Dr Appointment and new labs - 12 month check.

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Dr Appointment and new labs - 12 month check.


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Old 06-06-2014, 22:16   #1
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Default Dr Appointment and new labs - 12 month check.

I had my 12 month check up/yearly exam/intro to Medicare appointment yesterday. It was a very peculiar appointment.

First the results:

---------- 6/4/13 ------- 6/3/14
fasting ---- 93 ------- not done??? (I was fasting)
A1c ------ 4.4% ------- 4.7%
est avg bg - 73 ------- 83

Cholesterol - 231 ------- 242
Trigs ------- 120 -------- 160
HDL --------- 68 --------- 89
LDL calc --- 139 --------- 121
Ketones ----- 2+ --------- 3+ Nice fasting ketones!!

I was a little surprised to see the higher lipid numbers (except for HDL). The lab sheet says the high HDL removes one risk factor from the total count. Whatever that exactly means. The dr didn't say boo about my lipids other than HDL was great. Personally I am fine with all the numbers.

My TSH was a little high again, in 2013 it was 8.790 this time it was 6.200. The range is 0.4-5.00 uIU/mL. So I am going to do TSH and A1c every 6 months now just to watch the TSH. I don't mind as that way I can watch my A1c closer.

He said I could stop the Met completely, but I am going to taper down instead and just take 500mg a day for a month and see how that goes before dropping it altogether. Then he said a really ignorant thing, he said as far as he was concerned my diabetes was healed and I wasn't diabetic any more. Whaaaa??? I replied "only as long as I continue to eat the way I do". Earlier as part of the Medicare questionnaire he asked did I follow a Diabetic Diet? I said "no, lc/hf ketogenic. If I followed the Diabetic diet I'd be on insulin by now!" He really doesn't want to acknowledge my success is from lc/hf/k, he just can't for some reason.

We also discussed tapering down my Wellbutrin, take it every other day for a month and if things are still good, drop it altogether. He won't budge on my bp meds even though my bp is in good range (except at the dr's).

He probably spent the most time with me this visit than ever before, the Medicare questions took a lot of the time. But he really overlooked the physical exam part of the appt almost totally. He listened to my heart and felt my abdomen (with my clothes on) tested the feeling in my feet, that was all. (I asked him to do that as I have some numbness in the bottom of my feet when sitting. We agreed it was most likely from my low back issues, but it was nice to test anyway. I could feel everything.)

Then he had me put a short top on to do the biopsy on my ear. That was it! For as much time as it took, I felt a bit cheated.

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Old 06-06-2014, 22:27   #2
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Congrats. The numbers look very good, especially the A1c & the HDL. The only number that I might want to flag would be the TG. But, the lipid numbers fluctuate a lot in a day and it is best to look for a range rather than specific numbers.

Doctors putting their foot in their mouth ? Ah, aren't we all pretty used to that ?

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Old 06-06-2014, 23:29   #3
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Your TSH is too high! That can explain your higher cholesterol levels. Your doctor and lab are not up to date on ranges. The new range is between 1 and 3 instead of 1 and 5.9.

I am new, but google TSH and cholesterol and you will find plenty data backing up my claim even from the American Thyroid Association and we all know that most associations are super conservative.

I maintain a TSH of 1 to feel great.

Congrats on the low A1c!

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Old 06-06-2014, 23:46   #4
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Quote:
Originally Posted by cyclinglady View Post
Your TSH is too high! That can explain your higher cholesterol levels. Your doctor and lab are not up to date on ranges. The new range is between 1 and 3 instead of 1 and 5.9.

Congrats on the low A1c!

Thanks cyclinglady. He didn't seem alarmed about the TSH number, but he did order another test in 6 months. I'll look into it more though. Thanks for pointing that out. I think the ranges vary from lab to lab but usually are somewhat close.

Last year when I was high, he retested and got T4, total 8.8 with range 4.8-13.9, and TSH 1.94 range 0.34 -4.82. Apparently the first reading of 8.9 was an error, maybe this one is too. Maybe I should ask for a retest.

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Old 06-07-2014, 00:17   #5
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You should not wait for six months. The doctor should retest you in six weeks to monitor an increase in your thyroid meds which should have been given. You should continue to get retested until your TSH is stable and you feel great.

Why should he be alarmed? You will not die. You will just feel awful, slowly causing damage (thyroid regulates so many things) and by the time the damage is done, he probably won't be your doctor anymore.

Nice to focus on your blood sugar and avoid complications, but your doc should be concerned about your thyroid too.

Your triglycerides have increased despite your LCHF diet and is related to being hypothyroid and is putting you at greater risk for heart disease.

Just my two cents......

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Old 06-07-2014, 07:30   #6
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Thanks for your concern cyclinglady. I feel better now than I have in years, more energy, better moods, sleeping better, and add in the weight loss, I'm actually a pretty happy camper at this point in my life. I will do some research this weekend and talk to my dr next week about a retest sooner than 6 months.

It is puzzling to me how one test can show TSH of 8.79 and another the next day show 1.94. Makes me wonder if this year's 6.2 would come back much lower if retested. I just don't know.


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Old 06-07-2014, 08:08   #7
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It is weird! I am concerned about the triglycerides. From my research and recent personal (and not very scientific), experiment on my husband (he went on the LCHF diet too) triglycerides should go down (his did). LDL did increase, but we do not know he particle size and higher levels can mean more fat being released from fat cells into the blood stream. And he is losing weight.

I should get off my soapbox. It is just that my own thyroid went wacky swinging from high to low for two years and it caused so much damage. Thank goodness it is now stable.

Glad you are feeling better!

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Old 06-07-2014, 20:19   #8
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Good numbers grammaB.

I'm wary of when any association lowers its range for anything. You want to believe it's because they have discovered something new and that it is for health improvement, but how do you really know? Looking through my 1985 vitamin bible, high BP was quoted as anything above 140/90 and normal was 120/75. Now anything over 125/75 is hypertensive and they try to feed you meds.

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Old 06-07-2014, 21:19   #9
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I have the 2011 edition of The Vitamin Bible and it says: "According to revised new guidelines, only blood pressure of less than 120 over 80 is considered normal for adults." sigh.... yep, more pills!

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Old 06-07-2014, 23:00   #10
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I believe you will find that a systolic of 120 as a maximum value is not even close unless you are super young - double check this with Google, but I think values for anyone 50 years old and up of under 147, and 60 years old and up of under 150 are considered OK, and mine has been 134 (I am 53) and everyone in the doc's office was happy!


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