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Mary Shomon

Why an Endocrinologist or Thyroidologist Should Probably Not Be Your Thyroid Doctor

By March 8, 2009

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Many people think that the best doctor to treat any thyroid condition is an endocrinologist. Endocrinologists are specialists who take advanced training in the endocrine system -- including, supposedly, thyroid disease. Most endocrinologists, however, specialize primarily in diabetes treatment, and lately, more are also specializing in the profitable area of reproductive endocrinology ("fertility doctors.") In practice itself, few endocrinologists spend much time studying or focusing specifically on thyroid diagnosis and treatment. (Some doctors who want to focus their practice on thyroid disease have decided to called themselves "thyroidologists," but be aware that this label really has no official medical standing.)

The truth? Most thyroid patients do not need an endocrinologist. I know...it sounds counterintuitive to say this, but for most thyroid patients, an endocrinologist or thyroidologist should probably NOT be your thyroid doctor, unless you are in several special situations.

So, when should you use an endocrinologist?

First, if you have thyroid cancer, yes, you'll want to see an endocrinologist -- but only one who has ongoing and known expertise in treating thyroid cancer patients. Since many endocrinologists specialize primarily in diabetes, some rarely see thyroid cancer cases, and they're not knowledgeable about diagnosis and treatment. Don't assume that any endocrinologist will do. (A good source to find physicians who specialize in thyroid cancer is the Thyroid Cancer Survivors' Association).

Second, if you have acute Graves' disease, suspicious thyroid nodules, or a goiter -- yes, you'll want to see an endocrinologist. But again -- not just any endocrinologist will do. You'll need one who has specific expertise in treating thyroid patients. You do not want a diabetes specialist who handles a thyroid patient here and there on the side. Here, I'd suggest the American Thyroid Association "Find a Specialist" directory, or the endocrinologists listed in the Thyroid Top Docs Directory.

But if you have a "harder to diagnose" thyroid imbalance, autoimmune thyroid disease, subclinical thyroid disease, "normal" TSH but a thyroid history and symptoms, or you've already been diagnosed and treated but you still don't feel well, most endocrinologists are not for you. Why? Let's be honest here.

We have a severe and worsening shortage of endocrinologists. Right now, there are an estimated 4,000 endocrinologists in the United States who are serving as many as 100 million Americans -- with diabetes, fertility problems, polycystic ovary syndrome, osteoporosis, Graves' disease, thyroid cancer, etc. -- who reasonably need to be seen by an endocrinologist. That's one endocrinologist for every 25,000 people who need one.

Given such a shortage, most endocrinologists simply do not have the time -- much less the inclination -- to do time-consuming detective work with patients who do not have life-threatening thyroid conditions. (Please understand that I'm not suggesting that our thyroid issues aren't debilitating and entirely worthy of serious attention and in need of diagnosis and treatment. I'm trying to help explain how many endocrinologists view it!)

To get in to see an endocrinologist, you'll often have to wait months to get an appointment. And even then, your appointment will likely last just a few minutes. (Or you may find that you are passed off to a physician's assistant, and never even get to see the doctor.) If you do get face time with the doctor, some endocrinologists will, unfortunately, make it clear that you are "wasting their time" if you are coming to them with borderline test results, or a "normal" TSH test but continuing symptoms. At best, you might get a cookie-cutter official approach, as outlined by the American Association of Clinical Endocrinologists (AACE), which says that keeping the thyroid in balance requires only "three easy steps" -- testing using the TSH test, prescribing levothyroxine so the patient is in the "normal range" (of course, which "normal range" they adhere to is up in the air), and following up with a TSH test every 6 to 12 months.

My advice as a patient advocate? If you have thyroid cancer, nodules, goiter, or acute Graves' disease, find a great endocrinologist. Otherwise, you're likely to be best served by a doctor who specializes in hormonal medicine, a holistic doctor who works with difficult-to-diagnose disease (like thyroid, autoimmune, chronic fatigue), a psychopharmacologist (they tend to be adept at subtle thyroid diagnoses), or an integrative physician.

