New here-question

[susan400]

I am new to being diagnosed with hypothyroidism.. Here are my numbers:

TSH on 2/17/15  -       27.590
repeated test

TSH on 2/23/15 -        28.390
Free Thyroxine index - 0.81

My doctor's office told me, over the phone that I was hypothyroid and then, started me on Synthroid 50 mcg  

My concern is: should I have been examined first, like have my neck checked for any nodules, goiters, other abnormalities?  Should they have also run a T3? T7?    

I have not been putting on any weight.  I have been cold alot, anytime it's cold than 70 degrees, I feel 'freezing'.  And been feeling more sluggish.

I am on day 2 of the Synthroid.

Any advice?  All I know is to take it in AM before eating anything and wait for 1 hr until eating.  Other than that, I know nothing about it.

He said I will be coming into the lab in 4 wks for repeat TSH level.

Susan400

[goolarra]

Well, the nurse is probably just parroting what the doctor will say.  So, be prepared to stand your ground.  You might try telling him, "Even though you don't want that, 'I' want to see it."  As a last resort, remind him who is paying for the blood work.

Let me know how you make out.

[susan400]

Thanks so much.  I appreciate the information.  Knowledge is power they say.  I will insist of further testing.  Sometimes it's hard to deal with the nurse as the go between with the doctor.   I asked her before when I went in for my repeat TSH, if he had ordered the T3 and she said no, he did not want that.  However, I am supposed to be seeing Dr. anyway for my yearly physical appt. towards the end of March, so even if I can't make headway with the nurse, I can ask him directly then.  Susan400

[goolarra]

What's the reference range on your FT4?  Ranges vary lab to lab, so they have to come from your own lab report.  It looks quite low.

TSH is elevated, which helps confirm hypothyroidism.

You should have FT3 tested every time labs are drawn, and you should request it from here on.  Your neck can be examined and you can have an U/S to check for nodules and goiter after starting meds.  T7 is considered an obsolete test.

You should also have antibodies tested to see if you have Hashi's. Hashi's is an autoimmune disease and the most prevalent cause of hypo in the developed world.  TPOab (thyroid peroxidase antoibodies) and TGab (thyroglobulin antibodies) are the two markers for Hashi's.  Both must be tested since some of us are positive for one, some the other and some both.

So, while TSH and FT4 are by no means exhaustive testing, I think they're enough for a clear diagnosis of hypo and for starting meds.  Further testing can happen later, regardless of whether you are on meds or not.  You're scheduled for follow up in four weeks, which is perfect.  Oops, I just noticed he said "a repeat TSH level".  Be sure he tests FT3, FT4 and TSH and tell him you want the antibody tests as well.  Don't let him try to treat you on TSH alone.