ENDO vs family doctor

[elenka29]

What is the difference between going to the specialist for tests vs going the Internal Medicine doctor?
Will ENDO do anything different? More expensive tests and same result?

[estrelinha]

The internal medicine doctors treats life threatening diseases and looks to all your symptoms, ask for all kind of tests he thinks are necessary and gives you a diagnosis , an ENDO is a specialist of all problems related to hormones and usually ask for tests related to his speciality. Example:  If you don't know what you have and have mixed symptoms internal doctor is the right one, if you have a thyroid problem an ENDO is the right doctor.

[elenka29]

I guess, what I am trying to ask, really - is there more to it than TSH blood test?

[estrelinha]

Both doctors will ask for free T3, free T4, TSH and if they suspect of autoimmune thyroiditis will ask for anti-TPO (anti-peroxidase antibodies), anti-Tg.

[estrelinha]

So now you know the right tests, ask for them (TSH, free T3, free T4 anti-TPO and anti-Tg)

[AR-10]

An Endo is often a specialist in one field of Endocrinology, and unable to recognize his/her limitations.

The first Endo I saw probably can't even spell thyroid, let alone treat one. He can't tell the difference between hypothyroid and hyperthyroid, and I am not joking.

We are talking about people here. There are smart doctors, and there are stupid doctors. Some of them are General Physicians, and some of them are specialists.

Your GP can order the tests estrelinha listed, which would be good. If the GP is smart, he can do quite a bit to treat many thyroid conditions.

If he is not so familiar with thyroid problems, at least you will have test results in hand when you see the Endo, if you need to see one. Your GP can also help you find an Endo, hopefully a thyroid specialist, if you need one.

A GP can order an ultrasound test, if it is indicated. If an ultrasound indicates the need for further tests, then you are into the realm of the specialist.

Regardless of who you end up seeing for testing, you have to be fairly informed about what the tests are, and what the results mean. The doctor, whatever doctor, is going to give you his/her OPINION of what the test results mean. The only way to know if you are being given good advice is to know the facts.

Starting with a GP is fine. Depending on his/her experience and your medical condition, your GP may be able to treat you, assuming you need treatment.

Best of luck with your tests, and welcome.  

[elenka29]

thanks to everyone for answers.
In my test results what am I looking for. So far I am fully trust the doc to tell me. It is good or not good and didn't even know where I was with numbers. Should I be under 3 with TSH? What am I looking for with free T3, free T4 anti-TPO and anti-Tg?

[AR-10]

Your TSH should be between 0.80 and 1.80, for the majority of the population. A TSH of over 3.0 will keep you hypo. Many doctors do not realize this.

Your Free T4 and Free T3 should be about two thirds up the scale of the lab range used. Your Free T4 can be below midpoint and still provide enough Free T3, but your Free T3 must be above midrange or you will be hypo.

TPOab and TGab should be below lab limit, ideally. If you test positive for antibodies, the lower the number is the better off you are.

If you have an antibody and the test result is 80, that is not so bad. If it is over 1,000, that is not so good. It's hard to define a point where your antibody count becomes a problem. 200 or 300 can be a problem. 100 is proof of autoimmune activity, but it's hard to say how much damage is occurring at that point. The higher the count, the more troublesome it becomes.

That's the way I understand it. That does not mean I am 100% correct.

[stella5349]

I totally had a rollarcoaster ride with "Endo's" In my case as AR's I found the more specific the "title" was for the doctor - the less they seemed to know...... or care.

After 5 yrs I finally have a doctor who will "listen" and run all the appropriate tests - as  estrelinha gave you - plus he even runs more - like vitamin deficiencies and extra hormone testing.  "JUST TO MAKE SURE!!"

He is an MD with a background in bio identicial hormones.

I hope never to return to another endo again after what I went through.

[kamvick]

I see a general practitioner/gyn for everything and then I see the Endo Dr. for my thyroid. HE specializes in just that area. My general Dr. actually referred me to see him after she found out that I had an issue with my thyroid after doing my blood work. I am now going to have surgery and my Endo Dr. has referred me to a surgeon who I will see today who will let me know when I will have the surgery. I am not looking forward to it but this Dr. has been watching over me and my thyroid since 1999 and that's been almost 10 years so maybe after this surgery I won't have to keep going so much to see him, I go every 6 months. Good luck to you, hope you find a good Dr. who cares about you. Mine does and that's why I have had the same general Dr. for over 28 years.

[vintagedoll]

My GP is not working out.  He tested me once in Feb. and then retested me in March. I felt so bad even on the Synthroid that I requested to be tested again in mid June as my prescritpiton was running out and wanted to be sure I should even have it filled.  Or if he would give me something else.  The did finally re test me after I told them I was going to find another dr.  My blood level had gone half way back up to where it had started out in Feb.  But they say it is in a fine range.  How can that be?  I feel horrible.  By now...mid July...I feel even worse.   The receptionist said that the dr. will talk to me when I come back in for my next visit.   That was a month ago....my appt. is on Wed. July 23rd...this week!  I have no idea how the visit will go, but....I am sure I will walk out of there depressed.  I haven't been depressed.....but am starting to get that way.  The last two nights sleeping have not been great. I usually sleep great!!!  Lastnight the back of my head felt like it was going to explode!!!  Woke up with puffy eyes and headache.  What is going on with me?????  I don't know where to look for an Endo.  Do I even need one?  Who knows ????

[AR-10]

Tell your doctor you want your TSH to be around 1.0, and you want Free T4 and Free T3 tests to see just what your hormone levels are. Get copies of the tests.

If you get ANY resistance, go find another doctor and start over with the same requests. You don't need to be treated by a doctor that requires you to beg for testing. Having your levels checked every three months is not excessive. It is good medicine. Especially in the early stages of treatment.

You should be checked six weeks after any medication adujustment, and then again six weeks later.

Your doctor is not listening to you. He is dictating to you. I see a new doctor in your future.

[peggy64]

Stella wrote a good post on treating patients based on symptoms. Just because the leve is 0.3.3-0, yours is lets say at a 2.9. You feel awful. It might be within range, but is not an OPTIMUM level for you.

Suggest to your dr that he treat your SYMPTOMS. And ask to get your # down to a 1 or a 2. Most people seem to do better in that range.

We know how you feel. It is very hard to find a dr who will treat based on symptoms, because unfortunately, most drs are not educated enough in this field to treat patients with knowledge and wisdom. Just what the lab says....