Doctor frustration

[Becky]

(((Indy)))

It has been my experience with my own endocrinologist and NP that they're willing to engage in discussions when I ask questions or push back a little. Don't be afraid to respectfully question why she's doing or not doing something. I think you're on the right path with self-educating and with questioning the lab order you've received.

If it were me, I'd keep the March appointment, especially since you're feeling "off" and it could take months to get an appointment with a new doctor.

As for the second opinion: I've never done it myself, but your insurance company may have a program for second opinions. It might be worth asking...

Good luck!

[indysteel]

Thanks, Becky. My boss and I just discussed this, too. He's not a medical expert or anything, but we share the same insurance, so he at least understands things from that perspective. He suggested that I keep the March appointment and that, in the meantime, I make an appointment with a second doc, too. I would like to give my doc a chance to discuss this with me, hopefully in a non-confrontational way. I certainly don't consider myself an expert on the thyroid, but I've read enough at this point to have a feel for some of it. I just want to feel secure that we're looking at the right lab values.

[bmccasland]

(((Indy))) - when you go for the 2nd opinion, make certain you take copies of your lab results. That will help Doc #2 see what you've had done.

[indysteel]

(((Indy))) - when you go for the 2nd opinion, make certain you take copies of your lab results. That will help Doc #2 see what you've had done.

Thanks for that sound advice; I was already hoping to get my hands on all of them. I have the last set, but not the first two. Is there a polite way to get them?

My doc did agree to order a broader set of labs, so I'll either have to talk to her about this issue when my results come in or when I see her in March. Now I just need to find another endo.

[jusdooit]

You are correct that in most cases a Free T4 is best for monitoring treatment. Sometimes in conjunction with TSH. It may be that FT4 is not immediately available at the lab where your testing is performed, which may influence her decision to order it. I would have a frank discussion with her about your concerns and let her know you've been doing some self education on the subject. A good physician will not feel threatened and actually respect your desire to be a proactive participant in your care. As far a getting copies of your labs, you should only have to sign a release to get them either personally or sent to another physician.
Good luck!

[Artista]

Indy, I just ask for copies of my lab reports in a friendly manner. I don't even offer an explanation for why I want them. The office personal have always accommodated my requests with no questions asked.

[indysteel]

Thanks everyone!

You are correct that in most cases a Free T4 is best for monitoring treatment. Sometimes in conjunction with TSH. It may be that FT4 is not immediately available at the lab where your testing is performed, which may influence her decision to order it. I would have a frank discussion with her about your concerns and let her know you've been doing some self education on the subject. A good physician will not feel threatened and actually respect your desire to be a proactive participant in your care. As far a getting copies of your labs, you should only have to sign a release to get them either personally or sent to another physician.
Good luck!

She's tested for FT4 before so I believe it's available. My last two labs show that it's low normal. My TSH is high normal so my assumption is that I'm oversuppressing. I may need to cut the dose again (and i had to talk her into the last cut). My dose is already so low that I have to wonder whether I need it all or am a candidate for block and replace.

[e3rdpower]

Agreed for sure on copies of your labs. I keep them all. Also make sure to ask for Free T3, as that is the active thyroid hormone. Some of us (I am one) do not convert T4 to T3, so we have to take a combination thyroid replacement. (I am on both Synthroid and Cytomel) It is very frustrating, as so many endo's are not versed in optimal thyroid treatment, especially for athletes.
Good luck and take care.