Should I wait ... and wait ... to see an endocrinologist?

[ktromb]

I had to pressure my primary care doc to start me on Synthroid and he finally has but I get the feeling he's not especially knowledgeable about hypothyroidism. I spent the morning looking for an endo doc but they ALL have 3 to 4 month waits. Here are my test results: TSH 3.5 (range is 0.450-4.5). Free T4 is 0.82 (range is 0.8-1.7). Free T3 is 2.3 (range is 2.0-4.4). Doc refused to run antibody test because he doesn't think I'm really hypothyroid. Also he refused to lower my starting dose of Synthroid from 50mcg to 25mcg when I called him to complain of feeling way too awake. I'm 62 years old and I've read that it's a good idea to start us oldies on lower doses. Bottom line: I can see a doc who is in residency training on March 26. Worth waiting or should I just be more content with my primary care doc?

[ktromb]

Thanks so much! I've been on Synthroid for about three weeks. You mentioned in your reply to my earlier post that symptoms can worsen at first but I didn't really get it. Now I understand. I hadn't clued in that insomnia could be a hypo symptom. It's nice to feel less lethargic during the day but I hate not being able to fall asleep. Thankfully my psych doc has prescribed a small dose of klonopin which is helping. And I will be splitting the Synthroid for the next few days.

[Barb135]

Forgot to mention that you don't really need an endo to manage your thyroid, but you do need a doctor who knows thyroid and is willing to work with you.  Many people have had to change doctors in order to find a good thyroid doctor.

It does usually take month to get in to see an endo.  You might want to go ahead and set up the appointment for the 26th and see what this resident doctor is like. S/he will be working under a licensed doctor, so you should be okay.

[Barb135]

Yes, it is a good idea to start us oldies on lower doses.  How long have you been on the synthroid?  What do you mean by "too awake"?  If you had hypo symptoms, it's not usual for the Synthroid to be having an effect, if you've been on it long enough (4-6 weeks or more).

I, certainly, would never complain of being too awake... lol  If you're having trouble sleeping, that's a hypo symptom.  It's not unusual for symptoms to worsen or for new ones to appear, when starting on a thyroid replacement, since it takes your body a while to adjust to having hormones it's been doing without.

Your labs, particularly, FT3 and FT4 are very low in their ranges and your TSH is actually high, if your lab was using the current recommended range of 0.3-3.0.  I don't doubt that you need med.

If your doctor refuses to lower your dosage, you can always split the pills and take 1/2 each day until you feel that your body might tolerate more.  When I was put on med, I was started at 25 mcg for 2 weeks, then 50 mcg for 2 weeks, then 75 mcg for 4 weeks.