Drs appt today

[Goldenrescuemom]

I saw my primary Dr today. She says she thinks that 50 mcg of Levo is all I need but added 5 mcg Cytomel. I explained my continued symptoms and she said definitely no more Levo. She will order labs and I go back in 2 months. I asked about ferritin but not sure what she is ordering. She sends the lab orders to the lab. She says she will think about possible endo referral.

[FallingInReverse]

🤦‍♀️ US doctors throw up their hands when we don’t feel better at 50 mcgs then for some reason throw T3 at us.

Which probably sounds like heaven for our UK forum-mates… t3 without a fight : )

Your pcp has proven they know absolutely nothing about properly managing thyroid.

She didn’t even test your free T3!!! And so she nor anyone else on this planet know what your ft3 is, and therefore you will have no idea what 5 mcgs of T3 does for you when you test next. You will also NEVER know how well you convert. Which is a good thing to know if you can.

Best to not start the t3 until you get the right blood tests if you can.

Many UK-ers on this board will say hold onto that T3 no matter what. Fair point. But in a world where doctors knew what they were doing, she’d increase your Levo, retest in the next 6-8 weeks, and THEN consider adding t3. Or maybe more t4 for another round, but who knows because you don’t have the right blood tests.

I got T3 at exactly the same time you are, and I regret doing it out of order from increasing my T4 first.

What labs did she order? If you didn’t specify, pretty sure you won’t get the right ones.

What state are you in? Some states allow select blood tests without a doctors involvement.

Are you on private insurance? Does your insurance plan require a referral? Can you research your own thyroid friendly endo and accelerate that process?

Not sure your situation but this doctor is an obstacle to navigate around. If you listened to her you would remain unwell for way longer than you need to.

[Goldenrescuemom in reply to FallingInReverse]

I live in CA and I have a PPO. I need orders for all lab tests. I asked for specific labs mentioned here but she says she knows what she wants to test. She will send orders electronically to the lab.

[FallingInReverse in reply to Goldenrescuemom]

Yes - CA is one of the few states that forces us to go through a doctor even for a blood test. So that’s that!

I would strongly recommend you shop around for another PCP… one who is willing to at least listen to you and explain what they are doing and why. I’m also surprised your PCP is willing to manage your hypo… since they aren’t the least bit trained to do so ( as you are seeing.)

Perhaps when you get the results, ask her what they mean. If she has an answer for why she tests total T3, I’d love to hear it, as it’s a useless test for managing symptoms or dosing.

That being said - it’s probably pointless. When a doctor is uninformed curiously enough it seems to always go along with being supremely confident that they are not.

Let us know how it goes, if you stick with her, share you next blood test results when you get them. I do hope though that you get an FT3 result before starting the Cytomel.

[Mebythesea in reply to Goldenrescuemom]

hey fellow Californian here. I have a recommendation for a clinic group in SoCal that will see anyone virtually as long as you live in California I believe. They have an endocrinology specialty staffed by a few PAs. I e had good success with them so far getting appropriate treatment for my hashimotos. If you want to know more feel free to message me privately

[SlowDragon Administrator]

I followed advice here about testing before meds before 9 am

Was last dose levothyroxine 24 hours before test

Free T4 (fT4) 1.4 pmol/L (.8 - 1.8) 60.0%

So plenty of room to increase dose of levothyroxine…..perhaps initially to 75mcg and 50mcg on alternate days

retest in 8-12 weeks

Then probably room too to increase further after that

As soon as T3 is added, your TSH will suddenly reduce substantially and then it gets even harder to get any dose increase of Levo or T3

[Goldenrescuemom in reply to SlowDragon]

Yes I tested 24 hrs after my last dose of Levo and before 9 am ( I read that here ) I asked about increasing Levo and she said absolutely not but wants me to take the Cytomel and return in 2 mos after new blood work