new endo. will only medicate to TSH - Question and Answer Forum - Elaine Moore Graves' Disease and Autoimmune Disease Education

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Saturday, August 17, 2013

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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.

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new endo. will only medicate to TSH

3/20/2012 5:59 PM

Joined: 12/14/2010

Posts: 25

new endo. will only medicate to TSH

Hi Elaine,

I just saw a new endo. and we had a very frank discussion about my care with my previous endo. The first endo. told her all about me reducing my ptu and cutting up the pills into smaller doses. The new endo. said, "I will not medicate you to your FT4 levels, only your TSH". She wants me to go on 50mg PTU until my TSH rises to .36. She refused to see me again unless I do this. My primary care doctor will not see me either. I'm really not sure how to go about finding an internist, gp or osteopath near central Texas that will medicate to FT4. This is so frustrating.

Here are my last couple of labs:

3/19/12 taking about 3mg ptu every 4th day(gp. told me since my TSI was elevated I'd better get back on ptu while waiting to see the new endo.) So, between last month and now I only took six tiny crumbs of ptu total.

FT3 3.1(2.3-4.2)

FT4 1.22(.76-1.46)

TSH 0.25

2/16/12 taking no ptu

FT4 1.24(.76-1.46)

TSH .30(.36-3.74)

1/9/2012 taking about 3 mg PTU every other day

FT3 2.6(2.3-4.2)

FT4 1.05(.76-1.46)

TSH .27

12/5/11 taking about 3 mg ptu

FT3 3.0(2.3-4.2)

FT4 1.12(.76-1.46)

TSH .21

Questions:

Do my labs on 3/19/12 look ok?

Is there a way to get labs drawn through a private company w/out a doctor's(medical person) orders and still be covered under my insurance?

I am in a state of disbelief that I am a graves patient with no doctor. I'm at a loss as to what to do next and haven't been sleeping well for the past two weeks.

Thanks for all your help Elaine.

Karen

3/22/2012 1:59 PM

Elaine

Joined: 8/1/2008

Posts: 4841

Re: new endo. will only medicate to TSH

Modified By Elaine on 3/22/2012 2:01:16 PM

Hi Karen,

On a 50 mg PTU dose, your TSH will rise well over 0.36 in short time. You're essentially in remission as you're secreting TSH normally even without PTU. When was the last TSI level that you had? I'd go without PTU and either use Thyrosoothe at very low doses to reduce any symptoms or use dietary/lifestyle measures alone. You want to still have thyroid labs every few months and hopefully your GP will still order them. The dose of PTU that you've been on would be considered negligible and a higher dose would move you into hypothyroidism.

You can have labs without a doctor's order but usually insurance won't pay for them.

Best, elaine

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new endo. will only medicate to TSH

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