SO sorry to hear of another trip to the ER!!!

I can empathize with the thoughts of death. I remember during the worst of my meds titration process that I often thought everyone would be better off without me.

As horrible as it is to find the need to go to the ER, one GREAT thing happened to you - you got a FreeT4 test.

That test explains EVERYthing!!!

FreeT4 .7 is at the bottom end (or possible BELOW the bottom end) of every single different range that any lab uses.

(the most common FreeT4 range is .8 - 1.8 or similar.....some labs use something like .61 - 1.12 or .7 - 1.48)

Without a doubt, you need that levothyroxine.

You might have read me mention that the meds titration process isn't for the faint-hearted.

I'm glad you were given ativan and, truly, that's the type of Rx most of us need to be able to endure the meds titration process. I know that Xanax was my best friend at times.

I wished I didn't need it but the alternative was needless suffering.

I have a VERY important question to ask.....we've asked you this before and the answer will help us help you.

What is your dosing history?

As in, what was your starting dose, how long before the next dose increase....in other words, how long were you taking meds before getting up to 175mcg levo and now, 200mcg?

I hope you realize just how much we're trying to help you.

We can only do so much without important information.

Please - help us help you and answer the questions posed to you.

We've been down the road you're on.....many are still on the road.

We'd like to help make your journey easier.

I think like CD is saying the process you are going through is probably giving you a lot of symptoms, especially if you went right to 175. Your tsh has dropped signifigantly, even though it's still way too high. Your FT4 maybe hasn't budged yet and that's why you feel like this. I thought for sure you were hyper because of your symptoms but I had forgotten your history of that high tsh. CD remembered and she thought it was you were still hypo and it was just the shift in your hormones that is making you feel like this. better to start off slow then try to get right all at once, unfortunately, thyroid doesn't really work like that. What was your FT4 a month ago? Also what was the first dose you were put on?

I read another post of TC40's on here quite recently wherein mention was made of 6 dose adjustments over the course of the past year.

It's quite clear that her FreeT4 level still needs a LOT of help.

Working towards getting the TSH down to 1.0 or lower will work in the interim.

Moving forward from there, getting the FreeT4 AND FreeT3 tests are imperative for achieving wellness.

TC40 - are you taking your levothyroxine at least one hour before/two hours after food/drink other than water.....and at least 4 hours away from any iron and/or calcium supplements?

This is an important part of making sure our meds do the best possible job for us.

Hi. I appreciate you guys soooo much!!! I wish i could answer the dose changes with an accurate answer, but i have had my dosage changed soooo much inthe past year that i honestly can't give you an educated answer :( the sad part is that my endo will NOT ORDER ft4 tests on me. The only reason i GOT ONE is because i saw someone in the ER!!! i am also running the risk of being "fired for being seen in the ER". I DREAD calling her office on Monday. I feel like i've been bad by going to the er and getting tested. I am going to get a notebook and start writing all my dates, doses, symptoms, etc...starting this past month.

Ive been on thyroid meds for many years. Like 9 years. I used to have a WONDERFUL endo, but he left town. Since i started going tothe endo i go to now, it sems like i started at .125 in the past six months, if memory serves me, ive been bounced around from .175 one day, .150 the other day, etc Most recently i was on .175 everyday. When i got my tsh of 64, she upped me from .175 everyday to .200 everyday.

TC, isn't there some way you could report what she's doing to ...... ??
someone on up the ladder? If she fires you over that, I certainly would. Or is the medical profession like another profession I know, "don't mess with one of us, or you'll regret it!"

Wow, am I getting paranoid?

Would she really fire you because you went to the ER?:

Sorry to hear of the rough time you are going through, TC40, and want to send you good wishes that you will be feeling better soon.

I'm pretty new to this group, so I don't know the past history of your situation. Are you in a situation where you are stuck with this doctor you don't seem to like or respect very much? Taking care of yourself is a great, positive step. You can't be "bad" for going to the ER or any other healthcare provider you might need to see,

Can you get your thyroid treatment and meds from someone other than this endo Dr.? My treatment, labs and meds are coming from my primary care Dr.

