61 Y/O female was referred by her worried primary care physician.She had seen a doctor in Beverly Hills, who wanted to treat her with a cocktail of Human Growth hormone, DHEA, bioidentical estrogen, and thyroid hormone T4. He asked her to see me before starting the thyroid hormone. She has all the classic symptoms of hair loss, low body temp., fatigue, constipation, dry skin, and depression. The physical exam was normal. The thyroid was not enlarged, no nodules were felt. To complete the exam, a thyroid ultrasound was done to be 100% sure the thyroid was normal structurally. It was normal in size and sound wave texture. The thyroid tests were also normal, including TSH of 1.8 normal 0.4-4.0. The doctor in B.H. told her the symptoms were due to thyroid deficiency, even though the thyroid blood testing has always been normal, including 2 years ago when another alternative physician in Santa Monica gave her thyroid hormone for 6 monhs without an improvement in her similar symptoms. She told me the BH physician adds thyroid to all his patient's hormone "cocktails", even if all thyroid tests are normal. To help her to decide not to go back to that doctor, I even did an ultrasound to prove that she had a lovely normal thyroid that worked perfectly well.Taking thyroid hormone would not help, but could hurt her in the long run.Bone loss, and heart problems were a real possibility in her age group.
Remember, symptoms are non-specific, and must be confirmed by thyroid hormone blood studies.
Dr.G
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