working-with-an-integrative-doctorAbout three weeks ago, I felt the best I had felt in a long time, finding myself with enough energy to make it to workout class or yoga six times that week. I had been on a gradual upswing of energy during the day for a few months, and I was hopeful that this latest boost of motivation was a sign of the tides turning. What followed after that very physical week though was a crash in energy which I’m still trying to rebound from. And this is pretty much the story of my life lately, up and down, day in and day out. I always work to keep things in perspective, and so I know things could definitely be worse, but I’m just so tired of feeling fine one day, and terrible the next.

While an in-depth post updating you on my health may not be the sexiest of subjects to cover and may in fact be a snooze fest for some, I do hope that this update is helpful. I know so many of the women I hear from via email, online and on Instagram can relate to what I’ve been going through, and even if you’re in tip-top shape, perhaps some of this information may help you help someone you care about. Having just come back from a follow-up appointment with my integrative doctor/naturopath, I wanted to give you a brief run-down of what’s going on, and encourage you to seek out help if your story feels eerily similar to mine.

An update on Hashimoto’s
The last you heard from me about my Hashimoto’s diagnosis, I was basically told by my endocrinologist we’d have to take the “wait and see” approach, which is not atypical for many diagnosed with Hashimoto’s. The nature of the disease is that the immune system attacks the thyroid gland, causing the thyroid gland to go into overdrive, resulting in a hyperactive thyroid state, until it eventually burns out and then it becomes hypoactive. My TSH levels were in fact indicating I was in hyperactive mode, but they were not so bad that they required medication. Because of this state of limbo, my endocrinologist very strongly felt that there was nothing we could do besides wait until my thyroid was damaged enough, to really send my levels out of whack. Besides, my symptoms were more in line with hypoactive thyroid; fatigue, brain fog, sadness and other states of moodiness. Medicating me I agreed, did not seem like the right thing to do, but to do absolutely nothing felt really wrong as well. This feeling of unease is what prompted me to seek out an integrative doctor. By the way, during this time my doctor also ordered me to have a thyroid scan, which is basically a high power X-ray, to confirm what exactly my thyroid was doing, since blood work indicated hyperactive, but my symptoms indicated hypoactive. This procedure cost me $1400 after billed through insurance and I’m now on a 1 year payment plan with the hospital to pay off this test I had no idea was so damn expensive. I almost threw up when I got that bill and I tell you all this because when we get into the costs of the integrative doctor below, I wanted you to have a clear picture of the costs involved in both types of treatment; conventional medicine and the more holistic approach.

Meeting with an Integrative Doctor
On December 16th of last year, I met with local integrative doctor Dr. Kelly McCann, referred to me by Sarah. I never got around to writing about my first experience with her, but very briefly I can tell you it was very positive. To join her practice I had to pay a $350 fee. Because she is a MD, office visits are billed through insurance, but she unfortunately has an additional office visit fee of $70-$85, so I pay for my usual copay and her office visit fee. This at first feels outrageous and ludicrous, but I soon came to find out what I was paying for. Before my appointment, her staff had done the legwork of tracking down all of my latest lab results, and had contacted each doctor I had recently visited (hematologist, endocrinologist, and ENT) to get my charts. She had reviewed my entire history on paper before I even stepped foot into her office, and had also reviewed my extensive 45 page enrollment packet. She pretty much already knew what was going on with me before I even stepped foot in her office, so that our 1 hour visit could be all about getting to work on a treatment plan. After that first visit, she put me on a basic protocol to support thyroid function and help boost my immune system after all of my recurrent strep infections in the last year. She also ordered more tests, some were covered by insurance and some were not. Because I was trying to be cost-effective, I spread out the tests over the last 2 months, and waited until all test results were in before I went in for my follow-up visit. They will review test results over the phone with you, but because they don’t just tell you your results and send you on your way, but rather go over a treatment protocol, there is a fee for such phone calls. Hence, my reason for just waiting for a single visit. By the way, she wholeheartedly felt it was best to maintain a gluten free diet, something it is believed most individuals with any autoimmune disease, but especially Hashimoto’s, should do. I have my slips here and there, but for the most part I’d say I’m eating gluten free about 70% of the time.

