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Old 01-08-2017, 05:56 PM   #1
primroselane
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What questions do I ask?

I have been on thyroid meds for many years. It's a little unbelievable that I take these meds and know so little about what they do and why I take them. My first Dr. tested me because I was sleeping constantly. He asked me lots of questions about how I felt and had me on 3.5g of Amour. Then he died, and I feel my current dr. may be as clueless as I am. Looking over my recent blood work, I notice the only test I can tell would be thyroid related was TSH. It was 3.33. This Dr. has me on Amour 120mg. The Amour was at my request, because my first Dr. tried me on it after still feeling lethargic on synthroid. I had specifically asked that she test my thyroid because my energy level is low, and I wonder if that slows my weight loss. I go back in 3 months, could I get some advice on what I might ask for with my next blood work?
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Old 01-09-2017, 04:52 AM   #2
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If your TSH is 3.33 on thyroid Rx, then you are very under-treated. Most doctors who deal with thyroid, aim for a TSH of 1.0 as evidence of proper dosage.

Personally, with a TSH that high, I would not wait 3 months to get treated because you obviously need a change in dosage. Yes, your slowed thyroid will slow weight loss. Even at optimal dosage, we hypothyroids lose weight more slowly, so it's important to get to optimal treatment ASAP.
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Old 01-09-2017, 12:28 PM   #3
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Quote:
Originally Posted by Leo41 View Post
If your TSH is 3.33 on thyroid Rx, then you are very under-treated. Most doctors who deal with thyroid, aim for a TSH of 1.0 as evidence of proper dosage.

Personally, with a TSH that high, I would not wait 3 months to get treated because you obviously need a change in dosage. Yes, your slowed thyroid will slow weight loss. Even at optimal dosage, we hypothyroids lose weight more slowly, so it's important to get to optimal treatment ASAP.
Thank you Leo. Are there specific tests I should ask for? I'm pretty sure my current dr. doesn't understand much about thyroid.

I also am curious if I should give Synthroid a try, or stick with Amour?
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Old 01-09-2017, 02:32 PM   #4
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If you don't think your current doctor knows much about thyroid (and many don't), you should try to find one who does. Hypothyroidism is a lifelong condition, and it really helps to have a doctor you can trust--and who trusts you. For example, several times, my endo has changed my dosage based on my reported symptoms when my labs didn't indicate a change was needed. I've been with him over ten years, and he trusts me to report symptoms accurately--and the increased dosage turned out to be necessary.

As to what to test, many primary doctors only do the TSH because that's predictive of thyroid issues. But once you're diagnosed (as you are), the T4 and T3 hormone levels should be checked regularly.

I take Synthroid, but I don't know why you want to change. You mentioned that you still felt lethargic when you were taking it, but did you know that any T4 Rx takes 6-8 weeks to take effect in the body when you begin it?

What you take should be a decision between you and your doctor--and that's why you want a doctor who is 'good' at thyroid.
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Old 01-14-2017, 04:24 PM   #5
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I'll put in my 2 cents worth on this. If you didn't do well with Synthroid, my recommendation is to not go back on it. I did not do well on it either. I have been on Armour/Nature-Throid (same thing essentially) for about 30 years. It's not easy to find a doctor that will Rx Armour, so I would not run away from the doctor you have who *will* Rx it. I would have several tests done to show you the entire picture.

TSH is important for initial diagnosis, but Armour will lower the TSH levels significantly. I've been dealing with that recently and my research shows that Armour/NDT lowers TSH levels...moreso in the afternoon than morning hours.

The tests that show where you really are are specific and not just any T4 and T3 tests. Some are dinosaur tests or not known how to treat via them. The ones you want are FREE T4 and FREE T3. That tells you what your body has to use. It's like having a bunch of hamburger in the freezer, but you need to make a burger right now (sorry for my silly analysis). The regular tests show what is in storage...ie., your freezer. The FREE T4 and FREE T3 tests show what is available for you to use right now...ie., you can make a burger with the meat now and not have to wait for it to thaw...or in thyroid terms, for it to convert for use...and many of us (especially as we age) are not able to convert well at all.

