# Doctor in Maryland



## Nickel395 (Apr 2, 2010)

Anyone know of a good doctor in Maryland that is willing to prescribe something/anything other than Synthroid alone for hypothyroidism? I'm getting frustrated with just more of the same. Please help!


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## Andros (Aug 26, 2009)

Nickel395 said:


> Anyone know of a good doctor in Maryland that is willing to prescribe something/anything other than Synthroid alone for hypothyroidism? I'm getting frustrated with just more of the same. Please help!


Hi there and welcome.

What do your labs look like? Have you had FREE T4 and FREE T3 done? You may not be converting.

How much Synthroid are you taking on a daily basis and how long have you been taking it?


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## Nickel395 (Apr 2, 2010)

I have been on Synthroid 100 mcg since February 24. I was diagnosed in September 2009 by my gynocologist with a TSH of 5.140 Interestingly I recently got a copy of my labwork from June 2007 from my GP and had a TSH of 5.132 and was told it was normal, same lab though (LabCorp)UGH! 
My carpal tunnel improved with 25 mcg(my starting dose) but no more improvements until the 100 mcg with slowing of hair loss finally but many many symptoms remain. I asked for my T3 level to be checked and the results are below.

March 1 2010
TSH 0.745 Range 0.450-4.500
Thyroxine(T4) 10.9 4.5-12.0
T3 Uptake
T3 Uptake 34 24-39
Free Thyroxine Index 3.7 1.2-4.9
Triiodothyronine (T3) 108 71-180

It doesn't say Free T3 anywhere on the lab report. And with my TSH in a normal range I think I may need something else. What do you think?
Thanks for your input.


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## Andros (Aug 26, 2009)

Nickel395 said:


> I have been on Synthroid 100 mcg since February 24. I was diagnosed in September 2009 by my gynocologist with a TSH of 5.140 Interestingly I recently got a copy of my labwork from June 2007 from my GP and had a TSH of 5.132 and was told it was normal, same lab though (LabCorp)UGH!
> My carpal tunnel improved with 25 mcg(my starting dose) but no more improvements until the 100 mcg with slowing of hair loss finally but many many symptoms remain. I asked for my T3 level to be checked and the results are below.
> 
> March 1 2010
> ...


Your Total 3 is below mid-range which leads me to think that you are under medicated. You have only been on the 100 mcg about 6 weeks it looks like? I would give that another 6 to 8 weeks "because" your TSH is in a good place.

Total 3 is bound, unbound and sometimes even rT3 so you see; we do need a FREE T4 and FREE T3 test somewhere along the line to be sure as the Free is the unbound hormone available for cellular uptake.

Here is a good site to explain thyroid lab tests.......

Understanding thyroid lab tests......http://www.amarillomed.com/howto/#Thyroid

It's too early in the game because you simply may not be getting enough T4 to convert to T3.

However, If you want to know if you would benefit from adding T3 to the mix, the only sure way to tell is to get a FREE T3 lab test.

You would have options at that point. Cytomel (synthetic T3) could be added to the Synthroid or you could try Armour (T3 and T4 dessicated porcine) or WestThroid, NatureThroid or a compounding pharmacy.

Talk to your doctor about all of this and let us know.

With the Total 4, I can't even tell what the FT4 amount would be that is available for conversion; sadly.

See how your doctor responds to your request.


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## Nickel395 (Apr 2, 2010)

My mistake, I actually started 100 mcg on January 27(I looked at the wrong Wednesday) so my labs were checked around the 5th week of treatment and I am now at 10 weeks this Wednesday. Thank you for the info and link, I'll let you know what I find out.
Thanks again.


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## Andros (Aug 26, 2009)

Nickel395 said:


> My mistake, I actually started 100 mcg on January 27(I looked at the wrong Wednesday) so my labs were checked around the 5th week of treatment and I am now at 10 weeks this Wednesday. Thank you for the info and link, I'll let you know what I find out.
> Thanks again.


And I meant to mention to you that asking your pharmacist "which docs" Rx's these things for their patients is one good place to start.

You are welcome; we aim to please!


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## Lovlkn (Dec 20, 2009)

Nickel395 said:


> I have been on Synthroid 100 mcg since February 24. I was diagnosed in September 2009 by my gynocologist with a TSH of 5.140 Interestingly I recently got a copy of my labwork from June 2007 from my GP and had a TSH of 5.132 and was told it was normal, same lab though (LabCorp)UGH!
> My carpal tunnel improved with 25 mcg(my starting dose) but no more improvements until the 100 mcg with slowing of hair loss finally but many many symptoms remain. I asked for my T3 level to be checked and the results are below.
> 
> March 1 2010
> ...


Who is currently treating you? The reason I ask is they are using all the WRONG tests to track your thyroid hormones.

To accurately know where your levels are yu need a FT-4 and a FT-3 along with the TSH.

If your doctor refuses you can get those tests at www.healthcheckusa.com

Thyroid Function Profile with TSH, Comprehensive cost $85


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## Nickel395 (Apr 2, 2010)

My GP was treating me but I saw an endo last week that basically told me from the labwork above that my thyroid was fine and I should try Jenny Craig and go back to my GP for an antidepresant. I have an appointment with another endo next week and I'll keep trying different ones till I find one that understands. It is frustrating.


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## Andros (Aug 26, 2009)

Nickel395 said:


> My GP was treating me but I saw an endo last week that basically told me from the labwork above that my thyroid was fine and I should try Jenny Craig and go back to my GP for an antidepresant. I have an appointment with another endo next week and I'll keep trying different ones till I find one that understands. It is frustrating.


