Questions about adequate thyroid testing... am I hypo?

[lisaanne1]

HI everyone. I have a couple quick questions and hope you all can help me. I had 1/2 of my thyroid removed 3 years ago due to a goiter. My TSH back then was around .80 or so. Since my surgery, I have not been on any meds. My Endo will only test for TSH and total T4. I've never had any other test done for my thyroid. My latest round of blood work came back with a TSH of 2.52 (which is the highest its ever been) and my total T4 of 9 (range is 4.5 - 12). I've read that other tests should be done like free T3 and free T4 and also antibodies? Based on what my results are now, am I officially hypothyroid?
I went into my appt today because of increase hair loss, tiredness and the newest symptoms of all over muscle fatigue when using my muscles for everyday activites. The doc told me that yes my thyroid was on its way towards not working, but he wasnt going to put me on any meds until I expeience muscle cramps, coldness when its warm and constipation. I dont have any of those symptoms so he thinks I'm still OK.
Based on your experiences and what your doc does for you, what should I do?
Thanks so much!
Lisa

[SassySharon]

Take it from someone knows, find a good thyroid doctor.  Notice, what is what is being said.  A Good Thyroid Dr.  Not just an endo,  I found out my ex-endo really only treated diabetes, after I had invested a lot of time and money with him.  He dabbled in thyroid on the side, more or less.  We do not need a doctor that thinks of thyroid as a symptom that must reach a certain level of pain before they treat it.  Preventative care is essential to good health.  And you do not have to be full blown to begin treatment.  That would be like waiting to treat a wound after it has gangrene.  Just silly and unfair to the patient.  Please keep in touch with us and let us know how you are doing.        -sass-

[gimel]

Due to their training and beliefs an Endo and a good thyroid doctor almost seem to be incompatible.  Endos seem to be somewhat inflexible, and want to use TSH and the FT4 test to diagnose and treat  thyroid patients, rather than treating them clinically, for symptoms.

This is a link to the Top Thyroid Doctors site for Ohio.  I noticed several in the Columbus area  that look interesting, based on their patients' reviews.  If any look interesting to you, I would be glad to give you three questions to ask that would pretty much confirm them as prospects rather than suspects.  LOL  

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

[lisaanne1]

Thanks everyone.  I think I do need to look around for another Endo.  What's so funny is that my  doc is rated one of the best Endos in the city.  I'm in Columbus Ohio.  He always asks me first and foremost "how do you feel?"  And prides himself on not just going by the test results.  So if thats the case,  when I come in and complain about how awful I feel,   I get the whole song and dance about not having ALL the symptms yet.  I'm thinking about trying Raw Thyroid or something like that just to see if maybe that can help some of my symptoms.  I just dont know what other Endo from my area would be good.

[FTB4]

New Doc, is my vote, Any MD that wants you to suffer more before he makes a move to help you is a fool. Is this guy a Cab Driver or what?  Go Doc shopping asap Good Luck. FTB4

[gimel]

I totally agree with grantj, that you need to find a new doctor.  A good thyroid doctor will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  symptom relief is what it is all about, not test results.  Test results are valuable mainly as indicators during diagnosis and then afterward to monitor FT3 and FT4 levels (the biologically active thyroid hormones), as meds are increased to achieve symptom relief.

To understand more about the clinical approach, here is a link to a letter written by a good thyroid doctor.  The letter is for patients that the doctor is consulting with from a distance, and is sent to the PCP to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

If you will please tell us your location, perhaps members can recommend a good thyroid doctor, based on personal experience.

[grantj]

Oh my, I would be looking for a new dr. for sure.  Why does he want to wait until other symptoms appear?  Foolishness.  I wonder what his point could be.  I am no expert, just someone who is very thankful to be feeling great and living a good quality of life; AND, very thankful I have some tremendous dr. resources here in my city.  I cannot give you an answer regarding your test results, just that you should have the FT3 and FT4 tested for sure, along with TSH and antibodies.  I am pretty new to this forum, and am totally impressed with the level of knowledge and expertise some of these folks have.  You will surely get more info as more people see your post.  

In answer to your question on what my dr. does for me; he considered symptoms first, ordered the tests as noted, narrowed the "normal" ranges to a much more appropriate level, and suggested Armour thyroid;  Done deal, went on the meds and I feel great; get restested from time to time and adjust dose as needed for symptom relief.  I am hypo only, no Hashi's, no removal, etc.  Best to  you on your journey to feeling better.