Results are in... Help me prepare for dr's appointment tomorrow

[firstbaby]

Second update: So, my thyroid number came back normal (1.8) but my ferritin level was VERY low - I was a 4 and 11 is the bottom of normal. Also, the nurse said I'm very anemic so doctor wants to take iron 2x day for 6 weeks. A little nervous about taking so much iron and things *ahem* not moving. My prolactin levels came back normal which is what the doctor thought was the problem so not sure if he wants me to take the rx to "normalize" my cycles. Waiting to hear back. Thanks for the advice about finding a PCP. Am going to work on that next week. This was the first time I've needed someone fluent / checked in on women's health issues beyond I think I have strep, I'm having a baby, etc....

ETA - I have to laugh because when I asked him to check ferritin, he said "Do you know what ferritin is? Because if yours was low, you would want to run 5 miles but you wouldn't be able to run 1." Well, I've been doing 25-30+ miles a week with a long run of at least 10 miles. I kind of want a Superwoman shirt right now :)

Update: The doctor was pretty...dismissive. He said it sounded like I am heading "towards" menopause and while it could take several years, he ordered blood work to check my progesterone levels and wants me to start a prescription (I forget what it's called - something progesterone related) on a specific day after my cycle starts for 10 days and do this for 3 months to "reset / normalize" my cycles. I pushed him to check my thyroid and ferritin levels as well (my mom had her thyroid removed), but he didn't feel it is my thyroid because I'm not cold adverse right now(?!). So, if you were feeling this way and your blood work came back in "normal ranges" where would you go next? Endocrinologist? Someone else? Or would you just chalk it up to how we age? I'm 41 and run about 25+ miles a week, so I feel like I'm in decent shape. Just don't feel great.


I've been feeling really off lately and my cycles have been all over the place, so I made an appointment with my gyn for tomorrow. My symptoms are all over the board: tired, bloated, fevers / sweats at night, dizziness (especially right before my period starts), constant thirst, weird cycles and over the last year I've gained 8-10 pounds despite eating pretty clean. I had lost about 20 pounds 3 years ago by eating paleo/ doing my first Whole30. I started a whole30 two weeks ago to try to get some weight off and pretty quickly lost 5 pounds...and had 4 pounds come back on this week despite eating totally compliant. In fact, yesterday I ran 10 miles and walked 10 miles and was up a pound today! So, please help me prepare for my appointment tomorrow. I don't really have a "relationship" with this doctor other than I saw him regularly with my last pregnancy so it's the only doctor who I really have any relationship with. What questions should I be asking and tests should I push for? I think I remember reading that not all lab work to check your thyroid is created equal, so I want to be ready. Thanks in advance :)

[gcc2k]

I'm sorry you're going through that. I can't speak to the thyroid side of things, but as for peri menopause, have the dr check your FSH (follicle stimulating hormone) levels. High numbers indicate menopause. Also check your AMH (Anti-Mullerian hormone) level which basically reveals your ovarian reserve. A few months ago at 37 I was diagnosed with early menopause after experiencing some similar symptoms. My FSH was in the 80s and my AMH was 0.02. I was told I wouldn't be able to have more kids naturally.

[mackmama]

I had similar symptoms, and my GYN wanted to do a needle biopsy (I believe of the uterus) if the abnormal bleeding between periods continued. I'd also ask your doc about thyroid, perimenopause (check hormones), and to check your blood sugars (you will likely need to fast before bloodwork for that).

[firstbaby]

Thanks for the advice so far. :) Bumped with an update and another question!

[hobie]

I would find a new Dr for a second opinion, if not an endocrinologist.

[mackmama]

I wouldn't blow off your symptoms. Do you have a primary doc who might be more helpful re the next step?

[Kestrel]

If you have a blood-draw lab place by you, you CAN just go around the doc entirely. You will have to pay cash in advance, but you can get any blood work done that you can pay for. Just tell them you're paying cash, and not to bill insurance. You can have the results sent directly to you, or to you AND the doctor of your choice. I do it every year. (You do, however, need to know what test you want!)

[Green_Tea]

I think your doc was dumb to not check your thyroid, as you are already getting bloodwork done. It's an easy test and a standard one. Do you have a PCP you could go to?

Another option would be a naturopath. They can also have bloodwork done, and are frequently more willing to look at less obvious reasons for symptoms. My insurance covers bloodwork ordered by a naturopath, so perhaps yours does, too? Once you have the results in hand, you can decide what kind of healthcare provider is best suited to meet your needs.

[lauren3110]

I would push for the labs or see an endo. I have Hashimotos and my thyroid swings hypo to hyper frequently. My endo is great about treating based on symptoms and not just lab numbers. The ranges some docs use are way off. I feel best with my TSH around 1.5-2 once I hit closer to 3 I can barely function even though that is in the normal range. There are also many dietary things like soy that can mess with your thyroid too. I went a long time feeling awful bc my original pcp refused labs and I finally kept pushing and switched to a new PCP who discovered how off my thyroid was then sent me to endo.

[abh5e8]

Yes, if labs are OK, id go to PCP. Gyn doesn't treat thyroid issues, so may be why didn't check it.

[SnuggleBuggles]

I wouldn't have gone to gyn. Go to PCP or endo. Good luck!


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[firstbaby]

OP here. Sorry, I just reread my update and realized it was confusing. He did check my thyroid and ferritin levels after I pushed for him to check since he was already ordering a blood draw. Though he really dismissed my suspicion that it is thyroid based just on not being cold adverse. I went to him bc I don't have a PCP and he's the only doctor I've seen regularly over the last few years. When I was there in July, he told me to make an appointment if my cycles got closer than a certain number of days apart and they had, so I went to him. I will definitely follow up with an endo depending on how the labs come back. His office said I would hear from them by tomorrow.

[minnie-zb]

I would go to your primary care doctor. You are going to have a hard time getting into an endocrinologist if you don't have some sort of diagnosis or referral. I know when I was looking for an endocrinologist they wouldn't see me without a previous diagnosis and current bloodwork from my primary doctor.

[NCGrandma]

I would go to your primary care doctor. You are going to have a hard time getting into an endocrinologist if you don't have some sort of diagnosis or referral. I know when I was looking for an endocrinologist they wouldn't see me without a previous diagnosis and current bloodwork from my primary doctor.

Since it sounds like OP doesn't currently have a primary care doctor, maybe this situation can be a nudge to find one. I know that many women go to their ob/gyns for a variety of medical problems, but they will often get better treatment from a primary care doc as well as coordination of care with specialists.


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[JBaxter]

My primary doc checks my thyroid yearly at my appt. I'd find a primary.

[firstbaby]

bumped with lab results in OP. Thanks for all the advice!

[KpbS]

Glad you are getting some answers!! I too had tremendously low ferritin levels earlier this year. I took iron supplements and did not have things slow down. Quite the opposite to my surprise! So, I had to back of taking a purely iron supplement and just took a prenatal. It has worked well.

And that doc deserves a big fat I told you so for doubting you and you most definitely deserve a superwoman shirt for all of the running!! Wow!

[chlobo]

I've heard taking iron with something like OJ helps increase absorption.

[trales]

I take my iron with vitamin C to help with adsorption. I also take iron bisgylcinate, which does not have the same constipations issues as when I was taking 65mg of iron sulfate 3x a day (I got plugged then). I have been taking that for 4 years with vitamin C and have maintained a really nice iron level with minimal to no constipation issues.