Doctor frustration

[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.

[Red Rock]

Just wanted to give you my 2 cents worth. I can understand your frustration, as that is how I have been feeling with my situation. I felt like since I had this thyroid thing, that I had to be better educated than the doc. However, now that I am with an endo who, I think is super educated and seems to understand everything. (He should with a Ph.D and FACE qualifications) Perhaps I will get real results.

As far as you are concerned, I would go with what everyone has suggested. Keep a record of all of your blood draws and results through time. Yes, its the FT3 and FT4 that show what is and is not happening in the thyroid. I have had to go back and reread some of my med tech books to get a better understanding of all of this. If your intrested look at a Clinical Chemistry book. It might tell you more than you want to know.

I like your idea of getting a second opinon as well as trying to talk to your endo in a reasonable manner.

Hope it all goes well and you can get some resoution.

Red Rock

[indysteel]

Just wanted to give you my 2 cents worth. I can understand your frustration, as that is how I have been feeling with my situation. I felt like since I had this thyroid thing, that I had to be better educated than the doc. However, now that I am with an endo who, I think is super educated and seems to understand everything. (He should with a Ph.D and FACE qualifications) Perhaps I will get real results.

As far as you are concerned, I would go with what everyone has suggested. Keep a record of all of your blood draws and results through time. Yes, its the FT3 and FT4 that show what is and is not happening in the thyroid. I have had to go back and reread some of my med tech books to get a better understanding of all of this. If your intrested look at a Clinical Chemistry book. It might tell you more than you want to know.

I like your idea of getting a second opinon as well as trying to talk to your endo in a reasonable manner.

Hope it all goes well and you can get some resoution.

Red Rock

Can I come to Colorado and se your doc? Maybe he'll give us a discounted rate!

I'm starting to learn what I think I need to know. Elaine Moore's website has been a big help in understanding not just my labs, but where I want my labs to be. I did get my blood drawn today and should have the results in 48 hours or so. How my doc responds to them--assuming they're "off"--will be telling.

[Catrin]

{{{Indy}}} Nothing constructive to say, just sending you good thoughts and hopes this eases soon. I've never had a question about getting copies of my test results.

[indysteel]

Well, labs suggest that I'm still oversuppressing, i.e., the anti-thyroid drugs are putting me into a mildly hypo state. That, unfortunately, is no better for me, especially as it relates to my eyes. My doc asked me to take my dose down again (to 2.5 mg every other day). That's a very minor reduction in my dose (I'm currently alternating between 2.5 and 1.25 mg daily), and I'm not all that confident it's going to do the trick. So, I left a message with my doc's administrator to discuss the possibility of using a block and replace technique. Per that technique, I'd continue to take an anti-thyroid med, but I'd supplement it with a small dose of synthroid or the like. Not only would it get my thyroid levels to a better state, but I've read that it can also be helpful for purposes of remission (which is my ultimate goal). If she's receptive to that, great. If she's not, I'm definitely going to seek a second opinion.