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Comments
March 9, 2009 at 7:39 am
(1) Ewa says:

I’m reading your about Thyroid Diet where you state that hypothyroid patients become even more hypo during winter. I am hypothyroid and just after the clock changes in the fall, and there is less sun i turn HYPER. This has been happening for about 4-5 years and I have to drop from 112 to 100 or less. Is it Christmas stress or the meds? I take generic levo…

Also, my blood pressure is very high-173-86 etc. I have other problems FMS, CFS, carpal tunnel, some immono disease.

Should this be the case for endocrolonogist?

March 12, 2009 at 10:34 am
(2) Lyn says:

Amen to your comments about the necessity of finding a really competent and knowledgeable endocrinologist when it comes to thyroid issues. With a very strong family history of both medullary and papillary thyroid cancer, I recently had a scarey 6 month long saga that started with acute hyperthyroidism. It has slowly resolved and in retrospect, my latest (of a string of 5) endocrinologist believes that it was a viral thyroiditis, since it has nearly resolved now over the past 6 months. It took time and money and so much grief to get those simple lab tests, an ultrasound, and a thyroid scan to rule out cancer and get down to a logical probable cause. It should not have to be that way. Doctors have no time, just look only at the numbers (“your TSH is normal, so therefore your thyroid is normal”), and all but one of the five doctors I saw had extremely little knowledge of medullary thyroid cancer–a highly aggresive cancer that metastasizes very very early in the course and which therefore should be aggressively diagnosed or ruled out when there is a family history such as mine. What a trial it has been!

March 13, 2009 at 5:37 am
(3) Carrie says:

I can definitely state that the busy-ness of endocinologists is true. I see an endo in a large metro area for my thyroid, and my appointments rarely last more than 2-3 minutes. He reviews my latest labwork, asks how I feel, writes new scripts, then he talks to his recorder about my case (so fast I always wonder how someone transcribes it!), then I’m out the door. He will answer questions, but I always feel rushed. My initial wait to see him was several months, and I always make my appointments for the next appointment before I leave to guarantee a space at the right time. In addition, he overschedules and I always have a long wait. While he’s definitely not going to win any personality awards, he gets the job done right. When you find someone who gets your numbers where you need them to be, and treats you based on how you are feeling, it doesn’t really matter their title. Also, I have found that my endo has caught other hormone related issues I have struggled with (acne) and can effectively deal with that as well. But I think the key is finding a doctor who “gets it right” and listens to your body not to lab numbers.

March 13, 2009 at 8:02 am
(4) Linda says:

I have mixed feelings about your remarks. I was going to an endo for several years who was treating me for both Type II Diabetes and hypothyroid. He was just as concerned about the thyroid issues as he was about the diabetic issues. However, he decided to go into the ‘concierge doctor’ business and I lost him. I decided to let my Internist handle both my diabetes and thyroid. That has been for the last several years and I am very disappointed and have found another endo. This one is a female and her info says she specializes in thyroid. Am hoping by switching docs for these issues will be of help. All I know is I feel terrible, my scalp psoriasis is coming back and Internist just kind of blew off my thyroid issues, said my THS is ‘normal’, obsessed about my BP and weight, which now I know is all connected. My only problem is if this doc doesn’t work out, I can’t afford to go from doc to doc to finally get a doc who knows what they’re doing! We live in a very exclusive resort area and most of the docs think everyone is very wealthy who lives here and charges like it! I am so grateful to have discovered your site and bought your book and am reading it prior to my appt later this month. I am making the lists of what’s going on and am going to take both the lists and the book with me. Thanks for all the great help.

