Thyroid Disorders Community
Need help finding a new dr
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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Need help finding a new dr

Help- I was diagnosed with hypothyroidism in Feb 2011 and have never felt well esp dizzy and horrible brain fog.  I have seen an endo and 3 different internists who all have only tested TSH.   I just returned from appointment with gp who will only test TSH and refuses any other thyroid tests.  My TSH is 2.7 -She adamantly speaks at me that this is normal and she will not even run another test till next year.  I showed her copies of info stating proper testing and healthy levels to which she yelled,"Stop on the internet, I am the dr and I know how to treat hypothyroidism. No dr will say anything different that I say."  She was horribly rude today and  said I need Lexapro for all my anxiety. I am not the least bit anxious, I just want to feel as well as I did before my hypo diagnosis.   I checked into having labs done on my own but  not possible in NJ.  Does anyone have a dr in Northern NJ?  Thanks so much.                                                                                                                                                                                                                                      
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34 Comments Post a Comment
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798555_tn?1292791151
Print this and show her.

Hello Dr, I am one of those people that, thanks to the internet and other forms of media, now fully understands why I felt ill for so many years while at the bottom of the TSH range. Its because TSH is a signal, not an actual cell consumable hormone. Any doctor that does not understand this, clearly does not know how to aquatically treat or detect hypothyroidism. I and others are proof. And, by the way, which breakfast cereal did you find your medical degree in? Fruit loops?

Guess that wont work.

Try to talk to some Drs nurses on the phone to see how they test before investing your time and $.

Go top the pharmacy. Ask for any Drs names that prescribe Natural Thyroid or Cytomel. Thats totally legal. Any Doc that prescribes T3 meds will be testing T3, and most likely T4 also.
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649848_tn?1357751184
Along with what Moose said, you can go to a website called healthcheckusa and order the tests for about $85.  They send you a lab order and tell you which lab (national chain) to go to; within a couple days after getting the blood drawn, they e-mail you the results, which you can then wave in your doctor's face. .

By the way, should you wish to print this thread and take/send it to your doctor, I'm another one whose research on the internet got me well, when my doctor was keeping me sick, because of an attitude just like hers.  My TSH is lower than low and they kept trying to take away my medication.

Your doctor clearly does not understand the treatment of thyroid issues.  All she knows is what she learned in med school.  She needs to do some reading and catch up on current research....... Additionally, any doctor who yells at a patient for using the internet to further their understanding of a condition, either has WAY too big an ego or is so unsure of themselves, they don't want anyone to find out how little they know. Either way, you need to find another asap.

If you decide to order the tests online, get the option that tests TSH, Free T3 and Free T4, to start with.  You might later need to get the antibody tests, but hopefully, by then, you will be able to find a doctor who actually understands thyroid treatment.
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Avatar_f_tn
Thanks so much for your responses. I was shocked at the way the dr spoke to me yesterday. She was so condescending when I showed her info I found, when researching on internet that I am sure I just need to find a new dr.  She obviously doesnt understand thyroid issues and refuses to work with me to get me well.                                                                                                                  I checked online for the labs and they cannot in NJ by law. I will try to call some pharmacies to see what they say. I am so frustrated that drs seem to think  they know all and will not listen when a patient still feel symptoms .                                                                                                          
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929504_tn?1332589534
Seems as if you may want to switch GP's as well. If you do not feel comfortable with any doc, it's your right to change. The patient shouldn't feel like they are in the wrong for caring about their health. I fully understand what you are going through. Hang in there.
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Avatar_f_tn
Thanks for the support. I am having the hardest time finding a thyroid savvy dr. I have seen an endo and 3 gps who only use TSH.  I had info with me stating the importance of testing T3 and T4 but she refuses to do any other testing. She told me that she is not allowed to because insurance companies dont allow it and will not reimburse her.  As i continue to ask more questions,she becomes more angry and says I have anxiety and need Lexapro. I am truly a very calm person and thankfully have never experienced anxiety. I try to explain all I want is to feel well again, not dizzy or brain fogged. I have to find a new gp who will test properly and treat symptoms.  Wish me luck.
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Avatar_m_tn
I think you need to tell your Dr for HER to take the anxiety medicine. SHE is the one who has their underwear all in a bunch & is flustered.

You have called her out on her ignorance and instead of being humble and having an attitude to learn, she instead got condescending.  

Whether or not the insurance company will reimburse her makes no matter.  If insurance doesn't pay and the Dr informs you of that fact and you want the tests anyway and are willing to pay for them then there is ABSOLUTELY NOTHING stopping her from ordering the tests and billing you.

When I started studying this because of my wife's condition.  I realized that I have had many of the symptoms all my life.  But when I first asked the Dr to be tested. it was like pulling teeth. He said that I had "Medical student disease".  That is where medical students as they read and study they believe that have the illness that they are studying. When it is all in their mind.