I cannot tell you how many times I have been told this. I am so angry for you! How insulting and demeaning can you get? And you have to pay for this on top of it.

Let us know about the one next week.


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## Nickel395 (Apr 2, 2010)

Second endo seemed to listen better than the first but said the don't routinely test Free T3 but said she would order it if I wanted it. I said absolutely!!! Here's what she has ordered: Routine-CBC w/differential w Platelet
Lipid Panel
Metabolic Panel, Comp>14
Adrenal-Cortisol,Free,Urine by MS+ (24 hr urine)
Growth-IGF-1 by blocking RIA+
Reproductive-Estradiol by ICMA
FSH
LH
Prolactin,Serum ICMA+
Testosterone,Total by ICMA
Thyroid-TSH
Free T4 Direct
Free T3
Other-Feritin,Serum
Iron and TIBS
24 hour urinary creatinine
Plus they will do another sonogram because of nodules and perhaps a biopsy
Did this doc get all the right tests ordered?????
Thank you.


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## Andros (Aug 26, 2009)

Nickel395 said:


> Second endo seemed to listen better than the first but said the don't routinely test Free T3 but said she would order it if I wanted it. I said absolutely!!! Here's what she has ordered: Routine-CBC w/differential w Platelet
> Lipid Panel
> Metabolic Panel, Comp>14
> Adrenal-Cortisol,Free,Urine by MS+ (24 hr urine)
> ...


Very very good. Glad about the sonogram and possible FNA (fine needle aspiration.)

When you get results, we need the ranges also. Different labs use different ranges.

I must comment that I find it strange this doc did not order any antibodies' tests.

Suggested............

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies),TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/understanding/conditions/thyroid.html

And I hope you really really get that Free T3 test. Sometimes they say that but .......................???


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## Nickel395 (Apr 2, 2010)

The Free T3 is clearly marked on the lab slip but I will ask while the blood is being drawn. My next appt is in 6 weeks and they want me to have the lab work done 2 weeks before. When I get they results I will post them with the ranges. Thank you again for all your help. I appreciate your insight and advice.


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## Andros (Aug 26, 2009)

Nickel395 said:


> The Free T3 is clearly marked on the lab slip but I will ask while the blood is being drawn. My next appt is in 6 weeks and they want me to have the lab work done 2 weeks before. When I get they results I will post them with the ranges. Thank you again for all your help. I appreciate your insight and advice.


I most definitely will be looking forward to seeing results and ranges. And you are most welcome. It is my fond desire to be helpful and supportive.


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## Nickel395 (Apr 2, 2010)

Finally saw the endo today. She lowered my meds from 100 mcg to 88. Said I was taking too much. She said that explains why alot of symptoms are reutrning. The pharmacy was giving me a generic and she gave me a new script saying "Brand name medically necessary" Hope this helps. Below are my latest labs. If you need all results for the labs that were posted earlier let me know, but they were all normal with the exception of my cholesterol being a little high.

T4, Free (Direct) 1.98 Range: 0.82-1.77
TSH 0.072 0.450-4.500Ferritin,Serum 119 13-150
Free T3 3.6 2.0-4.4
Vitamin D, 25-Hydroxy,Serum 37 32-100

Sono shows a nodule of over 1 cm on the left so they are doing a FNB July 1
Also have a smaller nodule on the right so they will watch it at this point. 
Thoughts????

Thanks again.


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## Andros (Aug 26, 2009)

Nickel395 said:


> Finally saw the endo today. She lowered my meds from 100 mcg to 88. Said I was taking too much. She said that explains why alot of symptoms are reutrning. The pharmacy was giving me a generic and she gave me a new script saying "Brand name medically necessary" Hope this helps. Below are my latest labs. If you need all results for the labs that were posted earlier let me know, but they were all normal with the exception of my cholesterol being a little high.
> 
> T4, Free (Direct) 1.98 Range: 0.82-1.77
> TSH 0.072 0.450-4.500Ferritin,Serum 119 13-150
> ...


It is true and we will have to play the waiting game in order to know if this is true for you as well. It surely could be as if you are not exactly at the right place for you, you can become very symptomatic.

Your labs look very good. Not to worry about the FT4 being a tad over the top as this fluctuates on an hourly basis believe that or not. Perhaps that is another reason she decided to lower your thyroxine?

Your ferritin is terrif. Good for you!

Very very glad to hear about the FNB; this woman is on top of things. I hope that makes you feel relieved. Also glad you are on brand name only. It makes a difference to some of us.

I think this was a very positive appt.; what do you think?


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## Nickel395 (Apr 2, 2010)

I feel that the appointment went well also. Even though I did get a little emotional when she said she was going to lower my dose. But after she explained it I did feel better. The waiting game is the worst part, I feel as though I lose soooooo much "feeling good" time.


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## GD Women (Mar 5, 2007)

Your levels are just about like mine. Although my TSH was lower. Low TSH, High normal FT3 and FT4 even higher - out of labs.

Due to the fact that TSH fluctuates, my doctor goes by the FT4 when changing my med. dose. FT4 is more stable so when its off the thyroid is off. 
Actually there is a certain thyroid condition that thyroid is monitored by FT4 alone. Not say that you or I have this thyroid condition. 
I don't have much symptoms, however when my FT4 is off I am off, but when TSH is off I don't even know it. 
My last med. dose was changed to 88. So you are not alone in this frustrating thyroid issue.

Although I would like my levels to keep going hyper to the point I won't need to be on meds. any more and stay normal - am I dreaming.

Just keep hanging in there.


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## Nickel395 (Apr 2, 2010)

Thank you, I'll keep you posted on how things go with this dosage.


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