I just got home from the most frustrating doctor appointment ever. This is mostly a rant about what happened, but I would really appreciate the paleosphere's opinion about how to handle my next appointment with the next doctor, since I'm clearly not going back to this one.

I made the doctor appointment because I wanted to request some specific lab work. I'm sad to say that I've gained a good 20 pounds in the last 4 months that seems to be almost entirely belly fat. To top it off, the ol' libido is barely there anymore and I'm constantly tired and sluggish. My symptoms (along with suspiciously thinning outer eyebrows) make me suspect a thyroid problem. I don't know how much genetics plays into thyroid disfunction, but my Dad, brother and paternal grandmother all had/have thyroid issues. I explained all this to the doctor, but from the start, he dismissed my suspicions, and instead chalked my lack of energy up to the fact that I've been putting in some late nights at the office lately. It's true that I have worked a 50-or-so hour work week for about a month now, but the tiredness and other problem started long before that. He also stated that my BMI (~25) is "perfectly healthy," nevermind the fact that it was 22 just a few months ago.

Then the appointment took a truly bizarre turn. He asked me why, at 33 and married, I hadn't had any kids yet. I explained that my husband and I have chosen not to have children. My husband had a vasectomy a few years ago, (with my blessing) and besides, I have a wonderful 17-year-old step son who is awesome. I'm comfortable with our decision; kids are just not for us. He then suggested that I might be DEPRESSED about not having kids. (um no...) He insisted that having a baby is the "most important decision that a woman can make" and he urged me to have a heart-to-heart chat with my husband about it to make good and sure that I am totally okay with the decision (I'm not an idiot - we talked extensively about it before we got married and again before DH had the vasectomy). He reminded me that I only had a few low-risk years left to have kids. I get the impression that he thought I'd been bullied into childlessness by DH and was in denial of my true feelings - and the resulting depression was causing my lethargy. Oi.

Moving on. I finally convinced him to order a thyroid panel and was specific about the tests I wanted: TSH, Free T3, Free T4, Reverse T3 and Thyroid antibody. I also asked for serum vitamin D levels and a complete hormone panel, as I've been wondering if my testosterone and estrogen levels could be out of whack. He left the office, and a nurse returned with lab paperwork ordering a TSH test and "metabolism panel." I asked her to take it back to him and have him add the rest of the tests we talked about. She returned and said that he insisted that TSH was the only test I needed. D levels are unrelated to my complaints and the fact that I have a regular, monthly menstrual cycle proves beyond a shadow of a doubt that there's nothing wrong with my hormones. I demanded to talk to him again in person, but no matter what I said, I couldn't change his mind; the rest was unnecessary and he would not order unnecessary tests. Not happy, but I went ahead and had the blood drawn. Question: Will the TSH test tell me anything about the condition of my thyroid, or do I really need to find a doc to order the rest of the tests?

A little background on my lifestyle: For three years now, I've eaten extremely clean paleo, on the lowish carb side. Lots of homemade bone broth soups with meat and non-starchy veggies, eggs, WAPF-style fermented veggies and BBQ (hubs is a BBQ'ing maniac - he's almost always grilling/smoking/BBQing a dead animal of some kind in the backyard, lol.) On weekdays, I almost always have a leafy salad with some leftover meat and artichoke hearts for lunch. I still eat nuts, (pistachios and macadamias mostly) but plan to cut back on them to see if it helps at all. I ate nuts before the weight gain though, so not sure if it will do any good. Very little dairy - a small amount of hard cheese maybe once a week. Until a couple of months ago, I ate quite low carb - meat, good fats and non-starchy veggies only. I finally added a small potato/sweet potato with most evening meals after I noticed my energy level bottoming out, and it helped a little, but I'm still pretty drained and definitely not feeling like myself. The addition of the potatoes only brought me up to maybe 75g of carb a day, max. I'm scared to add any more at this point, since I keep gaining weight, despite keeping my total calories around 1,200/day. I just don't understand how I could possibly gain on 1,200 calories, but here I am with only two pairs of "fat pants" that fit me right now. Sigh.

I've completed Dr. K's leptin reset, and while hunger is rarely a problem anymore, I think I even gained weight during the reset. (Not saying the reset specifically caused weight gain, but I definitely didn't lose anything.) I also IF from time to time, (usually lunch) as my appetite allows.

Most days I supplement with D-3, fermented CLO/BO, vitamin C, zinc, biotin, CoQ10, ALA/Acetyl L-Carnitine, magnesium and Lugol's iodine. I try to eat a couple of brazil nuts most days for selenium.

I can't claim to have done much exercise in recent months - I used to lift weights at home (Fred Hahn/Slow Burn style) a couple times a week, but I gave that up when I started feeling so lousy. As of a couple of weeks ago, I joined a gym and have started walking (briskly ~3.5 mph) on a treadmill for 30-40 minutes everyday after work. It's really all I can manage right now, but it feels good to be doing something again.

For those of you who are still reading, I apologize for the long, boring novel! I just didn't want to leave out any important details. Does anyone have any words of wisdom for me? I'm so darn frustrated right now, and these CW doctors are NOT helping.