Endocrinologist

[Astara]

I asked my family practitioner (i usually see the RNP) if he would refer me to an endocrinologist. He told me that they would just be bored with me, they are for more serious thyroid problems (I have Hashimoto's). So I had no reason to doubt him. At my last (6wk) PP check up my midwife told my medicine dosage (200mcg) was just a little bit too high. she forwarded the paper work to my Dr. He put me back at my regular (pre pg) synthroid dosage of 137mcg. well its obv way too low and my hair is shedding very excessively and Im more tired than I should.. I went yesterday to re-test but im afraid they wont put it as high as I know it needs to be.. Is it true that endocrinologists only want to see ppl with serious thyroid conditions? the endo's also accept my ins. & my regular DR doesnt.

[littlemia]

I'm certainly not my endocrinologist's most exciting case (I have Hashimoto's, too), but he still sees me every six months. Everyone in my family who has Hashimoto's sees an endocrinologist, so it's definitely not true that they will only see people with serious thyroid disorders. As you know, hormones affect the thyroid, so it's possible that you could see a few dosage changes in the next year. I would definitely want to be under the care of someone I felt comfortable with and it appears from your post that you are not comfortable with your family practitioner's ability to treat your hypothyroidism. I would ask him again to give you a referral. If he refuses, I would consider finding another family practitioner.

Does your insurance require a referral from your primary physician to see a specialist?

[sublime311]

Here is an article for you:

http://thyroid.about.com/cs/doctors/a/needendo.htm

[*gemini*]

I also have Hashimoto's. When I first mentioned to my regular doctor that I intended to see an endocrinologist, she didn't seem very enthusiastic about it either. I went to the endocrinologist anyway and had my thyroid checked thoroughly ( including an ultrasound test and other blood tests that the regular doctor doesn't do ) and I'm really glad that I went. My dosage ( 50 mcg ) was apparently too low and the endocrinologist suggested 75 mcg and that I should go back to them annually for a check up including ultrasound.

My insurance requires a referral from my regular doctor but I received that without any problems.

Two opinions are better. :)

[WestieMomma]

An endo would definitely see you and it sounds like you need to see one. The only problem is that they often have a long wait to get new patients in because there is not that many out there..at least that has been my experience and I live in a large metro area. If you just had a baby I know it is very common for your levels to get out of whack during and after pregnancy. I would see what you latest labs show and if the doctor does change your Synthroid dose or not..maybe give it a few weeks to start working.

[Astara]

thanks to everyone for your replies.. I think I will ask for a refferal. It couldnt hurt? It just seems better to go to someone in this field that studied specifically for this..I had a feeling that that wasnt true.. I mean why would a DR be hesitant about that though? because they will lose money? I dont know..

I dont have to get a referral for insurance purposes, at the clinic the endocrinologists will only accept you if you get a refferal to them.

maybe give it a few weeks to start working.

hopefully there wont be much of a wait.. I know these levels are very wrong because I felt fine until they lowered my dose, they lowered it about 63mcg. To me that seems drastic, I should have said something at the time cuz I thought that then too. Thats when my hair started falling out and ive felt tired and today I had a massive panick/anxiety attack.(i've been on this dose for about 3 weeks and it just gets worse.. I mean my hair is falling into my daughters mouth just by me hanging my head over her face to talk to her) It just makes me feel uneasy about my FP, KWIM? :) Thank you all for posting~

[mandersald]

i have hashimotos as well and see an endo regularly. while my visits with him now arent that exciting since he basically tells me the same thing every time because my hormones have found some stability, i like seeing him as opposed to my gp for thryoid issues. especially since you haven't found a good dose of synthroid, and being 6 weeks pp, i think seeing an endo would be especially wise. and also remember that even though the normal tsh levels are like 1-5 or something, (i really just made that up, but i think its something like that.) what is normal for you could be completely different. and, i think endos are more sympathetic to that view point. plus, an endo could give you some different tests (different blood work and/or an ultrasound) that might prove useful. stand up for it!

eta: i agree that going from 200 mcg to 137 was a bit drastic. i know snythroid comes in 150 mcg (cause that's what i take) so maybe, hopefully, that's what they'll suggest. depending on when your last bloodwork was done, it might be too soon to notice. my doc usually recommends at least 6 weeks after changing my dose before retesting.

[littlemia]

I forgot to ask- does your doctor give you a copy of your bloodwork? If not, I would ask for it. I think it's helpful to track your levels versus your dosage versus how you are feeling at the time.

[Astara]

No, but thats a great idea! I think I will start requesting that :) Thanks~

The office called me back yesterday to tell me that my levels were still too high so they had to lower my dosage again. to 42mcg. I freaked out!!!! I hadnt been that low since I was like 14! So, I was like um no thats way too low. she said she would have the DR call me back. Another nurse called me back like a half a minute later to tell me that my dosage was changed to 112mcg not 42. Then She answered all my questions I had.. and my hair is probably falling out because im 3 mo.s Post Partum. I had no idea giving birth could affect me that way. I wish OB's or whoever educated people a little more as to what to expect PP as well. I have no reason to doubt my FP since, i've always had pretty much normal levels with them.. even though its the DR and not the RNP.

[lisariv]

I started reading this thread and before I read your last post, I was going to tell you that hair falling out (and extreme tiredness and exhaustion) PP is perfectly normal. I had both happen to me. My hair didn't start falling out until around 3-4 months and then didn't stop until close to a year. For the first couple months, I lost hair by the fist full. I had a receeding hairline for a while until it started growing back in.

However, I agree with what a lot of the others have posted. I definitely think that seeing an endocrinologist is a good idea. You won't be boring to him/her, that's what she does. I see an endo for my Hashimotos and wouldn't think of relying on just my GP for it, especially with all the adjustments that need to be made PP. I also agree that it's important to get a copy of your lab results. My only additional suggestion is that you get your blood drawn BEFORE your appointment, that way you can discuss your results and any necessary changes to your dosage when you see the endo. HTH!

[savannahgrl]

I asked my FIL about this. I read this thread last week (he is an endo) he said that they do not consider them boring at all. You need to see one.

That is awful that your FP told you that it would be boring to them. It sounds to me like he was worried that his client was going elsewhere.

I would go to get things cheked out! Good luck!

[alegria]

Sounds like you have gotten a lot of good replies. I just wanted to add that I, too, have Hashimoto's, and my synthroid dosage is much lower than yours. That said, until I recently moved, I saw an endocrinologist every 3-6 months. I liked knowing that a doctor was specifically watching this condition. I also need regular ultrasounds to monitor a lump (supposedly non-cancerous) in my thyroid, and I'd rather have an Endo doing that than a general doctor.

Good luck in your quest!