March 13, 2009 at 9:49 am
(5) Karen says:

Thank you so much for this article. It helped me to realize that there was nothing personal in the way I was treated by my endocrinologist. After my last encounter with him, or rather his assistant because he wouldn’t take the time to talk to me, I felt foolish, angry, and hopeless. My plan has been to shell out the money to see a holistic doctor that specializes in hormones and overall wellness. This article cemented that it really is the right decision to do so. I feel a bit more confident going forward, after realizing that my endo was not so much reacting to me, but rather to his overall work load, as well as his education that obviously lacks in the area of thyroid treatment. Thanks Mary!

March 13, 2009 at 9:51 am
(6) Rhonnie says:

I have been on a roller coaster for teh past 12 years with not getting the appropriate dose of Synthroid. I have developed a slew of complications from my Hashimoto’s such that I now take 10 different medications a day, which translates into 15 pills a day. I am only 53, but feel like the best part of my life stopped 12 years ago. I wondered if anyone had tried Chinese medicine, and if so, your opinion would be much appreciated. Thanks-R

March 14, 2009 at 9:10 am
(7) Lori says:

Although I do not have a life threatening condition such as thyroid cancer, I made the choice to visit an endocrinologist for my Hypothyroidism/Hashimoto’s. I wss originally diagnosed by my primary care physician, but I felt that she did not listen to me concerning my symptoms, instead she chose to base my needs on the numbers. If I was in the “normal” range, then nothing needed to be done.
My endocrinologist has treated my symptoms and together we have been able to discuss what an acceptable range is for me as far as my TSH levels. I have regular lab work appointments scheduled quarterly for the year and follow up appointments with the endo. as needed. He is also understanding about the weight issues and we have discussed diet as well. I am fortunate to have found an MD that will take the time to treat me as an individual. I think it is important to find a Dr. that will take the time to listen and work with each individual whether he/she is an endocrinologist or any other type of Dr.

March 14, 2009 at 10:00 am
(8) sarah says:

I’m a thyroid patient who actually got some face time with an endo at a major university med center – my DHEA and DHEA-s counts are 10x – yes, ten times – what they should be. First I got the resident who couldn’t figure it out, so he called in the main guy who went through the whole thing all over again. Ordered an adrenal CAT scan, which showed nothing. So, they’re stumped. Have no idea. Suggest coming back “in a couple months” to see if the values are still sky-high – this after a YEAR of monitoring with NO change by my clueless primary care doc.

When I asked the endo if the DHEA values had any interaction with my thyroid issues he said “Absolutely not.”

I’m disgusted with the lot.

It’s been six months and I’m just now getting the energy up to find another doc in order to figure this out.

Why getting to the bottom of a value ten times normal has to be such an enormous fight is beyond me.

March 14, 2009 at 8:31 pm
(9) Susan says:

I’ve been very fortunate to find an excellent endo practice with three doctors. The head doc requires patients to be seen by each doctor in turn so the doctors are familiar with all of the patients. They have been testing my Vitamin D levels for several years, as well as the TSH, 3rd generation; T3, Total; and T4, Free. They also prescribe Armour. I am blessed.

March 15, 2009 at 10:49 am
(10) Meredith says:

First of all, I want to thank Mary for all of the thoughtful, thorough, and just downright hopeful information provided on this site.

As for the article, I agree with Mary’s assessment completely.

However, I would say that the article lacks one big piece of information, namely, where/how does one find a reputable “doctor who specializes in hormonal medicine, a holistic doctor who works with difficult-to-diagnose disease (like thyroid, autoimmune, chronic fatigue), a psychopharmacologist (they tend to be adept at subtle thyroid diagnoses), or an integrative physician,” as she suggests? This has been one of my biggest issues, and I don’t blame Mary at all if she doesn’t have that information–frankly, I’ve been looking for years and been to a couple of alternative practitioners (e.g., an acupuncturist whose help has been beneficial)–but there doesn’t seem to be a good way to track these professionals down without a lot of hit-or-miss. I have Graves’ Disease with the connected eye problems, btw. I’ve been slowly learning alternative therapies (thanks again Mary!), which have helped. The thyroid has been (knock on wood) mostly quiet for many years (I feel great!), but my eyes have never quite recovered. I can’t countenance more steroid therapy, since I’ve already got a cataract, and no matter how slowly I ease off of the steroids, I bounce back worse than before. Besides, there’s that tooth-grinding irony of “you’ll get cataracts whether you use the steroids or not”. I am hoping that somewhere out there, there is someone who can help me before my issues become severe, but as I said before, finding someone isn’t like looking for a needle in a haystack–it’s like looking for a place that HAS a haystack so you can look for the needle, which may or may not be in that particular haystack after all!
Fear not, I’ll keep looking, and I’ll share if I do find a place that makes it a bit easier to find these wonderful people–but Mary, if you have any ideas on helpful places to 1)find and 2)vet practitioners, maybe that could be a great article in the future.

