T Nation

Does My Doctor Not Understand Thyroid?

I was seeing a very knowledgeable Doctor, who I liked. I’ve liked my consulting with him on my T replacement as well as thyroid treatment. He practiced both functional medicine, and primary care. Unfortunately, he is no longer available. Therefore, the primary care place had me seen by someone else recently. While I’m no doctor, my experience and own reading suggests to me that this new doctor doesn’t understand thyroid. Perhaps people here can weigh in so I can get a better idea how to pursue my response and figure out if I need a new doctor moving forward.

I am currently taking 2grains of Armour thyroid & 50mcg of levothyroxine. This has worked well for me .One thing to note is before these labs were taken, I was not fasted. I had eaten 90 minutes prior, and had taken my 50mcg of levothyroxine about 45 minutes prior to labs. This is because when I scheduled this appointment, I was told this was just a check in, and there weren’t labs being taken. Then when I got there, the doctor wanted to see labs.

TSH - <0.005 (.450-4.500)
T4, Free - 0.87 (.82-1.77)
T3, Free 12.6 (2.0-4.4) Had taken 50mcg levothyroxine 45 minutes before lab

Form these labs, this doctor lowered my levothyroxine from 50mcg to 25mcg. THe reasoning given was “Your TSH is low.”

My concerns:

  • To my understanding, TSH will always be low if you’re supplementing T3 (levothyroxine). Therefore, she is lowering the dosage for the wrong reason.

  • Free T3 very high, but I am assuming this is because I had JUST taken my t3 medication.

  • Free t4 a bit low. Previously I was on 2.5 grains of armoud thyroid, which has been lowered to 2 grains. I’m not sure if this is a concern or not, given T3 is tha active one of the two.

I’d appreciate any thoughts and feedback. Ultimately, I’ll still likely need to speak with a new doctor for my continued T replacement. Having my thyroid prescriptions filled through this practice is certainly a lot cheaper than alternatives, but I’m not sure it’s being prescribed correctly.