I can appreciate your frustrations, I once has a Dr who told me "what do you expect? you have four kids and you work full time" when I complained about still having symptoms. Needless to say that was the last time I ever saw him! I know that every situation is different, but here's a thought, have you had your blood sugar checked? That turned out to be my problem. I'm not diabetic, but was getting very close. The sluggish and tired feelings I've always had have been gradually improving, I wouldn't say eliminated, by treating to lower my blood sugar.

I hope you find resolution to your situation.

This is a very difficult position for you. In fact the diagnosis I got was from my primary health care doctor (GP in the UK) and apart from one very brief interlude with an endo (who told me to live with it and manage it) I have worked with her. Whilst not great (and not very sympathetic) I have achieved good management.
The recommended endo 8 hrs away may be worth a visit: but if it were me I would get my tests first before I went to save a second visit. Even the best endo won't have a magic bullet (sadly......) I think they get frustrated by this and dismissive.

I am currently booking an appointment with a dietician as my doctor feels I may have a contributory vitamin B12 deficiency- easy to identify and remedy with patches. I am attempting to remove factors which 'muddy' the position. My diaries and print outs from this site and others (see later) allow me to prove my diet is ok, that I exercise and I manage my blood sugar. I am now within normal BMI (not maximal I know) but can't be fobbed off withe you are fat, lazy and eat rubbish lecture. Still get the -its your age, the menopause (no longer relevant as I am post menopause). So at the end of it we have anemia or eccess iron (quick and easy test), diabetes (quick easy and monitored) dietary deficiency (now tested), hormonal (adrenals, thyroid parathyroid) hardest to test and poor sleep hygiene (monitored with fit bit ultra). That leaves, allergy (eliminate crap) IBS (not relevant for me) Parasites (take a dewormer), yeast problems (tongue examination etc easy). Finally environmental poisons (move house, go on a long hol, stay with friends for a while) and finally other diseases (MS, PVF etc....). Only a few of these need an endo.

In fact some of the best advice may come from fellow suffers who have found myriad solutions. Fortunately I thik this s is a good site as it includes those of us who use diet and exercise as well as meds to manage our condition. Already I have new avenues of help. The reason why thyroid is low may vary- autoimmune,secondary, dietary, inactivity, obesity and deficiency. These can be in combination too, so an endo may identify some but not others. Sometimes it is a question of finding a sympathetic GP- mine allowed me to try T3 but as it didn't help any I stopped it- I am able to convert T4 to T3 quite well. Another issue was that i wasn't consistent enough taking my T4, early in the morning on an empty tummy; doing as I was told made all the difference. Duh! Beginner's error. Alcohol and coffee in the evening make me worse as does diet cola and foods with aspartamine. Largely - I have concentrated on eliminating those things that made me feel worse, I closely monitor my diary here and I have a fit bit ultra (sleep monitored and it links here). I also monitor blood sugar and online log that but largely now I have given up sugar, caffeine, artificial sugar, and alcohol so those are not a factor. As I exercise a great deal then my marginal type 2 diabetes gives me no sugar crashes. But I track it. I also track body temperature especially in the winter and ketones in my urine for protein breakdown). I have a heart rate monitor too, but actually now only use that during exercise but at first my heart rate and blood pressure were all out of control because I was so unfit. All of these things are cheap to do.

So here's what I did and my primary aim is to feel well (not to be thin!):
1. Blood sugar stabilisation (used tryptophan and glutamine supplements - I now need neither) elimated simple sugar and processed food together with alcohol and coffee- afternnon naps where neccessary
2. Exercise regime (trying different programmes, different times of day, different combinations etc) reducing overall non-exercise stress, trying meditation and hypnosis
3. TSH tests and free T3 and T4 trying different meds at different times
4. Eating regime (my current phase- adding foods and taking them away) currently trying Coconut oil, cutting complex carbs at lunch helped a little
5. Weight loss slow and steady and gradually approaching goal
6. Deficiency testing- B12 and Bvits (just been done= now using patches)
7. Testing for other glandular issues- adrenals et al

I have found medication levels vary considerably almost day by day so achieving the maximum position may not be possible. For example most of the time I am happy on synthroid but need extra in the winter. Very heavy exercise helps me most of the time but occasionally I am almost permanently exhausted. My diet has to be pristine and without thyroid inhibitors most of the time but at others my body is tolerant. It is a moving target that no endo can manage for you, until there is a thyroid test kit like a diabetes test kit then we are guestimate land.
I emphasise with your position and understand how hard it is to get real consistent help and how tiring to fight your corner. This is an expensive condition to manage but you are doing all the right things for you. You seem to be doing most of the same things I mention but I sense you feel isolated and unsupported by your medical care.

Keep on posting and let us know how you get on, I am concerned as have trodden the same journey and know how hard this is.

Jasmin

I don't know where you all live, but here in Nevada if you want the labs to send you a copy of your results you can sign a request form each time you go in to have them done. I do that and then read info to help me figure out where I am or should be. I take that with me to the doctor and go over it with him. I have found an Endo that is awesome. Either he helped write STTM or has read it himself. lol. He is right on with his explanations and cooperation. If anyone wants info on him and you live near Reno, message me and I will give you his name.

Ginny:flowerforyou:

Here's a good article. With some great suggestions for dealing with an uncooperative Dr.
http://thyroid.about.com/od/thyroidbasicsthyroid101/a/Challenges-To-Getting-A-Proper-Hypothyroidism-Diagnosis.htm?nl=1