Thanks again!

March 16, 2009 at 3:56 am
(11) Valetudinarian says:

Hi Mary,

Prior to your article above, I have often wondered what kind of Doctor would best suit my 7 year-old daughter.

I have questions/comments regarding myself, but this is more important: My 7 yo daughter was dxd with Hashimoto’s last year. I have been wondering exactly who would be best suited for my daughter’s treatment?

As of now, she is seen by a pediatric endo at our local Children’s Hospital in a metropolitan area. As you can imagine, whenever you walk into a Children’s Hospital one is often thankful for the problems they have! But I wonder. Which is her primary problem? Autoimmune disease or thyroid disease? She also has excema which is an autoimmune disorder, too. Once you have one autoimmune disease, you are more than likely to have/develop more, right?

Neither my husband or I are particularly satisfied with how my daughter is being treated medically. One thing is that synthroid is her only option as a pediatric patient (for hypothyroidism). Another concern is that her Pediatric Endo (the department head at that)would NOT answer the issue of where she wanted to keep her TSH (like we now know adults should range from 2.0 to 4.0 but preferably 2.0 to 3.0). My daughter is holding steady at 6.0 — that can’t be where she should be?!?! She is better, but she still peters out during activities of which they attribute to her weight (she is probably 12 pounds above her optimal weight). We also asked if we should give my daugher a Selenium supplement for her condition, but her Docotor had no idea about how selenium may help the thyroid in Hashimoto’s disease (I see a fatigue specialist that deals with my hypo stuff and suggested it for her–but I wanted a “real” answer from my child’s OWN doc, kwim?)

This Ped. Endo was patient enough to listen to our questions, but not so willing to offer information or give satisfactory answers. As is usual at a Children’s hospital, an intern was present but could not really tell us more.

Also, I am having problems finding what labaratory values are appropriate for pediatrics rather than adults. Like you eluded to in your article, I feel as if my daughter’s Ped. Endo has bigger fish to fry (like treating kids with diabetes and other “more compllicated” metabolic diseases). She made the Hashimoto’s out to be no big deal and easily treated.

I am very hesitant to take my daughter to just anyone. I do not want to start taking her from Dr. to Dr. to experiment. I am really very unsure what to do, but I KNOW something does not feel right and I need to do something. Advice?

March 16, 2009 at 5:49 am
(12) Carina says:

My worst experience ever regarding treatment for hypothyroidism was to go and see an Endocrinologist. He treated me as if I had a psychological problem and was not even interested in asking me about my test results or symptoms I’m experiencing. Never again thank you.

March 19, 2009 at 12:59 pm
(13) Valerie says:

Here is a piece of advice for anyone with thyroid disease. Go to Drlowe.com. John Lowe is the most educated person I know about thyroid disease. Sorry Mary but I learned about him on your site and book. He has a clinic in Texas but offers phone consults to patients and their doctors. My Naturopath followed his advice and now I feel 100% better. I am on Cytomel now after being on 3 other thyroid meds that did not work for me. You need to keep trying because it took me 10years to get better. Some states don’t license Naturopaths to prescribe but if you can find a open minded doctor that will listen to his advice it does work!

March 20, 2009 at 2:30 am
(14) Victoria says:

Sometimes the best doc is just a GP who’s willing to learn and work with you. Thyroid may not be their specialty, but if they are willing to read more about it and work with you to where you feel better, they may be all you need.

