Need Help Convincing Doctor

[jilliansmom09]

Hi.  Due to a suspicious thyroid nodule, I had the right half of my thyroid removed in Sept. 2009. Since then, I have become extremely fatigued, increased hair loss, decreased memory/cognitive function, and loud ringing in my ears.....so bad that I have trouble falling asleep at night from the noise.  My TSH numbers before the surgery were in around 2.3.....constant around this value since at least a year prior. Since the surgery, the numbers have been around 3.3.....it had actually risen to 4.3 around at the end of November, but have since dropped back to 3.3.  Meanwhile, all of the symptoms persist, despite this mild fluctuation in numbers.  The lab at my doctor's officeuses the range of .5 - 5.0 for normal, but I have read that this has been disputed, and that the true "normal" range is .3 - 3.0, which would place me as subclinical hypothyroid, correct?  My doctor will not place me on replacement thyroid hormone and will not budge despite my contacting him several times with additional information and persistent sypmptoms.  In your opinion, what is the best way to handle this situation? My insurance is through an HMO, so getting a referral for a second opinion is not really feasible.  Actually, my endo. said to me that "any other endo in the building would agree with him," so it wouldn't really be worth it for me to even try to ask them!!

Many Thanks.

Erin

[Mark Lupo, M.D.]

There is debate on normal - but with this history, a trial of levothyroxine is reasonable given the very low risk of side effects with the medication.  Not sure why so many are stubborn on this point.  It is  important to have realistic expectations -- ie, the symptoms may not improve with meds and if this is the case, we usually stop the meds after 2-4 months of a trial.

[irishwinter]

I have seen the LATEST med research that talks about tsh normals should be 2...........so i would go on line and research...............your PCP MAY be open to caring for you in this case................I hipe you feel better....it definitely sounds llike you are low thryoid.............

[angelam2007]

I need some really good advice. Over the last two weeks I have had my TSH checked and on folllow-up FT4 and TPOAb, my endo told me there are no problems even though I have severe fatigue, unable to consentrate, memory loss, mood swings, baisel temp around 96-97, I frezze to death most of the time, when I exercice I feel hot on the outside, cold on the inside, I have developed red patches of dry skin on my arms, chest, legs, and now starting on my face, I can exfoliate and mositurize my face only to be flaky in a few hours. I have tingling in my arms and legs for years plus numbness. I can't build muscle tone, my vision goes blurry and double from time to time, and I retain water. I can't lose weight no matter how much I watch my diet and my cholesteral good is low, I can't raise it even with the omega 3, niaspan, niacin, garlic, and flax seed suplements and my bad is high. Caffiene doesn't give me any energy at all either. I am supost to consult my primary on Monday, but she is the reason I went to the endo, I had to argue with her to check testosterone and be treated for high levels, the only test she has ran is the T3 and T4 which have been normal over the last six years. My doc that left the practice for another feild, in '04 ran a bunch of tests for fatigue and said that I had a medabolic disorder and to supplement with B12 for diffencency. I hope I have told you my history in full enough for you to give me something to throw at my doc Monday, my levels checked out at TSH 4.7 on 3/12/10 and follow-up TSH 3.26, FT4 1.20, TPOAb 11 on 4/1/10, but I didn't know that I was coming down with a cold with the follow-up draw. I just remembered I need to tell you that I have a high wbc too, last checked in Aug. '09, a little above 14,500 also unexplained, went in to have tonsiels removed pre-op also worried my ENT of risk of bleeding due to platelets, I didn't have any complications though. Thank you for your help in advance.

[val1198]

Have you been checked for Lyme by a physician literate in diagnosing it?