Guest guest Posted December 7, 2008 Report Share Posted December 7, 2008 I've been treating a client who has Hashimoto's. Her symptoms have dramatically improved: she's no longer cold, has lost some weight, her energy level is good now, her edema is gone, she's sleeping well now, her digestion is much better, and her emotions have stabilized, among other improvements. The pulses and tongue have changed quite a bit too, and are much better as well. She just had a thyroid panel run, and to our surpise, her MD is telling her that she needs to increase her medication, because her TSH has gone up. She is having the thyroid panel run again, just in case there was an error with the first one, but I was wondering if anyone might shed any light on why the TSH might have gone up, assuming that the 2nd test gives the same result. Aside from pregnancy, which has now been ruled out, what might have caused the TSH to rise? Jeri Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 7, 2008 Report Share Posted December 7, 2008 Hi Jeri: Functional Changes: Detectable by CM but generally undetectable by WM - early stage disharmony. Organic changes: Detectable by WM and generally stubborn due to long-standing trajectory. It is important to remember that bloodwork can be very precise and useful, but that it has reference ranges for a reason. People behave in atypical fashion all the time (but less often, obviously, than they would fall within reference ranges).. In my experience, people behave even more atypically while under treatment - I've observed that bloodwork does not show, or inconsistently shows, a relationship to the person's demonstrable signs and symptoms *until they are nearly cured*. In other words, healing first occurs *within the realm of the illness*, meaning that functional results are achieved while the person still has (for e.g.) lupus. Then, functional results must be maintained over the long-term, allowing the body to not only function well within its constraints, but to organically rebuild itself and therefore show large changes in the blodwork that are reflective of the person's own sense of well-being. Many WM clinicians readily admit that bloodwork is not as reliable or objective as they would like it to be. I personally keep an eye on these types of results, work as closely as I can with the WM professional, and try to not get hoodwinked by the awe of numbers on a piece of paper. Hope that helps, Hugo ________________________________ Hugo Ramiro http://middlemedicine.wordpress.com http://www.chinesemedicaltherapies.org ________________________________ kurvenal <kurvenal Chinese Medicine Sunday, 7 December, 2008 14:33:44 Any comments on this case? I've been treating a client who has Hashimoto's. Her symptoms have dramatically improved: she's no longer cold, has lost some weight, her energy level is good now, her edema is gone, she's sleeping well now, her digestion is much better, and her emotions have stabilized, among other improvements. The pulses and tongue have changed quite a bit too, and are much better as well. She just had a thyroid panel run, and to our surpise, her MD is telling her that she needs to increase her medication, because her TSH has gone up. She is having the thyroid panel run again, just in case there was an error with the first one, but I was wondering if anyone might shed any light on why the TSH might have gone up, assuming that the 2nd test gives the same result. Aside from pregnancy, which has now been ruled out, what might have caused the TSH to rise? Jeri Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2008 Report Share Posted December 8, 2008 Chinese Medicine , " kurvenal " <kurvenal wrote: > > I've been treating a client who has Hashimoto's. Her symptoms have > dramatically improved: she's no longer cold, has lost some weight, her > energy level is good now, her edema is gone, she's sleeping well now, her > digestion is much better, and her emotions have stabilized, among other > improvements. The pulses and tongue have changed quite a bit too, and are > much better as well. > > She just had a thyroid panel run, and to our surpise, her MD is telling her > that she needs to increase her medication, because her TSH has gone up. She > is having the thyroid panel run again, just in case there was an error with > the first one, but I was wondering if anyone might shed any light on why the > TSH might have gone up, assuming that the 2nd test gives the same result. > > Aside from pregnancy, which has now been ruled out, what might have > caused the TSH to rise? > > Jeri > And long ago, before blood testing for such things existed, an MD would have readily accepted that the patient had improved, and that increases in, or tweaking with a successful treatment would be unwarranted, or just plain silly. Your case says a lot about the science and art of observation, of skilful diagnosis, and skilful management; all evident in your account. As for the TSH 'blip', it's my understanding that WSM changes the kinds of testing it offers for thyroid conditions every couple of decades or so... there does not appear to be a congruent, consisitent set of parameters, or a definitive test. For instance, the current 'standard' of establishing TSH levels [from the pituitary, not the thyroid itself] seeks to 'measure' thyroid function based on the output of the pituitary. I still don't get that! If - as is evident in this lady - TCM has enabled physiological thyroid function, it makes sense that a newly invigorated and harmonised thyroid would be signalling for more TSH from the pituitary. I'm not sure why an MD can't / don't /won't? see it that way, if his/her points of reference are the patient's obvious improvement, and not just a couple of blood tests. For my money, I's love to hear how you helped this lady! Margi Macdonald www.luminahealth.com.au Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2008 Report Share Posted December 8, 2008 On Sun, Dec 7, 2008 at 11:33 AM, kurvenal <kurvenal wrote: > I've been treating a client who has Hashimoto's. [...POST TRIMMED...] > Aside from pregnancy, which has now been ruled out, what might have > caused the TSH to rise? > > Jeri > > It is not