I am seeing a regular GP doc right now and so far he’s been a real peach in being willing to read more about thyroid disease and working with me to help me feel better.

March 31, 2009 at 1:17 am
(15) Pamela W says:

I do have four nodules which my endo has been following with regular ultrasounds, and they actually shrank last year. I have Hashimoto’s and was on Armour for three years and doing well; my endo wanted to switch me to Synthroid and did so, leaving me feeling like I would not be able to find an endo who would give me Armour. I feel like I owe a lot of the nodule shrinkage to a GF/CF diet (glutein free, casein free)but this receives absolutely no recognition from my endo.

May 6, 2009 at 1:40 pm
(16) Kaylee says:

I recently had to stop seeing my Endo because my oh so wonderful Ins and his group can’t play and get along -

So I switched to my GP after a HORRID experience with another Endo here.

I went to her because I was told she specialized in Pituitary tumors – I also called ahead TWICE before making an appt to make sure she wrote Armour.

Well I get there and the first thing she tells me is “all about the Evils of Armours” ya she can’t even pronounce it right!!!

I finally tell her that I will agree to her method, if she will keep an open mind and put me back on armour if the synthcrap doesn’t work………

Well in a matter of 8 weeks, 3 visits I am now sicker than I have been in 10 years, I have gained 9 lbs, want to fall flat on my face 90% of the day, no energy, felt lightheaded, dizzy, foggy etc……

She screams at me that she WILL NOT PRESCRIBE TO MAKE ME HYPER!!!.

All I said then was then whatever these symptoms are – fix them because I cannot function, live or drive this way, let alone run my business.

She fired me……..and vice versa at that point.

She not only did not realize that my TSH test would be suppressed using armour, but that a Pituitary tumor also will give a false TSH reading and show suppressed even when you are not.

In fact having a >.005 TSH after lowering from 4 to 2 grains is how the previous Endo discovered the tumor.

At least my GP is more than willing to write armour – but he is not going to be able to really help me with the tumor.

I also don’t sleep, never have slept much and think the tumor may suppress that hormone along with thyroid and testosterone.

I don’t know what kind of doc to go see or where.

My Ins. is not only an HMO but specific to Brevard Cty Fl. as well. But since I have to pay a 75.00 co-pay to see specialist anyway………

But I am not sure who best to see or what kind of doc to see.

May 27, 2011 at 11:46 am
(17) Sharon says:

Not sure where Brevard Cty is, but there’s an excellent MD near Orlando…Altamonte Springs fl. Dr Scott Vanlue at everythingwell.com. He will do phone consults, but that wouldn’t be covered by insurance. 1st 15 min consult is usually free

May 6, 2009 at 1:48 pm
(18) sherry says:

I completely disagree with your recommendation against using an endo as a primary thyroid doctor.

My endo is the only one who properly diagnosed my condition, when all other doctors, general or specialists tried everything and came up empty. from upper GIs to god name it testing was done on me to no avail. None of them ever thought to test my thyroid levels.

May 15, 2009 at 4:10 pm
(19) Guru says:

I don’t know if I agree or disagree, but I will say that the endocrinologist I went to said that I did not have a thyroid problem, but that I had cyclothymic depression. Strange to hear that from someone who is not a psychologist or psychiatrist, no? Turns out, I had Hashimoto’s all along, and now it’s Hypo with suppressed TSH, so probably a pituitary issue as well. Doctors have a tough plate, having to know and deal with a lot of different things and different issues/people. I don’t know how I would be in their shoes, so I don’t judge them. However, it is very clear to me that only God knows the answers to everything, and therefore, I will never truly trust any doctors totally with my health. They are too limited by their immediate senses, their natural biases, their time constraints, insurance requirements, and with scientific lab results. My body is what I live with every single day, all day long. No amount of their limited perceptions can fully grasp what is going on inside of me.