Well my cold hands and feet while in a 70+ room isn't some freaking mind trick.  My constipation, joint aches, ear ringing, higher cholesterol, heart PVC's all must be freaking mind tricks too.  What an idiot.  He did test my TSH only and of course it came back right in the middle of the range at like 1.2 so he wrote me off as a mental case hypochondriac.

So I wrote him off!  Changed Dr's.  I FINALLY was able to get an FT4 test after begging and pleading with the new Dr.  Well guess what.  TSH 1.58 and FT4 barely in the low end of the range.  No way Dr would even consider running FT3.  And with both "within range" the Dr. would not prescribe even a starter dose of thyroid meds.

Switching Dr's again!

Isn't this fun?
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798555_tn?1292791151
By saying "insurance companies" she is grouping them all together. Like none will pay for it? Give me a break, shes wrong,wrong,wrong, with an additude problem.

I sometimes wonder, once you do find a good one, what happens if you decide to move? Start all over? Were all in that boat.
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Avatar_f_tn
Oh I agree- She says " insurance companies" wont pay- when every test I have ever had has been paid with no question. She tried to act like she wouldnt be paid. Honestly at that point, I just said that I just want to feel well and need more testing other than TSH. She says TSH 2.7 is perfectly in range,  will not increase Synthroid dose, and no other dr will treat me differently.  I am so frustrated like so many other thyroid patients.
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Avatar_m_tn
You need to keep trying to find a Dr.

Suggestion was good about going to pharmacy and asking the names of Dr's who prescribe T3 medication or natural Dissected Thyroid (Armour or Nature Thyroid).  At least that can narrow the field of potential good Thyroid Doc's.

While TSH of 2.7 may be within range.  Many Dr's who even do use TSH alone will attempt to keep TSH between 1 and 2 or about middle of the range.  

You need to find a new Dr.  it is just that simple.  If you give up you'll just remain feeling as poor as you feel now.  I know it is a pain in the rear. But you have little other alternatives other than to remain feeling poorly.
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Avatar_f_tn
I know the only way for me to get well is to find a new dr.  It is just difficult to imagine trying a find a good one when I have gone to a few who have been less than caring.   I have asked around for a good thyroid dr in Northern NJ and so far no one knows of one.   If I find one, I will become a hero to many friends who are still not feeling well as they suffer with hypothyroidism.  Wish me luck.
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798555_tn?1292791151
Like I mentioned earlier -

Try to talk to some Drs nurses on the phone to see how they test before investing your time and $.

Go to the pharmacy. Ask for any Drs names that prescribe Natural Thyroid (Armour) or Cytomel (synthetic T3). Thats totally legal. Any Doc that prescribes T3 meds will be testing T3, and most likely T4 also.

These are proven methods to find a good thyroid Dr. , worked for me and others. I got really tired of wasting money booking appointments with new Dr's that were clueless.

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Avatar_f_tn
I took everyones advice and called around to a few local pharmacies.  I was told that Armour and Cytomel are not prescribed much or at all as they are inconsistent.  I asked them for all for any names of drs who do prescribe them and none could give me any help.   I also have started calling drs to ask what tests they do and I have received quite a few rude replies from receptionists who state I must make an appointment and the dr will decide what test to run.  Is this always this hard?
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798555_tn?1292791151
"Armour and Cytomel are not prescribed much or at all as they are inconsistent"

- Even pharmacists can be cluless. Whoever told you that probably dosent even know what a T3 med is. Pathetic. Many cant function with out it. Walgreens, perhaps in the next bigger city near you will have had Armour or cytomel in stock at some point.

Rude nurses usualy means rude doctors. Look further. You need a Dr with an open mind. Rude people are never open minded.
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Avatar_m_tn
in answer to your question: "Is this always this hard? "

Yes.  Unfortunately it seems to be more the rule than the exception.  Some people are lucky and have of find a good Dr pretty quickly.  Most others find it a seemingly never ending gauntlet.

Keep the faith. You're doing the right thing for yourself!

I agree with lazymoose.
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Avatar_f_tn
Hi everyone- Took your advice and saw a new GP. She came highly recommended by a fellow thyroid patient.  I just received these lab results    Thyroxine 7.7  (4.8-13.9)     T3 UPTAKE 34  (30-39)        Thyroxine Index 2.61  (1.4-4.50)     TSH 2.31  (0.34-4.82)   T3  0.85  (0.70-1.90)    I am currently on  Synthyroid 112 mcg.  Can I get  some assistance with evaluating these labs?   Thank You so much .                                            
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Avatar_m_tn
Before responding about your lab test results, are you having any hypo type symptoms?
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Avatar_f_tn
The lingering symptoms  I have are brain fog and dizziness at times.  But none of the four drs I have seen feel this is from hypo. But they give me no reason otherwise for it.
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Avatar_m_tn
Regarding your tests, the T3 uptake, and Thyroxine Index are outdated and not used very much now.  Also, the Total T3 test is not nearly as valuable as would have been a Free T3 test.  You also needed to get a Free T4 test.  

