June 13, 2012

Endo appointment and my Iron

I've known my endo since I was a kid.  I've known her Nurse Practitioner almost as long.  Although they haven't always agreed with my decisions (such as no flu shots while pregnant - or ever, for that matter), they respect my decision.

On Friday I had an appointment with my endo's NP for a diabetes recheck.  I hadn't been since December.  I had been so nervous about telling them I was taking an alternative route with my thyroid, that I just cancelled my March appointment.

I talked with my thyroid MD about it and he seemed to have no problems with me telling them I'm working with him.  (I had been paranoid about that, since he's always going on tiraids about the other doctors in town hating what he does.)  He even went as far as to say that he thinks my endo and her staff are a little curious, if not sympathetic, toward what he does.

The NP has always been very personable with patients.  She and I chatted like old friends.  We talked about my diabetes and she asked about my miscarriage and how I've been since then.  I said I wondered if it might not be good to check my iron since I lost so much blood.  She said sure and started adding the labs into the system. 

While she was adding the labs, I said that I wanted to let her and my endo know that since January I've been using some alternative methods with my thyroid, that I'm on NDT, and I'm working with a doctor . . . so I wouldn't be needing any thyroid labs drawn that day.

She was very stony-faced, tight lipped and said, "I'll take those labs out of the system then." She did it, said, "Okay," and very quickly changed the subject. 

It was one of the most uncomfortable few seconds of my entire life! 

I'm relieved not to have been yelled at or given a lecture.  But we'll see what happens when I meet with me endo for my 3 three month follow-up in September.  She might give me an earful about it, but I can also see her ignoring it.

Interestingly, they did draw thyroid labs.  (I almost always check with the lab tech to see what's being drawn, but I was so absorbed in thinking about the appointment that I forgot.)  My TSH was .687, FT4 .7 (I didn't even bother to ask about the ranges since I just had my own labs drawn last month). 

But my iron . . . well, ladies and gentlemen, can I just tell you I was shocked?  Serum was 53 (50-160) and % Saturation 13 (15-55). 

I want to get the full picture of things iron-wise, so I ordered my own iron panel and had it drawn this morning.  I got the whole panel because it was cheaper than just doing the TIBC and Ferritin.  Go figure.

Clearly I need some iron supplementation, but the full panel will tell me how much of a dose I can tolerate.   

I just keep kicking myself for thinking I was immune to low iron.  I think knowing that all our beef is grass-fed, plus eating spinach regularly made me think I'd be fine.

But it makes so much sense now regarding not bring able to tolerate raising my NDT.

Last March when my thyroid MD poopoo'ed the idea of testing my iron routinely, I should have just paid for the panel in the first place (it's only $54 bucks).  Then I wouldn't have wasted time and I'd feel even better than I do now.  If it had come back normal, I would have paid $54 for reassurance that my iron wasn't going to be a hindrance to me getting well.  It's a small price to pay.

Oh well.  Lesson learned.

Janie writes well about the whole iron scoop here.