Second Opinion . . .

[km05]

Is it common for an endo to be negative on treating with T-3 (cytomel) in addition to T-4?  
Is it common for endos to refuse to get free T-3 and free T-4 results with blood work (only concentrating on TSH)?
Also, has anyone ever heard that once a hypo patient is stabilized on a correct dose, the dose should remain basically the same with little fluctuation in TSH thereafter?
Last question - and the strangest - If a person were to receive a misdiagnosis of hashis through a saliva test, and was given thyroid replacement with a functioning thyroid, what result might you see in that persons thyroid function?
Any help would be appreciated . . .trying to decide on seeking a second opinion.
Thanks

[km05]

When I was first diagnosed four years ago, I was diagnosed via a saliva test at a Naturopath's office.  I don't know if anyone here is familiar with saliva testing  . . . ?  I wish that I had known enough to question it more at the time but I didn't.  I did not have a blood test before beginning meds.

The saliva test said my TSH was within "normal" range at 63 (ref. range 26-85 nlU/ml).  My free T-3 was within "normal" range at 0.46 (0.28-1.10 pg/ml).  I tested positive for antibodies (Thyroid Micrososomal Ab, SIgA) and my free T-4 was low at <0.1 (Normal: 0.17- 0.42 ng/dl).  

I was put on a low dose of Thyrolar (25 or 30mcg, I think) initially and my first blood test 1 month afterward came back with a TSH of 2.75.  Free T-4 at 6.4 and free T-3 at a low 80.  I was introduced to cytomel at this point.

The question now has been introduced by a new endo, "was I misdiagnosed in the first place?"This is of course driving me crazy since I have been on this medication roller-coaster for four years now.  
I know at the time, every symptom I had fit hypothyrodism.  I felt horrible.  Medication immediately improved me.

My question is . . . . would a functioning thyroid (and I mean one functioning at an optimal level) placed on medication still produce results within normal range after 1 month?  Does a functioning thyroid that is just given medication "go to sleep" and allow the meds to take over?

It was always my understanding that if your thyroid were "normal" and you were given replacement, it would push you hyper.  With hypothyrodism, I was always under the impression that numbers fluctuate because your thyroid is still producing some hormone . . . just not enough.  That is why you need yearly or bi-yearly testing.            
Am I wrong about this?

I have had blood work done off of all meds in the past year and my levels rose to 6.08 after five weeks (I felt awful!).  I was told that this could have been because the thyroid could take a while to wake up after being put to sleep?  I could have been in the adjustment phase and had my own thyroid "kick in" later on?

Does anyone have any info they can pass on to me?  I am going crazy over this last appointment and searching for a fourth Dr. now to treat my thyroid is just mind-blowing!    

[Totie]

My Endo & PCP do not believe in T3 medicine, AND they usually only go by TSH levels. My endo does run the Free T4, BUT not the T3.

Go figure..

[Barb135]

It's very common for doctors to be negative about cytomel AND it's very common for doctors to ignore Free T3 and Free T4 and treat only based on TSH ---- common, but not right!!  

Many doctors believe that synthroid is THE med for hypo and nothing else is needed.  In addition, TSH was the "gold standard" for thyroid diagnosis for so long, that most doctors can't seem to get out of that mode.  

As far as using cytomel - I don't think a T3 med should be used if you aren't being tested for the Free's and know that you really need it.  T3 med is about 4 times more potent than T4 med and can send you over the top in no time if you don't need it.  I would only start on a T3 med if I had been on a T4 med for a while and blood tests for both Free T4 and Free T3 showed that it was called for.  

I believe that if a person is put on thyroid med and doesn't need it, it can ruin your thyroid so it will no longer produce hormone.  

As far as TSH - that depends on the person.  My TSH is only about 0.03, as of my latest blood tests but since my Free's are only about mid range, I don't worry about the TSH that much.  Mine hasn't fluctuated much but I can't say if that's significant or not - like I said, I don't worry about it so long as my free's are doing okay and my symptoms don't come back with a vengeance.  

[mudkme83]

  It is  common for Endo's to disregard the fact that most of us feel a liitle better with T-3 added. A lot of doctors are so stuck on just handing out Synthroid or Levothyroxine. It all goes back to what they learned in Medical school. And yes they also have a tough time time listening to the patient when they ask for specific test. TSH alone does not account for your active thyroid in your blood,  the free's give us better idea as to whats going on.
  The best way to determine Hashi's is through  thyroid anti-bodies testing not a saliva test. If you were misdiagnosed you run the chance of going hyper. But if you were at the higher end of the normal ranges you need to be at 1-2.5 TSH level. Some of us thyroid patients have been through a few doctors until we can finds one who will to work us and actually listen.Hope this helps. Take care.