As for symptoms, those can definitely be related to still being hypo.  I am surprised that you don't have other symptoms as well.  Perhaps you have become so accustomed to having some symptoms that you don't recognize them as hypo related.
  
At any rate, the very limited test data that you have that is useful, indicates that you likely would find that your Free T3 is too low in the range, similar to your Total T3 test.  Many members, myself included, report that symptom relief for them required that Free T3 was adjusted into the upper part of the range and Free T4 adjusted to around the middle of its range.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Test results are valuable mainly during diagnosis and then to monitor Free T3 and Free T4 as meds are revised toward relieving symptoms.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

In the letter please note this statement.  "the ultimate criterion for dose adjustment must always be the clinical response of the patient. I have prescribed natural dessicated thyroid for your patient (Armour, Nature-Throid) because it contains both T4 and T3 (40mcg and 9mcg respectively per 60mg). This assures sufficient T3 levels and thyroid effects in the body. Since NDT has more T3 than the human thyroid gland produces, the well-
replaced patient’s FT4 will be below the middle of its range, and the FT3 will be high “normal” or slightly high before the next AM dose."

So the first thing I think you need to do is to request testing for Free T3 and Free T4.  If the doctor resists, then you should insist on it and don't take no for an answer.  I also suggest that you give him a copy of the above letter and ask if he is willing to treat you clinically as described in the letter.  If he is not, then you are going to have to find a good thyroid doctor that will do so.

If able to get the tests done, then post results and their reference ranges shown on the lab report and members will be glad to help interpret and advise further.
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Avatar_f_tn
Thanks for all your info.  I am so frustrated at this point.  I had been seeing an endo and a GP who only did TSH. I had printed the info you have posted and both refused to even look at it.  So I moved on and saw this new GP who I had been told was a thyroid savvy dr and worked so well on patient symptoms.  I saw her today and she told me that she ordered all the proper tests and the results are fine and refuses to make any medication change.  What do I do next? Honestly I have not felt well in a year and have spent hundreds of dollars trying.  
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Avatar_m_tn
What part of NJ are you in?  
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Avatar_f_tn
Northern NJ
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Avatar_n_tn
I believe there are Drs who do phone consulting. A friend of mine works with a  Dr out of Santa Cruz and is very happy.The Dr ordered  all the tests  consulted and prescribed all over the phone. They check in annually.
You still need to get your frees done.
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Avatar_f_tn
I cant believe I have seen 4 drs in the past year and not one has done the proper testing.  I have spent hundreds of dollars trying to get well and I am so frustrated that drs continue to tell me that my thyroid is fine and they see nothing wrong with me.  I truly dont know what to do next.
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Avatar_m_tn
Would a doctor in Clifton be close enough to interest you? If not, then please give me a town that I can use as a base.
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Avatar_f_tn
Clifton is close but I am willing to drive a distance. I will give you Wayne or Hackensack as bases.  Thank You so much for all your help.
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Avatar_m_tn
Sending by PM the best prospect that I can find from the Top Thyroid doctors list in NJ.
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Avatar_f_tn
Thanks for all your help. I will call for appointment tomorrow.  All I can hope is that he is as good as the patient reviewers say. I find it incredulous that I have asked four different drs for Free T3 and T4 and not one is willing to do it . I always hear that it is unnecessary and refuse to order.     Why are Free T3 and T4 not standard tests for drs to order and then be able to properly titrate dosage?  I am so frustrated with my medical care as I am constantly told these symptoms are not from your thyroid.
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168348_tn?1379360675
I'm going to send you a PM ...

C~
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Avatar_m_tn
I am in Northern NJ as well. I feel so helpless! I have been diagnosed with Hashimotos and been to two endos. The first one said I wasn't "bad enough" to be prescribed anything. The second refuses to prescribe anything but synthroid. She keeps upping it by 25 every 6 months, but nothing changes. I read this thread from a year ago and I am hoping that you can also share the name of the doctor who prescribes T3 meds. I can't go through another year like this. Thank you so much in advance! I hope you are still out there somewhere and can direct me to the right place. Thank you in advance!!
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Avatar_m_tn
I have two doctors for your consideration.  One was recommended by a fellow member and is located in Little Falls.  The second came from the Top Thyroid Doctors list for NJ, and is located in Clifton.  Would you be interested in either or both?  If so, I'll send a PM with links.  
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Avatar_m_tn
i am in NNJ too and cannot find a dr. who will help.  
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Avatar_m_tn
Sending PM with info.  To access, just click on your name and go to your home page.  Then click on messages.
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Avatar_m_tn
Can someone send me the name of the doctor in Clifton?
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Avatar_m_tn
Sent Pm with info.  Just click on my name and that takes you to your home page.  Then click on messages.
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