Help me prep for my doctor appointment please!

Hey everyone! I need your help! I am starting to get very frustrated fighting for my health, I know I need to address some things about my lab work at my appointment with my functional doc tomorrow, but I am just going in circles this guy..... he seems to be wanting to sweep a lot under the rug. I tried getting him to CALL me to discuss this info 2 weeks ago, and after five phone calls, the nurse rudely told me he would discuss at my follow up appintment... he doesnt have time to make calls in between appointments. What is making me so angry is that the labs say "I will call her next week" - written by the doctor - and I NEVER got a phone call... I only got the labs because I was curious. I am ready to walk in there and read him the riot act, but I know i need to keep composed so that I can get the answers that I need.

Issue #1 Insulin Resistance & PCOs
My doctor ran a test from "True Health Diagnostics" - overall picture of health, in simplest form. I have it ran 3 different times over the last year, with insulin resistance popping up each time. The first two labs I had eaten breakfast before the blood draw, so my doctor brushed it off as "normal bc I ate".

a month ago, I retested - and purposed fasted because I wanted to know for sure - it showed up every more insulin resistant than the last time.

Results: Evidence of significant insulin resistance; evidence of adipose tissue insulin resistance; Decreased insulin

When I called my doctor about this, very concerned - the nurse said "He doesn't believe that you are dealing with insulin resistance because of your clean diet and no carbs/sugar". I have been paleo (eating minimal brown rice on occassion) for over a year, and was strictly limiting my fruit intake at that time, no honey or other sweetners etc... very strict with sugar.

Here are the results I think are most important that came to this conclusion
(* = high, Test name (range) result)

Glycemic Control
Glucose (70 - 99) 78mg / dL
HbA1c (< 5.6) 5.3%
Estimated Average Glucose (< 116.8) 105.4mg/dL
* Fructosmaine (< 302) 315umol/L
Glycation Gap (< 0.45) -1.82
* Postprandial Glucose Index (< 6.0) 8.7
Insulin Resistance
*Free Fatty Acid mmol/L (< 0.60) 1.16
* a-hydroxybutyrate ug/mL (< 4.5) 15.2
* Oleice Acid ug/mK (< 60) 93
* Linoleoyl-GPC ug/mL (> 13.0) 10.3
HOMA-IR (<2.6) 0.2


Can someone please help me figure out how to get my doctor investigate this further? I dont want him to sweep this under the rug, I have TOO many problems not being addressed, I need to reach balance, I cant be ignorning things!

What are some important questions I can ask, or points that I can make to realize that I might actually be dealing with IR after all (it seems to be a "lyme thing") this was not an LLMD who ran this, but is lyme friendly - I still have a lot of educating to do.. I was also diagnosed by my gyno with PCOs, and it also seems to have a connection with that. when I asked her about it, she shrugged her shoulders over the insulin resistance thing because I am UNDERweight not overweight... she thought it was crazy that I have PCOs bc of my weight as well, but it was confirmed clinically (no periods for 9.5 months) by labwork and by ultrasound (right ovary filled with "string of pearls" poly cysts).

Reverse T3 and Sex Hormone Binding Glob
Now that I have learned about my PCOs diagnosis, I have read there is a connection with SHBG and PCOS - but i am having a hard time uderstanding that these results mean. Not sure if I need to address or be concerned. I tried asking my gyno about these tests but she didnt want to talk me to since I hadnt had my follow up with the ordering doctor yet (frustrating!!!)

*reverse t3, serum (9.2-24.1) 29.2
*sex horm binding glob, serum (24.6-122.0) 163.9

Thanks in advance - I really dont want to go in there ANGRY because ultimately, the only one who loses in that scenario is ME. I need to make the most of these appointments - im actually busy prepping for an ND appointment on Friday, so I cant even THINK about this appointment, but I know its equally important. ANY words of wisdom, suggestions, questions to ask, support - appreciated!!! Thank you guys!!!

Hi Blueberrymuffin - I actually KNOW that this guy "knows his stuff" its just a matter of getting him to realize that this could potentially be an issue for me, aside from my diet.

I do have a "back up plan" if I get no where - I have another doctor up my sleeve that i plan on calling after this appointement - but i want to try to make the most of this appointment now - I am also have a doctors not from him allowing me to work from home 3/5 days a week, I dont want to compromise my current work scenario, i am not well enough to go in more than 2 days a week right now. I want to keep a good relationship with him - he is also addressing a lot of other issues of mine - so he is helpful is most aspects - its just that I have a bad taste in my mouth from how these labs were handled...

Hi PeteZa, I understand where you are coming from, and you are probably right - but I do need to make the most of my follow up appointment just to I can figure out WHO to see next... do I need to see an endocrinologist to help me figure out the insulin resistance stuff?

Thank you PeteZa - thats probably the perfect way to start the conversation! :) I will call my back-up doctor on thursday if I am unsatisfied with the appointment tomorrow.

Thanks for your reply JDB15! I appreciate your suggestion.

I actually wanted to ask my doctor if I should see an endocrinologist, especially with the PCOS findings - so I will ask if he can recommend one, but i'll do my own research as well and I will also ask around the local lyme community. its stressful to even think about adding "another one" to the mix, but I know I need someone in this specialty.

I wish my doctor would just tell me this is "outside of his realm" and just suggest these things to me, rather than trying to sweep under the rug & stressing me out!!

My gyno suggested either bc pills or Metformin - down the road, she wanted to see how my next few cycles are first.

Interesting -thanks for the information, JDB15 - I am in the USA, but from all I have learned about PCOS in the last month, I wasnt so trusting of my gyno when she mentioned metformin, which is a diabetes med, and then couldnt make sense of the insulin resistance... time to go find some better doctors!!! Thanks again!!