BellaOnline Forums Health and Fitness Thyroid Health Just Diagnosed - What questions should I ask?

I'm getting ready to jump all over my doctor tomorrow morning about this.

I was due for a military physical, so they sent me off to get blood work beforehand. I got the blood draw this morning, and less than three hours later I got an email from my doc. All it said was that I needed a low dose of meds, go get them, take them, we'll re-do the test in two months, and if you have any questions, c'mon in.

Heck yeah, I have questions! I'm going to ask what values were tested, what the normal range is, where am I, what type this is, etc. I may get ornery and demand a referral to an endocrinologist. (This prescriptions is based strictly on lab numbers, and my doc is a PA with prescription authority so you can understand why I'm leery)

When I look at lists of common symptoms, sure I have some. I've had most of them since I was a teenager, and this is the third complete set of blood work I've had in three years, so you would think it would be caught sooner.

My mother took Synthroid for 15 years, but was told she didn't need it when she was 36, and hasn't taken it since. I always thought the thin hair and nails were a genetic thing; my maternal grandfather was bald, and I just thought we got that from him.

Thanks for any advice!

It'll be good if you can get referred to an endo, but regardless, make sure your labs always include a complete thyroid panel of TSH , Free T4 and Free T3. (The Ts are best tested in the free form.) You want a dr. who respects the newer TSH guidelines according to www.aace.org , and who will test the Ts in the free form.

Good luck and thanks for your service!

TrishInNC,

Welcome to the forum!
The tests Fayge recommended in her post above are the best for evaluating thyroid function and all tested together in a panel as she stated is important or it may not be thorough enough. Some Dr.s want to use TSH-only to diagnose and restest patients on thyroid hormone therapy, to monitor the treatment but I feel the Free T3 and Free T4 should be added to diagnose and at least for the first couple of follow ups to monitor the hormone replacement.
I would only add that you should also ask your Dr. to order "thyroid antibodies" ( TPO and TG) for you, to determine whether the cause is autoimmune (the most common cause). While some Dr.s say "if you're hypothyroid it doesn't matter what the cause is" I disagree because a patient has the right to know what is affecting their body. It also places you at slightly higher risk for developing other autoimmune diseases if you do have "thyroid autoimmunity" causing yours and would be something to monitor as well.
Keep posting if you can and ask every question you like, commenting on anything and posting your progress, lab results, etc... as you can. As fellow patients we learn from one another's experiences.

Talked to the doc today.

My TSH was 5.9, but my Free T4 was in the normal range, so they're calling it subclinical, and starting me off with 25 micrograms of Synthroid.

The weird part is that the TSH screen was NOT supposed to be run. But it was, and here we are. This has also developed in the last year and a half, because I was having some insomnia issues back then and a screen was run to see if it was thyroid, but levels were normal then.

I'm pretty sure that unless I make a really big fuss, I'm not going to get anything more than follow-up tests to make sure my T4 isn't too high. Military medicine, while free to me, is sometimes not the best care out there.

Turns out this is probably genetic. My mother was diagnosed as hypothyroid over 40 years ago and took Synthroid for 15 years before she was told she didn't need it any more. She hasn't been tested since, but she has the same symptoms (or lack) that I do; thin hair, pale skin, (we're Irish/Eastern European, pale is normal) poor nails, always cold. We don't have any trouble with our weight though, and I always thought that was a big indicator.

You're fortunate to have a Dr. who recognizes the need in some patients, to start treatment because some will not even consider it until TSH reaches 10.0 and above.
This is another reason I mentioned about thyroid antibodies testing because when they are highly elevated some patients experience serious hypothyroid symptoms even with what are considered only mild, subclinically elevated TSH (hypothyroid) levels.
That's interesting about your mom no longer needing thyroid hormone replacement because for the vast majority of patients diagnosed with a permanent type of hypothyroidism such as the autoimmune type and some types of secondary hypothyroidism, the treatment is lifelong. Treatment for subclinical hypothyroidism according to medical research published by the National Institutes of health, reduces the risk for future heart problems, elevated cholestrol etc...
You're also right-on about the fact that thyroid disease is hereditary in a large percent of cases.