May 31, 2009 at 2:22 pm
(20) Deirdre says:

I’ve been to two endocrinologists and one wouldn’t treat me with my TSH level, convinced that I had no functional thyroid problem. However, he did prescribe synthroid for the goiter and that does seem to be working. His take was that giving hypo people meds rarely made them feel better, so it wasn’t worth it.

Got a second opinion from an endo recommended by a relative and on a site. Her take was that people who felt better, well, it was generally placebo effect and wore off, but she’d continue (synthroid) treatment anyway.

I think I’m going to find a non-endo doctor who’d consider that maybe the synthetics aren’t giving thyroid patients the exact biochemistry that they need.

Meanwhile, I’m perkier and hurt a lot less, so I guess I didn’t have fibromyalgia after all….

June 4, 2009 at 2:02 pm
(21) Mark says:

Well I have to totally agree, and my final diagnosis was thyroid cancer (not found by an endocrinologist). I knew I had problems but thought it was just a basic issue.

First, an internist talked to the endo who looked at labs and so on, and he thought there ws nothing wrong (that was the endo in consult). That was the first endo blunder I had.

So I went to another doctor (not an endo) who diagnosed me. After surgery (removal of thyroid) an endo told me to go hypo to wait for radioactive iodine, but never gave me an appointment. On calling I was told there were no appointments available but I did not have any throid med. So that was a mess that took some time to clear up. So that was the second endo blunder I had.

Now I do poorly on synthroid relatively speaking (I gain weight on it) and my endo will not even let me try armour or nature-throid since he has bad info and is not updated. That is my current situation, basically what I call a misinformed endo blundering.

Now all these endos I encoutered supposed handle thyroid cancer, but they obviously have no time to update on it, have bad info, have terrible staff that don’t understand the magnitude of having no thyroid with no thyroid meds, and so much more. Basically it is hard for me to recomend endocrinologists at all, and I am a thyroid cancer survivor. Maybe there are some really updated ones and so on, but I would be hard pressed to advise endo’s for much of anything thyroid related.

July 8, 2009 at 7:36 am
(22) hurting says:

SO I went to my doctor to complain about a laundry list of issues and after listening to me he looked at my neck and ordered my to blood work. When I asked him what he was thinking he told me that he thought I had a thyroid problem. While waiting for the results to come back I did some research and found that I have many all but maybe three of the symptoms for hypo.. I never got a response from my doctor after two days of the results coming back I called in to the hospital. The nurse called me back the next day and said that my level was 2.5 and therefore completely normal, meaning that I don’t have a thyroid problem. She didn’t say anything else and just said goodbye. I am furious. From the research I am getting it appears that not only is that not the only way to test, it seems to be the most unreliable. And what is worse, if my doc doesn’t think that is the problem fine, but that still doesn’t take care of the issues I am having that is getting worse. It was almost like he was thinking that since that test came back normal than I don’t have anything wrong with me. Now I am trying to find another doctor that will dig to find what exactly is wrong with me instead of just do one test and then not even give me the results of it. If anyone has any suggestions on what I should do I would love to hear about it. I need to do something fast though because my symptoms are getting worse and I can feel it. It is starting to affect my job that I can barely perform. This is a list of my symptoms in no particular order: dry skin, acne, weight gain, cold and hot flashes, dizzy spells, memory loss, water retention (especially hands and feet), joint pain (was diagnosed with lymes disease when I was 3), no libido, fatigue (especially in the morning and right after I eat), mood swings, depressed and angry, lung sticks (when I breath in it feels like my lung is sticking to my rib), coughing up yellow/green stuff in the morning that is coming out of my throat, hair is brittle, hair shedding more, toenail fungus (my doc insists it is something like rosacea, but my toenails are being eaten up, its really gross) constant yeast infections no matter how many times I get treated for it, heart palpitations, eye twitch that is almost constant on my left upper lid, leg twitch, insomnia, headaches, ears ringing (especially my left one), muscles hurt, bad circulation in my hands and feet (they tingle and lose feeling a lot), I bruise easy, I constantly feel dehydrated no matter how much water I drink, heartburn, bouts of constipation and diarrhea, bouts of shaking and nauseousness, bleeding after bowel movements, and earaches when sleeping on my side. Nice list huh? The worst thing is that I can feel it getting worse and it feels like no doctor is going to help me. If it isn’t a thyroid problem, fine, but then I need the doc to search to find what it is so it/them can be treated.

