Endocrinologist Phuket? Bkk? Usa?

[MisterMan]

I am in the states now and just had some blood work done.

The results were:

Thyroid TSH low 0.06 normal .40

Prolactin 95.5 normal 3.9

I have been advised to so an Endocrinologist.

I have been to Thai gyno before ( I am female) and they never found any thing wrong in my blood work, obviously they did not test the same things as the doctor here in the states. Not surprising.

So I have some Thai insurance from work .. but think this my constitute as a previous condition? So that means I am paying out of pocket. As I work in Thailand and am not on an expat package this is also an issue.

And what does this imply? I Looked it up and it said benign tumors on the pituitary is the cause of high prolactin. F*king great!

I saw Sheryl's recommendation for Dr Rosannee in BKK. Thank you and another post about some uk site for info.

Would like some feedback as this is the first time I am not flying home through BKK.

Is there a competent Endocrinologist in Phuket?

Does anyone have any idea what these levels would signify?

The other hormone test were normal.

[lopburi3]

Thyroid TSH low 0.06 normal .40

I can only go by my results and Google but that does not appear to be a correct range for TSH test. It varies a bit by equipment but my listed normal range is 0.27-4.20 and US standard current seems to be 0.3-3.0 (was 0.4-6.0 prior to 2003 per Google).

[lopburi3]

Prolactin 95.5 normal 3.9

NIH has that range as 2-29 ng/ml as normal non pregnant and 10-209 ng/ml as normal for pregancy.

It also lists Hypothyroidism as a likely cause for high results if not pregnant so if your TSH is really low it would seem that may be the first thing checked. But I am not a medical person (but just had Thyroid removed so some recent experience).

[Sheryl]

TSH is not low in primary hypothyroidism, quite the opposite. However, there are pituitary conditions which can cause a low TSH and, as a result, secondary hypothytroidism. In other words the low TSH could reflect either primary hyperthyroidism or a pituitary disorder.

Prolactinemia can likewise be primary or secondary (secondary = due to something else0). Secondary causes include a number of drugs and medications, so a full history of all drug use (prescribed or otherwise) is essential).Primary causes can include pitituary tumors. Depending on size these may be treated with medication or surgery.

Neither a Thai nor a US gyno would routinely test for TSH and prolactin, only f indicated by symptomatic complaints.

Without knowing more about the symptomotology I can't say much as to whether it would likely to be considered a pre-existing complaint. In any case the first step is to determine what, exactly, the problem is.

You need to see an expert endocrinologist. The only place in Thailand you will find one of the caliber required is in Bangkok. Bumrungrad offers the best range of expertise in endocrinology.

While Dr. Rossanee is excellent you might do well to see someone more specialized in pituitary disorders. These two doctors are both US trained and Professors at leading medical schools. this has an added advantage in that should it be necessary for you to have surgery and should insurance not cover, they might be able to perform it at a government hospital. (Surgery is by no means a given, though. May turn out not to be a pituitary tumor, or may turn out to be small enough to be manageable with medication).

Dr. Sarat Sunthornyothin

Specialty: Medicine - Medicine, Endocrinology (Diabetes, Thyroid, Hormone, Nutrition)

Language Spoken: Spoken: English, Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine (First class honor), Chulalongkorn University, Thailand, 1990

Board Certifications:

- Diplomate of The American Board of Internal Medicine, 1996

- Diplomate of The American Board of Endocrinology, Diabetes & Metabolism, 1999

- Diploma of The Thai Board of Internal Medicine, 2000

- Diploma of The Thai Board of Endocrinology & Metabolism, 2000

Fellowships:

- Endocrinology, Baylor College of Medicine, The University of Texas, USA, 1996-1999

Academic Rank: Assistant Professor, Chulalongkorn University, Thailand

Special Clinical Interests:

- Endocrine Neoplasia, Lipid Metabolism, Osteoporosis and Hypertension

Day Time Location

Wed 17:00 - 20:00 NS 16A (Endocrine/Neuro)

Fri 17:00 - 20:00 NS 16A (Endocrine/Neuro)

Sat 09:00 - 12:00 NS 16A (Endocrine/Neuro)

Dr. Sathit Vannasaeng

Specialty: Medicine - Medicine, Endocrinology (Diabetes, Thyroid, Hormone, Nutrition)

Language Spoken: Spoken: English, Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine (Honors), Siriraj Hospital, Mahidol University, Thailand, 1969

Board Certifications:

- Diploma of The Thai Board of Internal Medicine, 1973

- Diploma of The Thai Board of Endocrinology and Metabolism, 1994

Fellowships:

- Endocrinology and Metabolism, USA, 1996-1977

- General Internal Medicine and Clinical Epidemiology, 1981

Academic Rank: Professor, Siriraj Hospital, Mahidol University, Thailand

Special Clinical Interests:

- Diabetes Mellitus, Thyroid Disease and Pituitary Disease

Day Time Location

Tue 17:00 - 20:00 NS 16A (Endocrine/Neuro)

Fri 17:30 - 19:30 NS 16A (Endocrine/Neuro)

[MisterMan]

Thank you very much Sheryl.

