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Dr Eisenbud's Avatar
  • Answered by:Dr Eisenbud
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Customer Question

My daughter ( 31) have goiter and probably Hashimotos. We found out few months ago. She is loosing hair. She is trying to be on the gluten free, diar free and so on diet, but nothing left to eat almost. her TSH now is 1.8, but high antibodies ( around 300). TSH few months ago was around 4- 5. She has high Mercury. We need to find good endocrinologist - naturopath around Philadelphia, PA. Can you help?

 

Optional Information:
Person's Gender: Female
Person's Age: 31

Already Tried:
Lipogen, other supplements. Diet. No gluten, no diary. My daughter is 31.

Submitted: 310 days ago.
Category: Endocrinology
Value: $45
Status: CLOSED
Expert:  Dr Eisenbud replied 309 days and 23 hours ago.

We want to lower the TSH to 1.0 to prevent a patient with Hashimotos from developing a goiter. If she is on thyroid would increase the dose slightly, perhaps an extra 1/2 tablet once a week. If not on thyroid would start with 25 mcg of L-thyroxine.

Good endo in Philaareaa is Dan Rubin MD, #(NNN) NNN-NNNN Good luck.

Customer replied 309 days and 23 hours ago.

Thanks.

But she does not want thyroid medications.

She wants to try naturopath first. She already has goiter as I wrote.

ca you help with information about naturopath Endo?

Thanks.

Customer replied 309 days and 23 hours ago.

Thanks.

But she does not want thyroid medications.

She wants to try naturopath first. She already has goiter as I wrote.

can you help with information about naturopath Endo?

What about antibodies?

Thanks.

Expert:  Dr Eisenbud replied 309 days and 23 hours ago.

Stay away from naturopath doctors. She needs proper treatment by an endocrinologist to prevent her goiter from enlarging. The only way to do this is by using L-thyroxine. The antibodies are slowly destroying her thyroid and there is no treatment to reduce the antibodies.

Customer replied 309 days and 22 hours ago.

There are so many side affects...
She just married and want children.

Expert:  Dr Eisenbud replied 309 days and 11 hours ago.

In that case she should review the data on Hashimotos disease and pregnancy. If antibodies are high(TPO antibodies) then pregnancy risk is increased unless she is on thyroxine before concepcion and her TSH is in the lower range of normal. This is fairly new information but we are now screening all women preconcepcion for TPO antibodies and if positive starting them on thyroxine before conceiving. There are NO side effects if used properly and in a correct dose.

Customer replied 308 days and 3 hours ago.

1. People have tons of side effects to thyroxine.

2. Daniel Rubin, MD
"Specialty interests: diabetes" - this is not what we need.

Expert:  Dr Eisenbud replied 308 days and 2 hours ago.

If Dr Rubin will check with the Endocrine Society recommendations he will see that screening for elevated TPO antibodies and TSH should be a universal pre-concepcion requirement. Thyroxine will have NO side effects if the dose is correct as measured by a normal TSH.

Customer replied 308 days and 2 hours ago.

We never saw Dr.Rubin, this was your recommendation for us to go. I just wrote that his Specialty interests: diabetes" - not we need.
And she has normal TSH by her last blood test - 1.8.
I am not sure that we understand each other.

Expert:  Dr Eisenbud replied 308 days and 1 hours ago.

Sorry for the confusion. Here is a web site that will list all the qualified endocrinologists. Just chick on "find an endocrinologist": AACE.com.

 
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