Total Thyroidectomy & Synthroid Dosage

[lilypad300]

I know it's different for everyone, but what is the average dose of synthroid for people who have has a thyroidectomy?  
My doctor started me off on .175 and then I had an anxiety attack the other day (see journal)  today he said my numbers were good, but reduced me to .137 and gave me some .150 samples as well.  He said to start on the .137 and if I felt sluggish to take the .150's .  How will I know the difference between general fatigue and not enough synthroid.  Would the .175 have caused my anxiety attack?  

help!
thanks!

[annie_2013]

Of course!!!!!!  :)

[gimel]

Well, if you are willing to travel a bit, I have personal knowledge of an excellent Endo in the Austin area.  Any interest?

[annie_2013]

I will follow your advice, I guess im getting desperate when I read on almost all of the houston area thyroid doctors' websites about Tsh t3 and T4 and nothing about freet3 or 4. Im also willing to travel around the Texas area to find the right doctor I'll keep loking and will definitely call for more info. Thank you so much again. = )

[gimel]

Obviously I don't have any direct experience with either of those.  From what I can pick up from an internet search, I think both places fall into the category of clinics that have been set up to fill the huge need for good thyroid doctors, which is due to most doctors having the "Immaculate TSH Belief" and using "Reference Range Endocrinology".  The potential problem is one of potential cost.  

I expect that you can get the diagnosis and treatment needed from either place.  If they are like many others that I am aware of; however, , I think you may find that they do lots of testing, prescribe specialized hormone therapy that is expensive by nature, and also push supplements.  Some of these places also only recommend supplements that they sell.  Much of all this is not covered by any medical insurance.

So, if you are comfortable with all that, then I think either place might work for you.  If cost is also very important, then there may be other viable alternatives.  For example, on this Top Thyroid Doctors site, for Texas, there are a number of doctors listed for the Houston area.  There might be a good prospect among them.  The best way to find out is to read the patients' reviews, looking for evidence that symptoms are considered in treating patients.  Also look for indications that the doctor is willing to prescribe T3 type meds, such as Armour, NatureThroid, or Cytomel.  

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

After you select some potential doctors, the next thing I wold do is call and say that you're looking for a good thyroid doctor.  Ask if the doctor is taking new patients.  Ask if he accepts your insurance.  Say that before considering an appointment, you would like to get answers to two questions.  First, is the doctor willing to treat a hypothyroid patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, instead of using TSH levels?  Second, is the doctor willing to prescribe T3 type meds?   If someone will answer these two questions, and the answers are yes, then it is worth making an appointment.  If either answer is no, then keep on looking.

If you need help in your search for a good thyroid doctor, just let me know and I'll be glad to do whatever I can.

[annie_2013]

Im going to print many copies and pass them on to my endo and to people I know that have this same problem so they can pass them on to their docs too...thank you. Been searching for someone who checks freet3 and 4 and I found these . I think I will make an appt with both .  Would love if u would give me ur opinion on these specialists

http://www.hotzehwc.com/en-US/Treatment-Programs/Hypothyroidism.aspx

http://www.taylorwa.com/

[gimel]

Okay, will wait for Free T3 result.  Whenever a doctor tells you that a test is in the so-called "normal" range, just give the doc a copy of the link to the scientific study from which I quote as follows.

"High individuality causes laboratory reference ranges to be insensitive to changes in test results that are significant for the individual.

The width of the individual 95% confidence intervals were approximately half that of the group for all variables.

Our data indicate that each individual had a unique thyroid function. The individual reference ranges for test results were narrow, compared with group reference ranges used to develop laboratory reference ranges. Accordingly, a test result within laboratory reference limits is not necessarily normal for an individual."

Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab. 2002 Mar;87(3):1068-72.

As I previously mentioned, a good thyroid doctor will treat a hypo patient clinically by testing and adjusting 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 letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."

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

The more you learn about hypothyroidism diagnosis and treatment, the better able to persuade your doctor to do what is necessary.  If the doctor remains obstinate, then you have to find a good thyroid doctor.