[Seeall]

I have been to Thai gyno before ( I am female) and they never found any thing wrong in my blood work, obviously they did not test the same things as the doctor here in the states. Not surprising.

 

Hi all, has anyone else found the testing in Phuket is lacking?

 

Thanks

[Sheryl]

A routine gyn check will not include thyroid panel or other blood work...in Thailand or anywhete else.

[Saltire]

On 7/9/2011 at 1:19 PM, Sheryl said:

TSH is not low in primary hypothyroidism, quite the opposite. However, there are pituitary conditions which can cause a low TSH and, as a result, secondary hypothytroidism. In other words the low TSH could reflect either primary hyperthyroidism or a pituitary disorder.

Prolactinemia can likewise be primary or secondary (secondary = due to something else0). Secondary causes include a number of drugs and medications, so a full history of all drug use (prescribed or otherwise) is essential).Primary causes can include pitituary tumors. Depending on size these may be treated with medication or surgery.

Neither a Thai nor a US gyno would routinely test for TSH and prolactin, only f indicated by symptomatic complaints.

Without knowing more about the symptomotology I can't say much as to whether it would likely to be considered a pre-existing complaint. In any case the first step is to determine what, exactly, the problem is.

You need to see an expert endocrinologist. The only place in Thailand you will find one of the caliber required is in Bangkok. Bumrungrad offers the best range of expertise in endocrinology.

While Dr. Rossanee is excellent you might do well to see someone more specialized in pituitary disorders. These two doctors are both US trained and Professors at leading medical schools. this has an added advantage in that should it be necessary for you to have surgery and should insurance not cover, they might be able to perform it at a government hospital. (Surgery is by no means a given, though. May turn out not to be a pituitary tumor, or may turn out to be small enough to be manageable with medication).

Dr. Sarat Sunthornyothin

Specialty: Medicine - Medicine, Endocrinology (Diabetes, Thyroid, Hormone, Nutrition)

Language Spoken: Spoken: English, Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine (First class honor), Chulalongkorn University, Thailand, 1990

Board Certifications:

- Diplomate of The American Board of Internal Medicine, 1996

- Diplomate of The American Board of Endocrinology, Diabetes & Metabolism, 1999

- Diploma of The Thai Board of Internal Medicine, 2000

- Diploma of The Thai Board of Endocrinology & Metabolism, 2000

Fellowships:

- Endocrinology, Baylor College of Medicine, The University of Texas, USA, 1996-1999

Academic Rank: Assistant Professor, Chulalongkorn University, Thailand

Special Clinical Interests:

- Endocrine Neoplasia, Lipid Metabolism, Osteoporosis and Hypertension

Day Time Location

Wed 17:00 - 20:00 NS 16A (Endocrine/Neuro)

Fri 17:00 - 20:00 NS 16A (Endocrine/Neuro)

Sat 09:00 - 12:00 NS 16A (Endocrine/Neuro)

Dr. Sathit Vannasaeng

Specialty: Medicine - Medicine, Endocrinology (Diabetes, Thyroid, Hormone, Nutrition)

Language Spoken: Spoken: English, Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine (Honors), Siriraj Hospital, Mahidol University, Thailand, 1969

Board Certifications:

- Diploma of The Thai Board of Internal Medicine, 1973

- Diploma of The Thai Board of Endocrinology and Metabolism, 1994

Fellowships:

- Endocrinology and Metabolism, USA, 1996-1977

- General Internal Medicine and Clinical Epidemiology, 1981

Academic Rank: Professor, Siriraj Hospital, Mahidol University, Thailand

Special Clinical Interests:

- Diabetes Mellitus, Thyroid Disease and Pituitary Disease

Day Time Location

Tue 17:00 - 20:00 NS 16A (Endocrine/Neuro)

Fri 17:30 - 19:30 NS 16A (Endocrine/Neuro)

Thanks great information and good timing for me at the moment.

 

Would you recommend these doctors for Type 2 (Male) diabetes issues including neuropathy?