Thyroid Diseases, Living Well With (cont.)

My doctor just gave me a result of 0.185 and said his norm is 0.5 to 1, but wants me to remain on my current medication of Levoxyl .125 and see me again in four months. Should I seek a second opinion? I feel fine. I am just having the weight issue, but have recently cut sugar out of my diet after reading your book. I have been on the new medication for 2.5 months.

While I'm not a doctor and can't give you specific medical advice, I can tell you that many practitioners have their own philosophy about where patients feel best and where patients are optimally treated as far as the TSH level is concerned.

Clearly, your doctor feels comfortable keeping you at a slightly lower TSH level and many doctors have this position because they seem to think their patients feel well -- as you have described that you do -- when their TSH level is somewhat depressed or lower. If you notice you're having symptoms that are indicating hyperthyroidism -- if your pulse rate is high, heart palpitations or you can't sleep -- then you definitely want to check with your doctor right away. But if your doctor is comfortable with this level and you are feeling well, I wouldn't think a second opinion is necessary unless you are having symptoms that are bothering you.

Unfortunately, even when we have our thyroid condition treated and we are taking thyroid medications like Levoxyl, we may still be battling the problem of additional weight. Changing the medicine dose and manipulating the TSH level may not have impact on the weight that you have already gained due to the thyroid condition. The best effort to focus on, as you mentioned, is changing your diet -- eliminating sugar, the anti-inflammatory food -- and boosting metabolism using various natural means.

My TSH is 4 and my doctor says this is normal. Where can I get something showing the new TSH levels to take to my doctor to convince him to try to lower the TSH level?

Good question. There are two places that you would want to check to get the information that would demonstrate to your doctor that a level of 4.0 should be considered evidence of borderline hypothyroidism.

  • The American Association of Clinical Endocrinologists (AACE) has sidelines regarding the new levels at their web site --
  • There is a detailed sideline from the clinical laboratory testing group that specifies these new ranges, and you can find a link to that information from my web site at

If the doctor is not willing to review materials that you bring from legitimate sources, such as AACE or the clinical laboratory guidelines, you may want to consider getting a new doctor. There's no reason to have to suffer with undiagnosed hypothyroidism, simply because your doctor has not stayed up on the latest developments.

Don't you have Hashi's? If so, how is it that you have come to be an expert in Graves' disease? By the way, I love your book Living Well With Hypothyroidism !

Thank you so much. Since writing Living Well with Hypothyroidism , I've tried to turn my own effort at research and information gathering into a patient advocacy campaign to help thyroid patients get the information they need to live well.

I do, in fact, have Hashimoto's Disease and in the course of eight years of writing my book along with running my web site and newsletters, I've corresponded with thousands of patients and hundreds of doctors all over the world who have every form of thyroid condition. I've felt that based on all of the information and research I was putting together from patients and doctors, that the type of empowered approach that I had used in the book for hypothyroidism, could be helpful for hyperthyroidism and Graves' disease.

My goal is to help patients step forward through the information gathering process and introduce them to all options, both conventional and alternative, to make informed decisions along with the practitioner.

"It's particularly important that doctors pay attention to symptoms, that patients not dismiss symptoms, and adequate treatment be provided the moment a diagnosis is made."

How serious is Graves' disease?

Graves' disease can be extremely serious, particularly if not detected fairly quickly by your practitioner. When left untreated, Graves' disease can cause episodes of extremely high blood pressure and pulse rates, and in rare cases, can even be potentially fatal if it progresses to a condition known as thyroid storm, where blood pressure and heart rate become uncontrolled.

It's particularly important that doctors pay attention to symptoms, that patients not dismiss symptoms, and adequate treatment be provided the moment a diagnosis is made. The challenge is that sometimes people will go into a doctor or an emergency room with a high heart rate and may have anxiety, and may be diagnosed with having a panic attack, or if someone is having rapid weight loss, there are many younger women who are told they are anorexic, and older women are menopausal, when the underlying facts are Graves' disease.

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