Dr. Thinks I am nuts.

[FrostyDarci]

I was put on thryoid medication at .05 daily because my TSH came back at 5.91. The Dr. had my blood tested again and it was at 4.9. The 4.9 is considered to be within the normal range for TSH with labcorp. I am still so sleepy all the time though and my knees hurt. I am working out hard six hours a week and cannot lose weight. I am almost out of my 3 month presecription. I think I need a higher dosage or I need to see and endo. How do I tell my Dr. that I don't think he knows enough about thryoid disfuntion?

[Smilerdeb]

I agree with the above postings....but if you are NUTS, then we ALL are lol :)
Find another Doc.....
As I always say to people who arent satisfied.....'go Doctor shopping ' :)

[Super_sally888]

Hi,

I think you are right that everyone's dosage should be based on relief of symptoms as with only reference made to testing results, and levels.  Also that the FT3 and FT4 levels are the important ones.  Shame that so many drs only look at TSH.

I have read a lot of literature that does state that target for many to feel good is between 1 and 2.  But I tried to make my statement not absolut by saying it is 'probably in that range, but depending on how she feels', which still gives room for other levels.

I thought that was relevant becuase the doctor told her she was okay at 4.9 when this is pretty obviously still hypo based on her symptoms....

I am one who has nearly nonexistant TSH levels.  On that basis I have been told I'm hyper by some doctor who tried to stop my meds and kill me! Luckily my current dr knows that TSH doesn't work for me and he has to medicate me based on the FTs.

Anyway, thanks.  We're all here to help the newcomers.  And the more good input we give the better.

[gimel]

I don't really think TSH should be mentioned in the same sentence as target.  This can be easily misunderstood as a recommended approach to determining a patient's dosage.  The real target should  be to get rid of symptoms by testing and adjusting FT3 and FT4 with meds, as required to alleviate those symptoms.  Since the ranges for FT3 and FT4 are too broad and too low, because they have never been adjusted like the TSH range, this frequently necessitates getting the "Frees" into the upper part of their range, in order to alleviate symptoms.  The resultant TSH level may sometimes fall into the low end of its range, or even below.  This doesn't mean the patient is then hyperthyroid.  A diagnosis of hyperthyroidism should mean that hyper symptoms are present.   Just my opinion.

[Super_sally888]

Oh yeah! Agree with Stella.

You need to bee tested for FT3 and FT4.  Most people with thyroid problems feel better when their TSH is towards the bottom of the range.  And 4.9 is still OUTSIDE the adjusted range that is now up to about 3.5 (I think).  AND as the others said, TSH is not a good measure of function for many.

Target is probably between 1 and 2, but also depends how you feel.

Yes, if your doctor won't give  you a higher dose and test more appropriately go looking for another doctor.  However, if you think you can educate / work with your doctor, by all means keep him.  maybe what he learns from  you may help others too.

[stella5349]

That doctor is nuts... just my opinion. LOL - not you. It obvious that thyroid is not his greatness.

[gimel]

When you start looking for a new doctor, you can't just assume they will be good thyroid doctors.  Those are hard to find.  One way to find one is to ask if anyone can recommend a good thyroid doctor in your area.  Another way is to use this site, which has been useful to several people in the past.

http://www.thyroid-info.com/topdrs/nevada.htm

When I read the patient reviews for the doctor in your area, they sounded like what you would like to hear about a doctor.

[FrostyDarci]

Thank You Both

[TamraW]

TSH does not paint the entire thyroid picture; however yours is HIGH. My endo uses 3.0 as the threshold. Some use 2.5.

Here's my advice. Switch doctors or, even better, get a referral to an endo.

Get these tests:
Thyroid ultrasound

Bloodwork:
FT4, FT3, TSH,
Anti-TPO and TGab (to check for possible Hashi antibodies)

Take care...
:) Tamra

[hope4thegoodstuff]

and I suppose they don't test for Free T3 and Free T4...those numbers are usually more indicative of a problem.  But this is something many of us fall into is... dr's rely completely on TSH...You might ask if they will test the FREE T3 and FREE T4, (it's important that you specify that) and see if you can get anywhere.  There are folks out here that are more knowledgeable than I am, but they will be able to help you better with those numbers.  

I had two dr's do the same thing...they made me feel as though I knew nothing about my own body.  I wasn't supposed to do my own research or buy reading material...It was the third that I found that got the ball rolling..