Current symptoms
Honestly, the last few months, since about November, I’ve noticed a huge improvement in my energy during the day, which I’m so grateful for. I am still crashing by 6 pm though, and most nights I’m in bed by 8:30, fast asleep by 9. On nights I don’t get to bed early, I pay for it the next day in a very big way. My brain fog comes and goes, some weeks I feel on top of my game, but days like the ones I had last week, where I completely forgot 2 very important events, show that I can still be quite flakey. Sleep has improved since getting my new mattress, but I still find myself 2-3 nights a week, wide awake and up for the day at 4 am. My motivation is nowhere near what it used to be, and I’m forcing myself to say no more and more, but I get little spurts here and there, usually when I have a toddler screaming at me and can’t do much about my streaks of creativity. Bottom line, life is not terrible and my health is overall, very good. I’m just not the same person I used to be, and at 38, I’d like to do what I can to make the most of the many good years I still have left in me.

Tests & follow up
Based on my symptoms, the doctor ordered further blood work, tests that were tailored to my needs so not really worth getting into, and she also ordered a saliva and urine neuroscience test from Pharmasan Labs. Most of the blood work was covered by insurance, but the neuroscience test was not and cost $279. The neuroscience test is used for reading the levels of all our neurotransmitters including serotonin, GABA, glycine, glutamate, histamine, PEA, dopamine, dorepinephrine and epinephrine and I had to submit 2 separate urine samples and 4 saliva samples, all taken at key times throughout the day. I had to fast for 12 hours before the test began, and could not eat, drink or chew on anything for 1 hour before each sample was taken. I recorded the times on a sheet provided, and stored the samples in vials provided by the lab, then immediately shipped them off to the lab the next day. I believe anyone can take this test, however I do think you need a doctor to sign the lab slip. Visit their website for more information.

Key areas of concern were low serotonin and epinephrine levels, and high norepinephrine levels. Clinical correlations for these high and low levels would likely result in difficulty sleeping, fatigue, anxiousness, low mood, difficulty paying attention , focusing and thinking clearly, and lack of motivation. My adrenal hormone levels were also tested, and found that they were very low in the morning, when they are supposed to be high, likely causing me to feel very groggy and slow to wake and be alert in the morning, and began rising just a bit at night, when they were supposed to be dropping, most likely contributing to those 2-4 am wakings. From this list you’d think I’d be a mess, but I feel I manage fairly well. Of course some days I have a portion of these symptoms, but I usually don’t feel all these symptoms at once.

The key takeaway here is that these test results aren’t necessarily linked to the Hashimoto’s, so just about any of you reading this could be suffering from these symptoms as a result of these disruptions. This is a big reason why I wanted to write all this out, to let you know that the symptoms you may pass off as mom fatigue and mom brain, may be a sign of something else going on. These tests and appointments are a burdensome expense and time consuming, so I don’t want to encourage you to get a whole battery of unneeded tests done, but if you’ve been feeling more than off for an extended period of time, and your life allows, please seek help.

I’m not one to look for problems and I promise you I’m not a hypochondriac, in fact I hate going to the doctors and prior to all this rarely found a need to visit a doctor other than for my annual well woman exam. But after my day to day quality of life being impacted for more than a year, I desperately wanted to get to the heart of this problem. I hope we’ve now found the root cause. Oh! And another thing they discovered is that I still have strep in my system! So another course of antibiotics and follow up tests to hopefully wipe it out this time.

I also wanted to tell you this whole long story so you can see the purpose of integrative doctors. They are programmed to think outside the medical box and look a bit deeper. For months my endocrinologist was telling me over and over that my symptoms don’t match my TSH levels and basic Hashimoto’s symptoms, and never delved further. Now that I’ve had these other tests completed, my chronic fatigue and brain fog was more likely a result of my neurotransmitter levels being out of whack and the beginning of adrenal fatigue. It all makes a lot more sense now. Had I not gone and seen this Integrative Doc, I’d likely still be banging my head against the wall wondering why my symptoms were not matching the textbook.