The "average" dose of Armour is about 2 grains/120 mg. Some need more and some people need less to be "optimized".

You can run the tests on yourself without a doctor if the doctor won't run these tests.

Other recommended tests are TPO AB (I think that's right). It tells you if you have antibodies. It will let you know if you have Hashimoto's. Most women do, I don't. I'm hypo, but not having Hashi's. Treatment is the same, but it's good to know if you have antibodies as I think you need to test more often than someone like me.

Leo is right that it takes 6-8 weeks for the dose to convert/balance in your body. So, you want to test ever 6-8 weeks until the tests show the improvement you want and you FEEL!

There is a new book out that is written by an MD who specializes in thyroid and tells her story of doctors not testing her correctly and the nightmare she endured...thus going into the medical field. Anyway, she has basic levels in all these tests that are "be at this level or above" for most people. It's above the low end of the range. Her name is Dr. Amy Meyers (I think she's in Atlanta?) bug she has a book called "The Thyroid Solution" and it's excellent. I highly recommend it. You can also go to her blog/website where she has just listed the levels she feels are "low optimal" and the tests you should have run. Just google her and look for her latest blog and it will be most helpful, but her book is amazing. I got mine online.

Finding an excellent and knowledgeable doctor is very hard. Leo has been very very lucky. Most of us don't have that type of luck. I've lived where I am for 12 years and am knowledgeable (very), but still haven't found anyone that I would consider even barely competent when it comes to thyroid diagnosis and care.

It's great that you found this group and are asking questions. There are a few of us who have been on this forum for a long long time and are always willing to help/answer.

Hang in there....I would keep this doc and request more tests. If they won't run them (that's why the book is great...to show them what a specialist requires), then you can run your own (which is what I've been doing for over 10 years). But you need that medical person to Rx for you! So, don't give up on this doctor just yet. They "might" run the necessary tests and you can help teach them and they can help others with their newfound knowledge (if they are willing to learn).
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Old 01-15-2017, 06:35 PM   #6
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Thanks y'all! Great advice. I live in a small town, so my access to Drs is very limited. The one I have now listens to me when I have something to say, so I will be sticking with her until she stops. She tried to Rx a statin for me, but I let her know in no uncertain terms that I wouldn't take one. She was fine with that and hasn't pushed the issue. Hopefully she'll be open to hearing what I've learned about thyroid. Perhaps I'll have the new tests run before I go back for cholesterol blood work.
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Old 01-16-2017, 04:46 AM   #7
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Keep in mind that if your thyroid hormones are too low (i.e., you are under-treated and need a higher dosage), that will elevate your LDL.

When I was first diagnosed, my LDL was too high, but as my thyroid Rx took effect, it gradually went down to normal levels.

Doctors who don't understand thyroid will often prescribe statins when it's a dosage adjustment of thyroid Rx that is needed.
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Old 01-16-2017, 09:59 PM   #8
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Someone told me long ago that medical doctors have to offer statins if cholesterol numbers are high....or else they can be sued. Don't know if it's true, but I've always had high cholesterol (all family members have) and high LDL, but also very high HDL! Go figure. Even with my NDT, I've always been high with cholesterol and have always refused statins. They say that they don't do any good for women in studies, only really for men. Leo, you are lucky that your Rx lowered yours...mine has remained high forever. I think it's hereditary. But mine tested for big and fluffy so it's not the dangerous type. Yay to that.
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Old 01-23-2017, 05:05 AM   #9
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Someone told me long ago that medical doctors have to offer statins if cholesterol numbers are high....or else they can be sued.
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Shelley,
It is more about reimbursement. If a patient comes in and their BP is high and the md does not address it whether counseling was put in the chart regarding diet changes or the patient was put on meds the MD will not be reimbursed for the visit. At least that is how it is in the er. Our providers are being ding constantly because a person may come in with a finger laceration and their BP is high and the provider didn't address it in their charting. It is a no win situation...........
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