Good Doctor Please

Question

Hello. I am desperately looking for a good thyroid specialist in Johannesburg. My endo refuses to up my dose of hormones as my levels are all fine, but I am still so very sick. I really need a good doctor who can treat me holistically and stick with me until my symptoms are resolved.

gimel · Accepted Answer

Being a pituitary hormone, TSH is affected by so many variables, that I'm not sure there really is a limit that can be used in that manner.  Just because TSH is often suppressed when taking thyroid meds, does not mean that you become hyper.  You are hyper only if having hyper symptoms, due to excessive levels of FT3 and FT4.  For example, my own TSH has been around .05 for well over 25 years without ever having hyper symptoms.  In fact I continued to have hypo symptoms during that time, until I learned about the importance of FT3 on this Forum.  When mine was tested and found to be in the lower part of its range, my meds were changed to include a source of T3.  After some tweaking I feel best ever.  

Recall this from the link I gave you.  "Excessive thyroid dosing causes many negative symptoms, and such patients do not feel well. I suggest lowering the dose in any patient who has developed insomnia, shakiness, irritability, palpitations, overheating, etc.. Atrial fibrillation can unfortunately occur in susceptible patients with any increase in their thyroid levels. It should not recur if the dose is kept lower than their threshold. Thyroid hormone does not cause bone loss, it simply increases metabolism and therefore the rate of the current bone formation or loss. Most older women are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies."

LouisaRuth · Answer

One more question in light of the above. What is considered to be a safe minimum TSH level? Recent research seems to indicate 0.04 - 0.4?

LouisaRuth · Answer

Gimel thank you, thank you. Your words and the article are like music to my ears. I will spare everyone a long, frustrated and tearful rant about the treatment I have received from doctors. Suffice to say it is wonderful to have support from patients and doctors who understand where I am coming from and what I need to feel better. I am going to use your advice to screen the few 'good' doctors I have managed to find  - including the possibility you sent me. 

Thanks again!

gimel · Answer

I sent a PM with a doctor's name.  Not sure it will work for you, but possibly worth a try.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting the biologically active thyroid hormones, Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this link to a letter written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the Primary Doctor to help guide the patient's treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

If you are able to come up with prospects for a good thyroid doctor, I have found this to be a good screening device, to avoid all the cost and frustration of finding out belatedly that a doctor is not going to work for me.  I call and say that I am looking for a good thyroid doctor but before making an appointment, I would like to ask a nurse two questions.  That almost always works to get a nurse on the phone.  Then I ask if the doctor is willing to treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 without being constrained by resultant TSH levels.  I also ask if the doctor is willing to prescribe thyroid meds with T3 in them.  If either answer is no, then I keep looking.

Good Doctor Please

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