Hypothyroid cycle

[North48]

Can hypothyroid cycle?  My Tsh lab test was 3.1 and the free T4 1.2 neg with TPO antibodies and the dr says they do not treat unless its over 5.0 and I'm not showing any signs of antibodies.  I have all the symptoms of hypothyroid and this has been going on for about 5 yrs but my tsh was always around 1.25 - 1.85.

[gimel]

My doctor isn't taking any new patients, so I've used these very questions when looking for a good thyroid doctor for a friend of mine. The response was interesting.  About half did a good job of trying to answer the questions.   One insisted that if I wanted these answers I had to make an appointment and come into the office.   Of those that answered , only one gave the right answers. So far, my friend is happy with the doctor.

It might take you some time, but will be far better in the long run.  Good luck and let us know how it goes.

[North48]

Thanks again for some outstanding info.  Those have been my thoughts of questions to ask but it really helps to have someone confirm my thoughts.  I generally would feel a little foolish of asking such questions but with you confirming my thoughts of what I have to do helps tremendously and having them written in front of me.

[gimel]

The very best way is through personal referral from a happy thyroid patient.  Lacking that you can inquire if any Forum members in your area can recommend a good thyroid doctor.  If you get no good referrals, then you will have to resort to basically interviewing doctors (through asking questions of their office staff) to decide if you want to hire the doctor.  Some of the questions that come to mind are as follows:  1. When you do thyroid testing, do yo check for free T3 and free T4 along with TSH?   2. What reference range do you use for TSH?  3. Do you take symptoms into consideration when making decisions on meds, or do you rely on lab tests only?  4. Which lab test do you rely on the most---free T3 or TSH?  5. Do you ever prescribe a thyroid med other than a T4 only type?  

If you get the wrong kind of answers to these questions, then you will be wasting your time and money going to that doctor.  By the way, you would expect Endos to be a better potential source for a good thyroid doc, due to their training and education,  but some of them specialize in other areas, so ask about that also.  

[North48]

Thanks for the response. Now I have another question and that is how do you find a good thyroid doctor?  How does anyone know whether they use the old reference range or are using current methods?  Do you call around to find out what ranges they use?

[gimel]

Even though the reference range for TSH was recommended to be changed from .5-5.0 to .3-3.0 over 5 years ago by the Amer. Assn. of Clinical Endocrinologists, many labs and doctors are still using the old range.  With your symptoms and a TSH over the current range, I would suggest that your doctor should also check your free T3 level and consider prescribing some thyroid med for you.  If that happens,  then I would want the doctor to determine med type and level by monitoring the free T3 and free T4 levels, rather than by TSH level.  If your doctor is not receptive to that, then you will need to find a good thyroid doctor.