I've been thinking about the fact that most endocrinologists seem to be expert in diabetes and only secondarily if at all in matters such as thyroid. Thyroid is treated in a simplistic way from a belief that it is indeed a simple matter compared with diabetes. Why do so many of them have no clue as to how to diagnose and treat thyroid sufferers? I think it is because the approach to diabetes treatment is fundamentally different, and to try to extrapolate diabetic treatment thinking to thyroid matters is fundamentally wrong. In diabetes, no hormone is totally lacking (rare to have zero insulin unlike for T4 in hypothyroidism), but simply in inappropriate levels, giving glucose problems and all that follows. Diabetes comes in several forms, in one of which diet can be a major help. It's therefore quite OK to experiment with insulin injection, drug levels and/or diet to come to a satisfactory outcome. But this isn't true for hypothyroid patients. The situation is stark and only open to one option. Often they have either no hormone at all made in the body or very much less than can support health. So the only recourse is not to drugs none of which can flail the failing thyroid into more action, but only supply of the hormone itself. Diet cannot cure the basic matter either. Furthermore, thyroid action is absolutely fundamental to the body and is closely and strongly maintained to obtain best outcome given the circumstances. So whereas the pancreas insulin is fluctuating quite strongly in amount, moment by moment, according to sugar levels, the healthy thyroid is much more stable in the amount of hormone it puts out at each moment.
Accordingly, it is quite wrong to use "diabetes" thinking in diagnosing thyroid problems, for example by withdrawing thyroxine to see what happens, as could be done quite legitimately with drugs and diet in diabetes, with a view to optimizing appropriate treatment. I think this is the problem when endocrinologists suggest the completely incorrect courses of action they do. They cannot reset their minds from the way in which diabetes is detected and controlled to a fundamentally different (and more restricted) way in which hypothyroidism should be approached..