Should I call endo monday???

[froggy0936]

It's me again with more questions! Lol. Quick recap..TT 12/17/09. Endo started me on Synthroid a week later..50mcg. Low dosing was due to the fact that I have anxiety. Had 1st set of labs and TSH was 66.060! On Feb 13th he bumped me to 75mcg. Due to have bw done March 12. Obviously, I'm extremely hypo. I might have 2 to 3hrs of energy out of the day and that is it. I literally feel as though i can't function. Extreme brain fog and depression. Never had a problem with depression before. I don't have many of the other hypo symptoms but the 2 that I have are ruining my life!! I can't concentrate, my body feels like lead and I cry or am mean for no reason. Do I really need to wait another 2wks for a bump in med? I'm sure I'm so far in the hole that with even this bump to 75mcg..I feel no different..in fact I feel worse!! I can't imagine continuing to feel this way. I'm so keyed up on the inside (I never feel relaxed for some reason) but it's hard to be up and doing things for a couple of hours! I'm sleeping at night and do not take naps. I have my 1st and only labs in my previous posts. They are within range. I'm looking at my script for my bw March 12 and it says T4 Total, T3 Uptake and TSH high sensitivity. I see people say to have "Free T3 and Free T4" tested but my endo said that would be done only if TSH came down to where it should be and I'm still not feeling well and I'm only a little over 2months post op. I want to call him Monday and beg him to raise med or do something..as this is the worst I've felt since TT. How am I going to feel like this for another 2 weeks? I was never depressed nor felt like this in my life! An antidepressant is not an option. I've tried them for my anxiety and there are way to many side effects. I'm very sensitive to meds and I don't need to feel worse. Please advise if I should push endo or just sit here and suffer!! Thank you all in advance!                

[Barb135]

I wasn't saying she *shouldn't* call -- only reminding that it does take time for the med to work and raising the dosage too quickly can be trouble also; also the need for proper testing to see what's going on.  

I totally agree that just because this doctor is "Director of Endocrinology" doesn't make him any better than anyone else.  He sounds exactly like the type of doctor I would kick to the curb in a heart beat.  

froggy -- would you rather insult the doctor or continue to feel like pooh? I think the problem is that he's not testing the right things.  Without knowing what your FT4 and FT3 are, there's no way to know exactly how to dose you.  Too many doctors are reluctant to test FT3 and FT4 -- I'm not sure why, but it seems that they are stuck on the "old school" methods of treating thyroid issues based on TSH levels; therefore, they are keeping too many patients ill.  Looks like it's up to us patients to retrain them.  I just got my pcp into the FT3/FT4 "mode".  

I haven't had TT, so that could make things different, but I started out with a TSH of 55+ and I felt much the same as you do.  It's very frustrating when the doctor who is supposed to be helping you won't even listen.  It's taken me almost 2 years and having to kick a very well respected doctor to the curb, but I can finally say "it's better".  

Again, I'm not saying that you shouldn't call your doctor -- I'm merely saying that you need to know what's going on with your blood work, as well as your symptoms, which is why you should demand the FT's.

I'd also recommend that if you get to feeling TOO badly, don't hesitate to go to the ER; there may be something that can be done to help you.  

I feel for you and am wishing you the very best of luck.  

[stella5349]

Oh - answer to your question of should you call? - YES! - call and demand testing right now and make them order the FT3 and FT4 with the TSH. Also, it wouldn't hurt to run the reverse T3 here either.

( Barb, I know the adjustment time you are saying with 5-7 weeks - but what I read is this person is slipping and getting more symptomatic as time goes on) My belief is if things are getting worse ( or even improving) .....something - based off symptoms - is happening and tests "should" uncover this...

**** again, tracking lab sheets here w/ each visit and labs done is definately a plus ****

[stella5349]

I don't care if he is the Pope! - It's your health.... your illness.. and your quality of life!

He - or any endo should not have an issues running the right thyroid hormone tests to determine exactly where you are at.

The choice is yours..... letting him badger you into thinking he is right  - or standing up for yourself and wanting more tests to see if that would help you feel better.

The title of "Director of Endocrinology" does nothing for me - its an appointed title and Who knows how he achieved that.

Don't allow a big head with a fancy title to intimidate you. Fact is - you feel like garbage and you want to get well.

[froggy0936]

Why are dr's so reluctant to do these proper tests?? He already gave me the script for the bloodwork and I know he's not going to change it. It would be an insult to him if I insisted that he did...he's the "Director of Endocrinology" and thinks he knows everything! He is very well respected. I'm not sticking up for him by any means! I think he should have raised my med sooner than 9wks post op! I understand it takes awhile for the med to get into your system correctly, as he told me I have to be patient..but isn't it funny now that he is doing bloodwork every 4wks (and only checking the things i've posted) to see about an increase in meds? That's kind of him contraidicting himself to me...or that's his way of shutting me up! I just never thought I'd feel this bad! It seems to be getting more difficult instead of easier. It just stinks when you don't feel the slightest bit of improvement and truthfully, I felt 10x better before TT. That's why I don't answer too many posts on here...I don't want to discourage anyone!! Lol. .....Thank you!    

[Barb135]

It takes 5-6 weeks for an increase in med to take full effect and you've only been on the 75 mcg dosage for 14 days.  I know you feel horrible and patience is the last thing you want to think about right now, but you have to give the med a chance to work.

If you start going too high, too fast with the med, you could end up in worse shape than you are now.

I disagree that FT3 and FT4 are only for "fine tuning". Those are the actual thyroid hormones and if you and your doctor don't know their levels you/he won't know how to dose the med.  You can't do it on TSH alone because some people do better with TSH over range and some (like me) do better with it below range.

I would never recommend adding a T3 med without knowing exactly what your FT4 and FT3 levels are.  If you add a T3 med when you don't need it, you could go hyper very quickly and that could be worse than what you are suffering now.  

I would only recommend adding a T3 med if your FT4 tests high and your FT3 tests low -- that could indicate a conversion problem, in which case a T3 med would be appropriate.

By all means do whatever it takes to get your doctor to test for Free T4 and Free T3.  Total T4 and T3 uptake are pretty much obsolete and won't tell you much at all.  

You need to know the levels of the actual hormones in order to be dosed correctly; please do not let your doctor base your med dosage only on TSH -- that's a recipe for disaster.  

[froggy0936]

Thank you both and I'm definately going to call Monday. I see other people post here with higher TSH than mine and some say they don't feel so bad?? I must be crazy then! LOL. I just hope he doesn't make me wait until the 12th. You know, to them, it's just a couple of weeks away...to the patient, it feels like a lifetime! ...Blessings to both of you....Lynda xoxo.