New endocrinologist

bluepotatoes66

So I get to see a new endocrinologist on Thursday, because I wasn't a huge fan of the last one.

However I am unsure how to bring up the fact that I think I need a higher dose of my NDT (Armour) despite the last TSH reading being just fine - I am getting symptoms that indicate to me that I am headed into a hypo period because of insufficient meds. This is the main reason I am seeing the new doc in the first place: My GP basically threw her hands up in the air and said "This is beyond my area of expertise, you need to see the endocrinologist again".

If they want to test again - would it be worth asking for Free T3 in addition to the Free T4 they normally run? I suspect that may be where my problems really are, but I am not sure.

Also on the same note - I know there is a test to test for the antibodies for Hashimoto's, but for the life of me I cannot remember what it is called - does anyone remember? For anyone that has had the test, does having a definite diagnosis help with your level of care?

Sorry for all the questions, just nervous about meeting a new doc whose treatment philosophy I don't know.

lindsey1979

bluepotatoes66 wrote: »

So I get to see a new endocrinologist on Thursday, because I wasn't a huge fan of the last one.

However I am unsure how to bring up the fact that I think I need a higher dose of my NDT (Armour) despite the last TSH reading being just fine - I am getting symptoms that indicate to me that I am headed into a hypo period because of insufficient meds. This is the main reason I am seeing the new doc in the first place: My GP basically threw her hands up in the air and said "This is beyond my area of expertise, you need to see the endocrinologist again".

If they want to test again - would it be worth asking for Free T3 in addition to the Free T4 they normally run? I suspect that may be where my problems really are, but I am not sure.

Also on the same note - I know there is a test to test for the antibodies for Hashimoto's, but for the life of me I cannot remember what it is called - does anyone remember? For anyone that has had the test, does having a definite diagnosis help with your level of care?

Sorry for all the questions, just nervous about meeting a new doc whose treatment philosophy I don't know.

The two most common thyroid antibody tests are Tg and TPO. But, docs will also look at scans of the thyroid for inflammation.

Definitely ask for Free T3 and Free T4. TSH does not always show the whole picture -- especially for those with Hashi's. The Free T3 and Free T4 numbers are more helpful, but even those may be limited if you have Hashi's as it's impossible to know how much the antibodies are blocking the hormones -- it could be 5% or it could be 95%. That's why it's soooo important to see an endo/doc who also looks to your symptoms in addition to the tests as tests can give an incomplete picture.

I think this article does a good job of explaining the various tests, especially for Hashi's patients and the importance of also taking clinical symptoms into account: http://www.thyroid-info.com/articles/woliner.htm

In addition to your thyroid, you may want to have other things checked if you haven't already -- adrenals (DHEA, cortisol, etc.), blood sugar (A1C), liver enzymes, common vitamin/mineral deficiencys (D, magnesium, iron, iodine, etc.) as deficiencies in some of these areas can have some symptoms that are very similar to hypo symptoms or can acerbate hypo symptoms.

Good luck!

editorgrrl

A good endocrinologist will adjust your meds based on both your levels & your symptoms. I was diagnosed with Hashi's via an ultrasound (+ maybe an antibody test, but I don't remember), and the only way it affected my care is that my endo explained my thyroid may over- or underproduce in response to the attack.

You just have to "test drive" endos until you find one that listens to you.

bluepotatoes66

lindsey1979 wrote: »

The two most common thyroid antibody tests are Tg and TPO. But, docs will also look at scans of the thyroid for inflammation....

In addition to your thyroid, you may want to have other things checked if you haven't already -- adrenals (DHEA, cortisol, etc.), blood sugar (A1C), liver enzymes, common vitamin/mineral deficiencys (D, magnesium, iron, iodine, etc.) as deficiencies in some of these areas can have some symptoms that are very similar to hypo symptoms or can acerbate hypo symptoms.

They've looked at my scans before and they are relatively inconclusive - what they got from them was "likely Hashimoto's" - I have nodules that shrink and grow semi-randomly - caught them on one ultrasound, gone on the next.

Adrenals I haven't had looked at. Blood sugar is doing good - had a fasting test done about three months ago, along with liver enzymes, and D and magnesium - all relatively good. Have to supplement for the D as it is low, but I have done that. The other ones I may ask about, depending on what the recommended course of action is.

editorgrrl wrote: »

A good endocrinologist will adjust your meds based on both your levels & your symptoms. I was diagnosed with Hashi's via an ultrasound (+ maybe an antibody test, but I don't remember), and the only way it affected my care is that my endo explained my thyroid may over- or underproduce in response to the attack.

You just have to "test drive" endos until you find one that listens to you.

I'm hoping this one is good - I read her description on the medical center's website and chose her based on that, so I'm a bit nervous - the last one was stuffy and very academic.

indianarose2

I always look up doctor reviews and recommendations on Mary Shoman's about thyroid website. Good luck and don't give in to under par treatment!

bluepotatoes66

Well, I did get in to see her and she's a bit of a mixed bag.
Seems to be okay with including T3 in with T4 only meds (but not a huge fan of Armour). Does seem to believe in open communication between patients and doctors, so we'll see how well this works out.

editorgrrl

Your endo sounds way better than mine. Happy NSV (non-scale victory)!

Fuzzipeg

Hope she comes up with the goods in the longer term for you. So many of us may well be envious.