Hey TC40

It saddens me to read of stories like yours - doing well with a certain doctor who either retires or moves......and the patient doesn't really know exactly what the doctor did for him/her because it really didn't matter - the patient was doing well.

Then, a new doctor comes into the picture and things aren't going so well. Not going well for a thyroid patient means being besieged with symptoms that makes it hard to function.

Well, it's hard to do what it takes to achieve wellness when we're not feeling well.

I was in your shoes even though I know what it took to achieve wellness. My problem was that I "dated the wrong guy too long" (I stayed with a thyroid-clueless doctor for too long)

I finally became sick and tired of feeling sick and tired....and started interviewing doctors. I got lucky and met my current doctor on the 3rd attempt.

I know you said you live in a small town and there's only 2 endos in the town.

Well, there are NO endos in my town. My current doctor is an internist and she's just a 1/2 hour away. I'll be moving permanently to my second home (and selling my first home) in 18 months - I plan on driving the 1.25 hrs. it will take to see my doctor. It took too long to find her. Utahgal drives 2 hours for her doctor.

We do what it takes to achieve wellness.

If you'd like some suggestions on how to find another doctor, please let me know. I've accumulated several over the course of 5+ years of participating on multiple thyroid forums.

In fact, utahgal just shared a link to a site that brought me to a "Good Doctor List" and I created a thread about it yesterday:

http://www.dailystrength.org/c/Hypothyroidism/forum/15973254-possible-thyroid-doctors

Maybe someone on the list is "worth the trip". It all depends on just how much you want to feel better.

In reading about the additional info you provided, a few questions come to mind.

Firstly, are you religious in taking your meds every day and within the parameters I mentioned in an earlier post on this thread?

While I understand that each of us needs to take whatever dose we need to take to achieve wellness, you are taking pretty hefty dose sizes of levo as of late and I'm surprised that your levels aren't better.

I will not deny that I wonder if your endo is concerned about patient compliance......as in, are you taking your meds as prescribed? That could cause a doctor to dig in his/her heels.

If you have concerns that the endo will fire you because you're going to the ER to get labs vs. being scared of your symptoms, I'm not so sure I agree with that. Truly, why do you even have to call her tomorrow??

Your labs proved the need for your current dose of levo ***if you've been taking your meds properly all along**

Please don't feel ashamed of anything you might have done in the past. You've come here for help and we're not here to judge you.

Instead, we're offering advice that can help you achieve wellness.

You are legally entitled to hard copies of your lab results.

I think it would be a good idea to at least get last year's history so we can help you see what's been going on.

As I mentioned already, with your TSH being SO very high, you can make do with that for now because you really need to get it down below 1.0 before you have to start worrying about the other levels.

As you work towards that, you can be interviewing new doctors. It's clear to me that you'll need to widen your search to out-of-town but, again, if you want to feel well, you'll need to make that commitment to yourself.

For whatever it's worth, someone who has been taking thyroid meds for 9 years isn't likely to see a TSH as high as yours unless something is very wrong. That's why I asked about your dosing practices.

Once again, I've posed a few questions to you and your answers will put you a few steps closer to wellness.

What do you think?

@normalparanot

I was incredulous when thyroid forum members mentioned being fired by their doctors. I never heard of such a thing.

Well, it happens.

The thyroid forum member who helped me the most when I started T3 had mentioned the possibility and shared some stories with me. She actually cautioned me about things to be discussed or not to be discussed with doctors. She mentioned doctors "turning" on patients. Well, it happened to her during our association.

A doctor who had been practicing "thyroid-friendly" medicine stopped doing so for whatever reason. My thyroid bud speculates it was due to the fact that the doctor was a bit aggressive with her dosing practices and, supposedly, patients were calling when they were having symptoms such as the ones TC40 is having.

Perhaps word got back to the head of the practice and he/she had liability concerns. Remember - most thyroid patients are kept hypo.....doctors seem to think this is safer.

So, just as some people thought TC40 might be having hyper symptoms.....and patients themselves get confused with their symptoms, doctors will err on the side of caution....keeping the patient hypo.

I can't tell you how many people have come to forums thinking they were dealing with hyper symptoms because they had one or more of the following symptoms: elevated heart rate, hot flashes, anxiety, palps, insomnia.