Treatment Protocol
So now begins the process of taking lots of supplements, for what will hopefully be a rather short period of time, to help my body get back on track. Here’s the breakdown of the protocol:
Week 1:
Calm PRT: 3 capsules before bedtime to help lower my cortisol levels.
Travacor: 1 capsule 30 minutes before bedtime to help build up the serotonin levels.
Week 2:
Continue with Calm PRT and Travacor, and add the following.
Focus DL : 1-2 capsules before breakfast and 1-2 capsules before lunch to help with brain fog and mental clarity.
A-Drenal: 2 capsules before breakfast and 2 capsules before lunch to help build up the adrenal glands and support adrenal hormones.
Other treatment, both temporary and permanent:
Vitamin D 5000 IU : 1 capsule daily
Continue with daily selenium to support thyroid function.
Amoxicillin 10 day course to rid body of strep antibodies, and Lauricidin Monolaurin for 1 month to serve as an antimicrobial to help further rid the body of strep.
Probiotics and magnesium are on hold for the time being because they’re both messing with my bowel movements too much, causing me to get extremely constipated. I’m also going to stop taking my LLV pack from doTerra because I just can’t take anymore pills!

It’s a lot and I feel like a crazy person for going down this road, but I’m willing to try anything at this point to restore as much of the old me as possible. If you ask friends and family members who know me well, especially Art, they’d tell you I’m usually a go-getter who can thrive off of huge workloads and 6 hours of sleep. While this last year of extreme slowing down has been good for me in so many ways, forcing me to say “no” more and rid my life of extreme busyness, I’d like to at least return to the days where I could go out on a date with my husband and not feel like falling asleep during dinner. It would also be nice to not want to rip my hair out during bath time or being so tired by the end of the day I feel physically ill.

And to be honest, I also vacillate between feeling proud of myself for being my own advocate and seeking answers and treatment, and other times I feel like a giant jerk for taking all these tests and ordering expensive fancy supplements. This is all so different from how I was raised, in a world of affordable in-network Kaiser healthcare, and a good dose of “suck it up.” My parents just about fell over when I told them I had just spent close to $200 on supplements. By the way, don’t buy your supplements direct from your doctor, find them online instead, where you’ll save yourself at least 20%.

So that’s where I’m at right now. I’m going to order all my supplements on Amazon today and begin taking my antibiotics today as well. The naturopath is hopeful that I’ll only have to be on this complete regimen for 3 months, and after that we’ll scale it back to the basics. I’ll certainly keep you all posted, but in the meantime, please let me know if I can answer any questions. Thanks as always for your support and virtual high fives. You guys are awesome.

  • Pat Schwab

    Best wishes for better health.

  • Pat Schwab

    Hope all this helps improve your over all health.

  • Kristy

    Wow. This is really interesting. Thank you for posting your full experience. It is definitely worth passing on to people I feel have had some issues that they are having a hard time resolving. Good luck with your new regimen and please keep us updated. Thanks.

  • Carol

    This is very interesting to read about, but not so great to be going through! Wishing you a speedy recovery.

  • Wow. This is incredibly interesting. Many of these symptoms describe me to a T and I cannot figure out why I feel that way, since I eat healthy 85-90% of the time and I work out regularily!
    I hope this works for you. Being drained of energy is just about as bad as being in pain. 🙁

  • KateB

    Very interesting, Andrea. Hope it all works…especially getting the strep out of your system. That is bizarre that it’s still hanging around!

  • Joyce

    Thank you so much for this information! All the best to you and your family.

  • Andrea Howe

    Thanks so much everyone, for all the well wishes. 1 week into the protocol and I’m sleeping better already, which is a huge plus. I start the Focus DL tomorrow, and hoping it helps my foggy brain, as I feel like I’m slowly losing my mind 😉

    • Joyce

      Hi Andrea,
      I was wondering how you have been feeling now that you have been taking these supplements? Thanks and I hope you are well.
      All the best,
      Joyce

  • I feel for you. My daughter was diagnosed with Hasimotos and Graves’ disease 1 week after she graduated from UC Santa Cruz. Her heart rate was 170.
    She worked with an endrocrinoligist for a year , but in the end had to have radiation on the thyroid.
    She’s in a good place now , but of course will be on levothyroxine for the rest of her life.
    Sometimes life throws things at you that are physically so difficult. It’s a tough road to walk.
    It sounds like your covering all bases, and I hope it gets better soon.

  • thyroid geek

    Could you please clarify on thyroid x-ray??
    I am aware of thyroid ultrasound or I-123 uptake scan.
    if your blood was positive for TPO antibodies, uptake scan was the waste of money plus radiation exposure to thyroid, breast and ovaries:(
    An ultrasound with power Doppler is more useful and a least dangerous!!
    Regards, OT
    Long Beach, CA