border checkpoints from Mexico and Canada. After radioactive iodine treatment -- which is most commonly used to treat Graves' disease and thyroid cancer -- some of these patients are radioactive enough to set off the "radiation portal monitors" that are installed at the border checkpoints to detect people who are trying to smuggle nukes or "dirty bombs" into the U.S. Read the Newsweek article now.

Want to Know How to Avoid Problems At Border and Airport Security Checkpoints?

• Read Radioactive Treatments Can Trigger Airport and Border Security Alarms...Even Weeks After Treatment -- August 2006

More Information

• Thyroid Treatment Can Trigger Homeland Security Detectors -- November 2004
• Patients Given Medical Radioactive Materials May be Detained in Antiterrorist Security Sweeps -- December 2002

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I regularly receive emails from people who say "What about me? I don't have a thyroid! You're not writing anything for me!"

Actually, I DO write about people who have no thyroid all the time. People with no thyroid may not realize it, however, because they may never be told that without the gland, they're now "hypothyroid." Don't have a thyroid? Find out more about life without a thyroid gland.

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