When they shared their labs, it was clear they were hypo.

However, when doctors hear about what they consider "classic" hyper symptoms (and the TSH is lower), they will reduce the patient's dose even if the FreeT4/T3 levels are too low.

That's why my first-ever thyroid forum had the mantra "symptoms can be confusing, labs don't lie".

Anyway, it seems that if a doctor has a fragile ego and the patient complains more than they'd like to hear and/or the patient is pushing for a certain type of treatment, it's easier for the doctor to say he/she can no longer provide care for the patient.

I cannot stand the fact that I'm not comfortable sharing as much with my doctor as I share with you guys here.

My doctor told me I'd feel better 1-2 wks. after starting meds. She obviously has no clue.
'
However, as you guys know, she works with me.

I am VERY respectful with her.....I only share "classic" hypo symptoms with her. She never heard about the 20+ symptoms I had in the early months of the meds titration process.

I fill in the blanks for myself with the comfort of the knowledge I've gleaned through research. It's not 100% but, it's what I had to do to become free from thyroid symptoms.

Sad state of reality.....sigh

Hi again!! I always take my thyroid med FIRST THING when i get up and wait an hour before taking my other meds and eating breakfast. I am faithful about that for sure!!!

Im going to get a report of my levo rx history from my pharmacy later today. I will let you know what i find. Ty allll for ur help!!!!!!!

Glad to hear you've been taking your meds faithfully and you're waiting an hour before taking other meds/eating breakfast.

Do you always take your meds with just water?

Or are there sometimes when you might take them with coffee?

And, do you take iron or calcium supplements? If yes, when do you take those?

I'm just trying to address possible variables that could affect your levels and dose needs.

It would be great if you could also get your lab history......this will tell us what motivated her to have you take the dose shown in your Rx history.

Truly, with a TSH as high as yours has been, a dose increase was definitely appropriate.

I just wonder if you've been undermedicated for a long time....

Again, your lab and Rx history in conjunction with each other will tell most of your story.

If you have any records of how you were feeling at certain times, that would also be helpful....

I'm not thyroid savvy like cd, but I do have a question for you. Do you take the generic equivalent of Levoxyl? My doc writes "medically necessary" on my levoxyl script. I guess quality varies.

My doc also told me that her thyroid patients set their alarms for 3:00 am, take their meds, and go back to sleep. She said it's absorbed better when we're asleep. WHAT??? I didn't think there WAS a 3:00 in the morning. Talk about inconvenience. The things we must do when we don't have a thyroid!

My levoxyl is dosed at 200mcg, plus 10mcg of cytomel every day. I had to beg for that dose. I told her I had been hyperthyroid for 30 years and nobody cared. If they will allow a hyper patient to remain hyper, then why did she want me to be hypo, when I'd been hyper for so many years? And the hypo symptoms were HORRIBLE!!! She said I was a good bargainer, and gave me the dose I asked for. And I'm feeling so much better. Just had blood drawn, and I see her on Wed. Wish me luck that it stays the same...

I want my headstone to read "I TOLD you I was sick!"(I'll have the last laugh)

Good luck TC40.

Have you considered that your adrenals may be fatigued? It's pretty common. When I was diagnosed last year, my body could not tolerate the thyroid medication, things went haywire. I had the same symptoms as you and went the emergency room countless times only to be told it had nothing to do with my thyriod and was just anxiety. WHATEVER, I knew better. I was hospitalized twice while trying to increase the thyroid medication. I finally ended up in the same situation as you...hopeless, near suicidal. I was discharged from the hospital the 2nd time in April 2012 with a TSH of 34 and was told by the a**hole endo treating me at the time that my thyroid had returned back to normal and had "healed" itself!!! I look back now on the situation and probably would've spit in his face had I known then what I know now. I found the naturopath doctor who I treat with now a week after that incident. He immediately put me on a cortisol replacement and did not have me start dessicated thyroid for another 3 weeks or so...and I was able to slowly tolerate it. Maybe your recent increase is too much for your adrenals to take? I've posted a link below that you may find helpful.

http://www.stopthethyroidmadness.com/adrenal-info/