My endo's response for the 4 tests I asked for

" Treating the vitamin D and B12 deficiencies helps one feel better but it does not help the thyroid levels. I can test for the vitamin D and B12 but I would talk to your primary care provider about the need to check the other labs. "

"You now have hypothyroidism so please start levothyroxine 100 mcg daily. Please check thyroid function tests again in 4 weeks and you can also check the vitamin D and B12 levels. I do not recommend checking FT3 as this gives us information only on your thyroid levels over the past 24 hours. The TSH and FT4 levels are more helpful for dosing."

I am wondering if this is the typical thought of Endocrinologists? I think it's good she will order the B12 and D3. I will call my General Dr. and ask for the ferratin and folate, but what reasoning should I give him?

Thank you in advance, you shining thyroid angels!


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23 Replies

  • Once taking B12 further testing will show skewed results. Tell your Doc you need good Folate levels to support the B12 so need the test and Ferritin as you feel tired .... 😊

  • Ok, putting in a call now. thank you!

  • In the UK it is usually the General Practioner who checks for minerals/vitamins deficiencies. You should tell your doctor you have been advised that all vitamins/minerals have to be optimum and request the ones you haven't had yet.

  • Not taking T3 is potentially negligent, it could indicate the need for further considerations and yes it has a 12 hour half life or thereabouts but it shouldn't fluctuate wildly if your system is managing well so a snapshot is fair enough, maybe several snapshots at different times, before and after treatment changes etc. is valid to rule out complications and indicate how your conversion of free t4 is doing...... t3 does all the metabolic work, t4 is a hormonal messenger and the precursor/substrate for t3.

  • Thank you. Is it ok just to print up what you wrote and bring it to my general dr? There is a chance he may order the T3 test. I think he will comply with the ferratin and folate tests. I also don't understand not addressing the antibodies. Is it something that will take care of itself once I get into balance? Should I switch endocrinologists? How does one go about finding an Endo who sees the whole picture?

  • RKStarkey,

    In the UK FT3 is rarely tested unless TSH is suppressed <0.1. If you are unable to persuade your endo to test perhaps you can order private labs?

    If you have positive thyroid peroxidase &/or thyroglobulin antibodies you are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

  • I was hyper 3 weeks ago - seriously, with very suppressed TSH and super high antibodies. Nodule+ right thyroid taken out,and now I went from<.001 to almost 12. Before I had Graves, and now my Endo didn't mention what the high TIS means or what to do about it except know it's high. I naturally eat very little of gluten, in fact, I have a hard time eating food at all. I stick to my farm grown eggs, and grow most of my greens and all my tomatoes. I don't eat very much at all, and still I've gained 3 sizes this yr, being very hyperthyroid. I will first check with my General Dr. (they're called PP-preferred provider here) and see what he says about ordering private labs. I've not done that before. I have 2 other drs at the UW in Seattle, and will see about plugging into their endocrinologists also. Also some of my bloodwork this past year is labeled 3rd and 4th generation....any idea what that's about? T3-3rd generation, t4-4th generation..

  • RBStarkey,

    TSH responds to circulating T4 and T3 hormone. When T4 and T3 are high TSH will be low. Conversely, when T4 and T3 are low TSH will be high.

    If TSH is high post hemilobectomy you have become hypothyroid. If TSH is over range you will need thyroid replacement.

    3rd & 4th generation refers to the age or status of the lab analysis machinery used to analyse your results. 4th generation is, I think, the most recently manufactured machine.

  • when I had very low TSH my T4 was in range( 1.30 .70-1.48), and T3, I don't believe was ever tested. Thank you for the generational answer - I thought it had something to do with T3. This is so hard to keep straight, and to understand...almost like electricity. My mind just wants to shut down.

  • Would you recommend I send my endo this link? I am thinking this one would be good too, but I am so afraid of offending her.

    Do you think there is anyone on this site who might know of a good endo in Seattle Area?

  • I've been reading posts here for several years now and yes, they are easily offended. I'll add that most are unwilling to change their mentality. I'm in the U.S. also and find it very difficult to get a doctor to read articles or even the research so most of us are here to learn what we need to know about this condition so we can supervise our own treatment. It's almost dangerous not to. You can try to find a better doctor but I just use a Physician's Assistant and tell her what I want in the way of tests and hormone but I'm older and she knows I've learned a lot so she doesn't argue with me.

    As I said before, how does she know you are hypothyroid? Does she also call it hashimoto thyroiditis? I have doubts about her.

  • Most people here are in the UK so it's doubtful.

    You need to start educating yourself RK. I use his videos all the time but there are other good ones.

  • Hi RK, it just occurred to me that there was a great SIBO summit that took place in the Seattle Area. They were either gastroenterologists or naturopaths but not endocrinologists I don't think. Shivan Sarno was the narrator if you go to Facebook she has posted some parts of the conversations. Evergreen Summit #1 Landing Page shows the 20 doctors and a few samples.

  • Hi RH, doctors are still in the dark ages even in the U.S. but mine will at least do the essential thyroid tests. If you look at labs like Genova, they offer TSH Ft4 Ft3 reverse T3 and antibody tests as a package. You need them all to make an evaluation.

    Do you still have half of your thyroid? Perhaps you don't need more hormone if you feel hyper when adding it. Why your doctor would decide you are hypo without seeing an FT3 level is strange since that is the more definitive test. If you are hypo, it will be below range.

    Your doctor is ignorant.

  • Thank you Heloise. She is very young, and I was assigned to her when I was getting free medical (no longer the case). You confirmed my thought of switching.

  • Autoimmune conditions are multi-faceted problems. I also like this man on You Tube who gives all the causes of this condition.

  • Yep, I have something,but somehow this hormone replacement will make it all better. Today I took my first dose of the levothyroxine, and have had a low-level stomach ache since. I have never had stomach issues, and am wondering if this is a common side effect?

  • I haven't heard that complaint but I have read that the stomach lining can be inflamed with autoimmune conditions. Maybe it will pass as you become accustomed to levo. I had some harsh reactions when I started on Synthroid with serious muscle spasms up my spine.

  • my surgery site got infected, and I ended up pulling out a big knot which I cut off, so they put me on antibiotics 4'xs a day, and I had to take my once a week bone-growth pill which must be first thing in the morning, empty stomach, and can't eat for 1/2....I took all 3 at once, empty stomach. I won't do that again.

  • Antibiotics always make me sick. I hope that "bone growth" pill is progesterone and hydoxyapatite calcium and not boniva.

    If this means you are older I would cut that levo pill in half for a while. I think 100 mcgs. for a starter is a little high. If you were hyper at one time and I assume that was before your surgery your FT4 above is high also. If that was previous, what is it now?

  • t4 is .6 range .6-1.6 and this was 2 weeks ago, 2 weeks after surgery. 4 weeks with no meds. Do you mean,take it in the am and then pm ?

    Here is when I was first diagnosed hyper:

    Free T4 1.30 ng/dL 0.70 - 1.48 ng/dL

    bone growth, is because i was one every 6months of Prolia, missed one shot, and had 12 fractures, which now they are walking me off of Prolia so it doesn't happen again. They drop my dose every 4 months, I should be completely done in 6 months. Its alendronate. I hate the thought of being on it, but they don't know what else to do for me.

  • Prolia is now standard bone growth shot they are giving to most people if they have insurance, if they had chemo.

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