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What do I say to the doctor so he will order the right tests?

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Old 10-22-2008, 08:26 PM   #1
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What do I say to the doctor so he will order the right tests?

Hi all. To make a long story short...graves diagn. in january 2008, went on methimazole and propl. for heart palps., did fine, but had a tt in june of this year as 'treatment' for graves. I was put on 0.100mg of synthroid for 2 monthes and had my levels checked. My tsh was .10 on a scale of .50-5.00. The doc refused to do the ft4 test like my endo did. So, he reduced the synthroid to 0.075. It is almost time to retest after 2 monthes on this new dose. So how or what do I say to him to convince him to test ft4 also? I am not savy enough to know why I need that tested, but lots of people on this board say they should check that. What does ft4 readings mean? Or how can I ask him to test it and sound like I know what I am talking about?
I feel like crap and have gained about 12 pounds since june. My stomach looks like I am 6 monthes pregnant....what's that all about? I am extremely saddened and kind of depressed on how being hypo now is turning out for me.

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Old 10-23-2008, 11:32 AM   #2
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osteoblast HB User
Re: What do I say to the doctor so he will order the right tests?

Lucy-sorry to hear that it has been so hard for you. I am not an expert on the tests but it seems testing the tsh and the free t's is what is considered current best practice. Hopefully someone will comment on the best tests for you to have.
About getting the tests you want from your dr. Well, that is something I can comment on.I have been to several endo's since being diagnosed hypothyroid due to hashi's and also having a mass found.
My experience about tests can be summarized as follows --
The younger more with it endos always test tsh along with free t's and are amenable to do other testing you want and should have like ferritin(iron storage) and vitamin d.
The older more established endos don't generally test free t's and act put out if you make a request for tests they have not ordered for you. When my thyroid mass was found and I went to a thyroid cancer specialist to review my case, I had thought of transferring to him but --he said he wouldn't test free t's and acted so put out by my request. He finally gave in and said he would check --I think it was the t3. One or the other but didn't see any sense in both. I decided to keep my other endo who will do the tests and see this guy if I need to in the future just about the thyroid mass.
While this sounds a bit ageist , it has just been my experience.
Also I have found that you have to take drs. as you find them--meaning you are not going to change them. And, if you want to change them you may as well move on to someone you are more in synch with. It saves alot of anguish . But, this is just my experience.Some people may live in an area where they really do not have much of a choice of drs. or are limited by their medical plans and/or finances which is a limiting factor at a point for almost everyone. So, basically to respond to your question "what to say to get the tests you want" I do not think it is so much a matter of what you say to the doc, it is basically their orientation and how they have decided to do the testing and that is it. Best of luck to you in getting the tests that you want and that will help you to feel better.For your health and well being you should take the steps you can to push for what you need.

Last edited by osteoblast; 10-23-2008 at 11:36 AM.

Old 10-23-2008, 04:13 PM   #3
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GravesGirl73 HB UserGravesGirl73 HB User
Re: What do I say to the doctor so he will order the right tests?

Tell him this"people with Graves disease(you still have the antibodies) tsh is falsely decreased by the thyroid stimulating antibodies(TSI)." Also the FT4 is what your body has available to use right now. Yours must be too low, and that's why you feel crappy.I hope this works!

Last edited by GravesGirl73; 10-23-2008 at 04:14 PM.

Old 10-23-2008, 05:45 PM   #4
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Re: What do I say to the doctor so he will order the right tests?

Look over these threads:

These are some threads I composed a while back that go over the basics of thyroid care and concern.

FT4 is a FREE thyroixine hormone test. This is the test that measures the active T4 in your system It is what your body converts into T3 the main metabolic fuel for every cell in your body. You need both to function. IF your MD is not watching both the Ft levels in conjunction with your TSh they are not managing your care properly in my opinion.

If we learn by our mistakes, I am working on one hell of an education.

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