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Why do Doctors Not Listen
I went to the doctor May 12th with severe hypo symptoms. Was prescribed 50mcg of Levothyroxine. Called because it was not helping symptoms had eased and went back to where they were. So new blood work comes back from last Saturday and the levels have not changed. TSH actually went up a smidge. She said lvels were good and we would talk when I visit her.
Levels 5-12-10.TSH 3.86 (0.40-4.20). Now TSH is 3.97 same range. FT4 was 0.9 (0.6-2.7) has not changed any in a month. First FT3 is 2.5 (2.1-4.4).
I am at my witts end. If I go with another dr there will be a period I don't have meds as she only gave me two months worth. I called back and explained that those were the same exact levels as when she started me on medication. Is not the point of medication to either lower or increase levels? I am awaiting an answer.
Levels 5-12-10.TSH 3.86 (0.40-4.20). Now TSH is 3.97 same range. FT4 was 0.9 (0.6-2.7) has not changed any in a month. First FT3 is 2.5 (2.1-4.4).
I am at my witts end. If I go with another dr there will be a period I don't have meds as she only gave me two months worth. I called back and explained that those were the same exact levels as when she started me on medication. Is not the point of medication to either lower or increase levels? I am awaiting an answer.
Any recommendations for a good thyroid or a any doctor that will help with thyroid in Kansas City area? I am having the WORST time. I feel AWFUL, my numbers have never been at the "right" levels with the levothyroxine, tirosint, or Armour. I am SICK of feeling like this. HELP!!!
Thank you Stella. I have two months worth of prescription so I need to find someone within that time. I am looking. I just want to say that you all are great here. I don't know what I would have done without this forum. Thanks to all.
PS - Ramsey
It may help to look at Intergrative docs, Most due treat by the frees and offer a variety of options for meds and treatment.
It may help to look at Intergrative docs, Most due treat by the frees and offer a variety of options for meds and treatment.
Gimel... you're a doll. You are #1 in my book man!!!!
Thanks for being apart of this community. Just wanted to throw that in here. :)
Thanks for being apart of this community. Just wanted to throw that in here. :)
I'd say, directionally correct. With Hashi's there is a gradual destruction of the thyroid glands, so you really need to get your levels up to where you are feeling better and then they usually have to be continually increased enough to offset the loss of natural thyroid hormone.
That's why I say that the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever type meds are required to relieve symptoms, without being constrained by resultant TSH levels. I throw in the latter part of the sentence because frequently TSH levels will be suppressed to the low limit of its range, or below, and the doctor will automatically pronounce you as hyper, and want to reduce your meds, even if you still have hypo symptoms. In actuality you really aren't hyper, unless you have hyper symptoms caused by excessive FT3 and FT4 levels. So be on guard for that.
That's why I say that the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever type meds are required to relieve symptoms, without being constrained by resultant TSH levels. I throw in the latter part of the sentence because frequently TSH levels will be suppressed to the low limit of its range, or below, and the doctor will automatically pronounce you as hyper, and want to reduce your meds, even if you still have hypo symptoms. In actuality you really aren't hyper, unless you have hyper symptoms caused by excessive FT3 and FT4 levels. So be on guard for that.
My numbers did not change at all on 50mcg so she raised it to 75mcg. Does that sound right?
You are so great with all your information. I live in Cincinnat, Ohio if anyone has a recommendation for a doctor. I will scope the internet tonight. I called one office of internist's and she said none of them specialize in thyroid but they all treat it. I asked if they treat the frees or TSH and she could not tell me. I will do as you say and ask a nurse. Thanks again for the great information.
Sorry. Typo.
Should have been, "Then ask if the doctor is willing to prescribe meds other than T4 only types".
Should have been, "Then ask if the doctor is willing to prescribe meds other than T4 only types".
The best way to find a good thyroid doctor is through a personal recommendation from a satisfied patient. If you tell us the area you are in, perhaps members can make suggestions.
When you have a good prospect, I suggest calling the office and saying you are looking for a good thyroid doctor, but would like to ask one of the nurses a few questions before making an appointment. then ask if the doctor is willing to treat a patient for symptoms, by testing and adjusting FT3 and FT4 levels, instead of relying on TSH. Then ask if the doctor is willing to prescribe meds other than T$ only types. If answer to either is no, then keep looking.
When you have a good prospect, I suggest calling the office and saying you are looking for a good thyroid doctor, but would like to ask one of the nurses a few questions before making an appointment. then ask if the doctor is willing to treat a patient for symptoms, by testing and adjusting FT3 and FT4 levels, instead of relying on TSH. Then ask if the doctor is willing to prescribe meds other than T$ only types. If answer to either is no, then keep looking.
That was a great response. Thank you. I did have an antibodies test and I have Hashimotos. I think this doctor does not look back at anything. I told her I was diabetic but when I called that my sugar was out if whack she said I did not know you were diabetic. Once I call her on something she has missed she usually will fix it. I am looking right now for a new doctor. Probably won't choose an Endo.
You might also mention to the doctor that over 8 years ago the AACE recommended that the TSH reference range should be revised from .5 - 5.0 down to .3 - 3.0. Both your test results are well over 3.0. In addition, TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a diagnostic for thyroid problems. At best it should be considered as an indicator, to be considered along with more important indicators such as symptoms, and also the levels of the actual, biologically active thyroid hormones free T3 and free T4.
FT3 is the most important because it is four times as active as FT4, plus studies have shown that FT3 correlates best with hypo symptoms. Both your FT3 and FT4 are too low in their ranges. Forum members frequently report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range. Symptom relief should be the objective of your treatment, not just getting test results anywhere within the range.
You might also consider asking the doctor to test you for thyroid antibodies, which is the main cause of hypothyroidism. Frequently if tests for TPO ab and TG ab indicate a problem, then doctors are more likely to prescribe meds, regardless of what they think about the other test results.
In my opinion the very best way to treat a thyroid patient is to test and adjust levels of FT3 and FT4 with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels. I think you need to find out if the doctor is willing to treat your symptoms in this manner. If not, then you will need to find a good thyroid doctor that will do so. Based on the doctor's response so far, I think you might as well start looking anyway, because it sometimes takes a while to find a good thyroid doctor.
FT3 is the most important because it is four times as active as FT4, plus studies have shown that FT3 correlates best with hypo symptoms. Both your FT3 and FT4 are too low in their ranges. Forum members frequently report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range. Symptom relief should be the objective of your treatment, not just getting test results anywhere within the range.
You might also consider asking the doctor to test you for thyroid antibodies, which is the main cause of hypothyroidism. Frequently if tests for TPO ab and TG ab indicate a problem, then doctors are more likely to prescribe meds, regardless of what they think about the other test results.
In my opinion the very best way to treat a thyroid patient is to test and adjust levels of FT3 and FT4 with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels. I think you need to find out if the doctor is willing to treat your symptoms in this manner. If not, then you will need to find a good thyroid doctor that will do so. Based on the doctor's response so far, I think you might as well start looking anyway, because it sometimes takes a while to find a good thyroid doctor.
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