uncommon for a patient w/ Hashimoto's to have a TSH value that fluctuates throughout the course of the disease depending on the autoimmune activity at the time the test was taken. Is her MD an endocrinologist? Or a general practitioner? I would think an endo would be very familiar with that...although it is not unusual for an MD to change-up the dose of meds in response since they don't treat the autoimmune component of the disease anyway. Typically they'll just keep adjusting the meds until the thyroid is completely destroyed such that these fluctuations won't be such an issue... What we can do to help a patient like this is to address the autoimmune component of the disease to help support the patient so that the hormone fluctuations (i.e., the attacks on the thyroid tissue) calm down. Check where the thyroid antibody levels are in relation to the TSH levels to tell you what's really going on. J ________ Joy Keller, LAc, Dipl.OM Board Certified in Acupuncture & Oriental Medicine Ramona Acupuncture & Integrative Medicine Clinic Phone: (760) 654-1040 Fax: (760) 654-4019 www.RamonaAcupuncture.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 8, 2008 Report Share Posted December 8, 2008 Hi Joy and everybody: Joy: Typically they'll just keep adjusting the meds until the thyroid is completely destroyed such that these fluctuations won't be such an issue... That's a good strategy. I mean, a good stragedy. Hugo ________________________________ Hugo Ramiro http://middlemedicine.wordpress.com http://www.chinesemedicaltherapies.org ________________________________ Joy Keller <JKellerLAc Chinese Medicine Monday, 8 December, 2008 17:15:35 Re: Any comments on this case? On Sun, Dec 7, 2008 at 11:33 AM, kurvenal <kurvenal (AT) ameritech (DOT) net> wrote: > I've been treating a client who has Hashimoto's. [...POST TRIMMED...] > Aside from pregnancy, which has now been ruled out, what might have > caused the TSH to rise? > > Jeri > > It is not uncommon for a patient w/ Hashimoto's to have a TSH value that fluctuates throughout the course of the disease depending on the autoimmune activity at the time the test was taken. Is her MD an endocrinologist? Or a general practitioner? I would think an endo would be very familiar with that...although it is not unusual for an MD to change-up the dose of meds in response since they don't treat the autoimmune component of the disease anyway. Typically they'll just keep adjusting the meds until the thyroid is completely destroyed such that these fluctuations won't be such an issue... What we can do to help a patient like this is to address the autoimmune component of the disease to help support the patient so that the hormone fluctuations (i.e., the attacks on the thyroid tissue) calm down. Check where the thyroid antibody levels are in relation to the TSH levels to tell you what's really going on. J ____________ _________ _________ _________ ___ Joy Keller, LAc, Dipl.OM Board Certified in Acupuncture & Oriental Medicine Ramona Acupuncture & Integrative Medicine Clinic Phone: (760) 654-1040 Fax: (760) 654-4019 www.RamonaAcupunctu re.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2008 Report Share Posted December 9, 2008 How I treat Hashimoto`s: 1st use TCM diagnosis and treatment> herbal, acupuncture, and/or biotherapeutic drainage medicine, 2nd need to Suppress TSH with natural T4/T3: 4:1 ratio or T3 alone and Thyroid 4ch, monitor levels of Free T4 and Free T3 that they are in the range of high normal, this will stop the antibodies attacking the thyroid until you find the cause > gluten > HM > dysbiosis >leaky gut. 3rd Know cortisol status > salvia test, but be aware results may appear normal due to insufficient liver function not clearing cortisol, 4th determine blood sugar regulation by random glucose fasting and 6 hr home glucose tolerance test > if a problem will not be able to dose with adequate Thyroid Med T4/T3 or T3 > due to misinterpret signs of Thyrotoxicosis; heart rate above 100, anxiety and insomnia. 5th they need to exercise. 6th nutritional supplements > B complexes etc. Ross - Hugo Ramiro Chinese Medicine Monday, December 08, 2008 2:56 PM Re: Any comments on this case? Hi Joy and everybody: Joy: Typically they'll just keep adjusting the meds until the thyroid is completely destroyed such that these fluctuations won't be such an issue... That's a good strategy. I mean, a good stragedy. Hugo ________________________________ Hugo Ramiro http://middlemedicine.wordpress.com http://www.chinesemedicaltherapies.org ________________________________ Joy Keller <JKellerLAc Chinese Medicine Monday, 8 December, 2008 17:15:35 Re: Any comments on this case? On Sun, Dec 7, 2008 at 11:33 AM, kurvenal <kurvenal (AT) ameritech (DOT) net> wrote: > I've been treating a client who has Hashimoto's. [...POST TRIMMED...] > Aside from pregnancy, which has now been ruled out, what might have > caused the TSH to rise? > > Jeri > > It is not uncommon for a patient w/ Hashimoto's to have a TSH value that fluctuates throughout the course of the disease depending on the autoimmune activity at the time the test was taken. Is her MD an endocrinologist? Or a general practitioner? I would think an endo would be very familiar with that...although it is not unusual for an MD to change-up the dose of meds in response since they don't treat the autoimmune component of the disease anyway. Typically they'll just keep adjusting the meds until the thyroid is completely destroyed such that these fluctuations won't be such an issue... What we can do to help a patient like this is to address the autoimmune component of the disease to help support the patient so that the hormone fluctuations (i.e., the attacks on the thyroid tissue) calm down. Check where the thyroid antibody levels are in relation to the TSH levels to tell you what's really going on. J ____________ _________ _________ _________ ___ Joy Keller, LAc, Dipl.OM Board Certified in Acupuncture & Oriental Medicine Ramona Acupuncture & Integrative Medicine Clinic Phone: (760) 654-1040 Fax: (760) 654-4019 www.RamonaAcupunctu re.com Quote Link to comment Share on other sites More sharing options...
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