Avoiding Pitfalls in Thyroid Diagnosis and Treatment

Your Doctor Isn't Using the Recommended TSH Reference Range

"Thyroid disease is easy to diagnose, easy to treat..." That's the mantra that many physicians and practitioners repeat. Unfortunately, thyroid disease is not always as easy to diagnose and treat as the experts believe. And that means that patients - and doctors - are more likely to get sidetracked. Here's a guide on how to avoid some of the common pitfalls that can get in the way of proper thyroid diagnosis and successful treatment.

The thyroid stimulating hormone (TSH) test is the key test used by many physicians to diagnose and manage thyroid problems.

At most laboratories in the U.S., the "normal" reference range for the TSH test runs from approximately 0.5 to 5.0. But more than six years ago, endocrinologists and laboratory experts recommended that the range be narrowed to .3 to 3.0. This remains a raging controversy, with some experts using the new range, and some practitioners and many labs still continuing to use the older range. Patients who fall into the limbo -- and it's estimated that millions of Americans have a TSH level between 3.0 and 5.0 -- may or may not be diagnosed as hypothyroid, depending on the philosophy of the doctor doing the diagnosis.

This obviously can be a pitfall to proper diagnosis. And, if you're being treated by a doctor who follows the old range, you may only receive enough treatment to get your TSH into the 3.0 to 5.0 level -- the limbo between the old and new range.

What should you do? Start by reading The TSH Reference Range Wars: What's "Normal?", Who is Wrong, Who is Right... And What Does It All Mean For You and Your Health?

You're Undertreated

When you're hypothyroid and treated with thyroid medication, one of the objectives is to give you the right dosage of medication so that you're symptoms are relieved, without being overmedicated.

One of the key pitfalls in treatment, however, is that some doctors believe that getting patients to the high-normal level of the TSH reference range is all they need to do for treatment. This means that patients may be medicated to a TSH level of 2.5 to 5.5 -- when other practitioners believe that those are levels that may still be indicative of hypothyroidism.

If you are getting treatment, but still suffering hypothyroid symptoms -- and in particular, if your TSH levels are above 2.5, you'll want to read Is Your Hypothyroidism UNDERtreated? and Help, I'm Hypothyroid and I Still Don't Feel Well .

You're Overmedicated

Thyroid hormone replacements drugs (like Synthroid, Levoxyl, and Armour Thyroid, for example) generally have few side effects or risks when taken properly. But the most common risk associated with these drugs is development of hyperthyroid symptoms due to taking too much thyroid medication.

If you're overmedicated, you may experience insomnia, weight loss, anxiety, fatigue, weight loss, and other signs and symptoms of an overactive thyroid.

Learn more about overmedication and how it can be a pitfall to feeling well with a thyroid condition.

You're Forgetting or Refusing To Take Your Medicine

It may seem obvious, but if you have a thyroid condition and your doctor has prescribed medication, taking that medication is essential. Some patients are afraid of prescription drugs, think that they are more harmful than helpful, or don't believe they will help -- and even after being diagnosed, don't take their medication.

In some cases, patients have a hard time remembering to take thyroid pills each day.

Either way, if you aren't taking your thyroid medications, this is a huge pitfall in your treatment.

If you are having trouble staying on schedule with your medication, read 10 Creative Ways to Remember to Take Your Thyroid Pills.

And if you have been dubious about taking your prescribed medication, read: When Patients Won't Take Their Thyroid Medication: The Health Implications of Failing to Take Prescription Thyroid Drugs.

You Need a New Doctor

One of the most important factors in successful diagnosis and management of a chronic condition like thyroid disease is having the right doctor for you. A good doctor will be your partner in care, and ideally, will fit with your health care needs.

When it comes to dealing with thyroid disease, the wrong doctor can be a major pitfall in your diagnosis and treatment process. But how do you know when it's time to change doctors? What signs should be a warning that your current practitioner may not be the right one for you?

Read about the 10 Signs That You Need a New Doctor.

You Feel Like Giving Up

There are times when no matter what you've done -- what doctors you've seen, medicines you're prescribed, vitamins and supplements you've taken, and nutritional and lifestyle approaches you've pursued -- in the end, things just don't seem to be working, and you feel like giving up. You may wonder if you'll ever feel well again, and whether your efforts to feel and live well are worth it.

When you get to that point, don't lose hope. Feeling like giving up can be a pitfall in proper diagnosis and treatment.

Read I Give Up: What To Do When Your Thyroid Treatment Doesn't Seem to Be Working.

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