by THOMAS on Mar 14, 2015 • 1:56 pm
How many of you folks have had this experience with your doctor? You make an appointment with your primary care physician because you are feeling “out of sorts” and are concerned that something might be wrong. So you go to the clinic and they perform all of the usual stuff, you know vitals (pulse, blood pressure, look in your eyes, ears, nose, throat etc.) and then you explain to the nurse that you have been feeling a little tired and sluggish lately. You go on to mention that your appetite has not been the same and you have been feeling cold all the time. So then the doctor comes in and he takes a look at your chart and says hmmm. So he decides to do some blood work which includes all the basics, you know CBC, UA, cholesterol, thyroid etc. You are instructed to come back in a few days for a follow up office visit. So you go to your follow up appointment and the doctor comes and tells you that your blood test results came back negative and there appears to be nothing wrong with you. But you question the doctor and ask, “then how come I feel so lousy and tired all the time and I’m always cold? “The doctor then replies, “Well you are probably just run down and you need to get some rest”. You then say to the doctor, “but I am sleeping fine but even when I wake up I am still tired after a full nights rest”. The doctor replies,” well you might be suffering from a little depression so I’m going to suggest a low dose of an antidepressant.” So he writes you a prescription and sends you on your way with a recommended follow up in a couple of weeks.
Does this sound familiar to any of you out there? I have actually had several patients relate this very same experience to me. They left the clinic thinking to themselves, “You know I don’t feel depressed, I am just tired and cold.” And luckily they decided to either not fill the prescription or did not take the recommended medications. This business of dismissing patients concerns upon the basis of an apparently negative blood test is not only disconcerting but just down right lazy on the part of the physician. But this is what can happen when you fail to recognize a subclinical presentation. There are two (2) possible explanations for a patient who presents with feeling tired all the time, feeling cold, weight gain, decreased libido, and poor memory and that would be either an adrenal or thyroid problem. The only way you would really know is to do a complete and thorough clinical workup of this patient. But western medicine has moved away from the traditional clinical model in favor of more testing. That is why I have continued to stress to my patients the importance of evaluating clinical signs and symptoms and not relying on the test as testing misses a lot of stuff. I currently have both a thyroid assessment tool and an adrenal assessment tool on my website and both can be downloaded and printed. This way the patient can see for themselves by comparing signs and symptoms of each and can bring their results to the clinic for further evaluation. Another experience of mine has been the finding that many of my patients who have been diagnosed with thyroid problems actually have an adrenal problem as the underlying cause. The reason for this is that if the cortisol and DHEA levels are low, thyroid hormone activity is diminished. In other words, sufficient cortisol and DHEA levels are necessary for the activation of thyroid hormones. Yes, the endocrine system works in strange and mysterious ways but it makes perfect sense when evaluate clinical findings as opposed to relying too much on testing alone.