Thank you both for your replies.
Question about the T4 advice. I've spent probably 80+ hours researching on the web for Hypothyroidism. My perception is that the common theme is that T4 dosage is a waste of time. The theory most discussions center on (1)FDA not allowing changes in T4 dosages, (2) since T4 is the mechanism that regulates T3 most people are more successful going straight to T3.(3) When people are on T4 most Dr's refuse T3 treatment (to the detriment of the patient), and it's not until a T3 therapy regime is followed until Hypo's are feeling better.
I have the best Psychiatrist in the world. He's shown more than enough patience and been more "experimental" than I could ever have hoped for. (i.e. trying off label/augmentation therapies--From what I understand, Adderall treatment for depression is fringe off label). Had he not put me on Adderall *nothing* we tried would have worked. The only two therapies he suggested and I adamantly refused were Lithium (did not want the excessive weight gain) and the ECT suggestion.
So based on Paragraph 1 above--I know I have to be the aggressive one, and continue to "fire" Doctors that even refuse to consider open discussion on extensions to therapy.
For reasons (not appropriate for discussion in a Medical advice forum), I firmly believe It's against a Doctor's best interest to do anything more than conservative/down the middle/whatever a Pharmaceutical Rep/Medical Diagnostic Lab tells them to do. Whenever you doing something out of the norm, it "costs" you more--either time, energy,effort,monetary, etc..You let someone in front of you in traffic, it "costs" you more time as you get pushed back in line. I know that Doctors are not in the "cure" business, they are in the "treatment" business. Which I completely understand and accept.
However, with that said. Do you know where I can find a list or a resource, of Endocrinologists who are more open minded? Where can I find reputable Scientific Endo data to review?--besides the obvious....New England Journal, etc.
Does there exist a scientific target for TSH fT3 fT4 level?
It appears no, since even different labs can't agree upon a standard reference range.
It simply boggles my mind that a scientifically measurable factual consistent reference range does not exist between labs. It seems that if you are pulling blood (to obtain a Scientifically factual number), why would the range differ from one Lab to another? That, above all else, calls into question the validity of the test in the first place. If the establishment can't agree on a Reference range, how can they agree on Treatment Methodology??
It appears to me that seeking accurate Medical Thyroid advice/Treatment, is nothing more accurate than seeking Psychiatric advice/Medication. It's nothing more than a guessing game until you get it right FOR THE PATIENT (and NOT measure against a "norm").
Since my Psychiatrist is treating me, I know it's important that I take upon myself to monitor my levels. I realize it's not is expertise.
What I find unbearable is that The American Association of Clinical Endocrinologist, their own Medical Governing board, changed Medical Standards and most Doctors and Labs fail to acknowledge this.
It's a sad state of affairs that a PATIENT has to bring MEDICAL JOURNALS into his Doctor's office to get the help the Patient needs.