July 24, 2009 at 10:40 pm
(23) Janice says:

To Hurting: Go see Dr. Eric Braverman @ http://www.pathmed.com
He will be able to find out what is going on.
I hope this helps you.

August 14, 2009 at 10:47 am
(24) Deb says:

Do not go to Braverman!!! I flew from Florida to New York to see that quack! He was not helpful at all! He diaognosed me with so many different ailments! The only thing that I needed was thyroid meds and he said my thyoid was fine!

August 16, 2009 at 3:59 pm
(25) cor says:

to Hurting: I just wrote your list of symp. and I have most all the same. I have been on antibiotics for Lyme almost 2 years. I felt great from this past April thru June. Then came July and all went downhill again. I take Armour and wonder if it’s a bad batch I’ve heard people talk about. I thought the Lyme was being beat but now I don’t know. I just keep plugging along hoping tomorrow will be better but in the back of my mind now I say “yeah, but for how long-and why won’t it last. 3 months in over 3 years is not a good life!
Hope you and all the other here find the right Doc and right treatment. We all deserve it!!

September 25, 2009 at 9:51 pm
(26) Lynn says:

Hello, I did see one of the “holistic” DR’s on the Top Doc List in Florida. He seemed extremely smart and very thorough. BUT, before my visit, I researched him and it the article it stated: “He recommends viatamins and supplements but does NOT sell them due to conflict of interest issues” WRONG! After my visit, the ladies at the desk started to line up bottle after bottle of things the DR recommended I start using. I was OVERWHELMED and just bought one bottle (I felt obligated like I was at a Tupperware home party!).
I was a little bit disappointed after I left and a little bit more disappointed when I found the same supplement at my local health food store for 1/6 of the price!!!
Even though I thought this DR may be right about my thyroid/hormone condition…I never went back.

November 27, 2009 at 10:16 am
(27) Dave says:

For comment #23

I have heard of the same bad experiences with Dr. Braveman in NYC.

Suggest see Dr. Kamau Kokayi in Manhattan. He is a Yale MD with 20 years of Holistic Medicine experience, and did a fantastic job of addressing my thyroid issues using a combination of Armor Thyroid and Chinese Supplements to strengthen my immune system.

He can be reached at 1-212-661-0060, http://www.drkokayi.com

Feel Better!

Dave

Dr. Kokai also does a radio show on Public Brodcasting Network, WBAI 95.5 FM, 12 noon on Wednesdays.

March 22, 2010 at 3:41 am
(28) gabriela says:

After years of misdiagnosis, a multitude of prescription and OTC drugs, scans, x-rays and ultrasounds, it was discovered I had hashimoto’s hypo. I began a course of dessicated thyroid treatment which worked well initially, but then suffered a relapse. THe problem was my adrenals. This is a common problem with hypo patients and treating it will eliminate most if not all of those horrendous symptoms. I suffered almost all of those described by ‘hurting’ except the bleeding after bowel motions and they all disappeared after my dessicated thyroid dosages were adjusted, which takes time adn I began taking hydrocortisone for my adrenals. Vit D, magnesium, iron adn VIt C were also essential, butmost importantly I found a great MD (GP in AUstralia) who suffered from Hashis and adrenal fatigue herself. Adrenal fatigue is not recognised as a disease by doctors so you must find a dr who will acknowledge its existence and prescribe the necessary treatment.

March 30, 2010 at 3:11 pm
(29) Norm Jezzeny says:

My wife suffers greatly from Exhausted Adrenals and advancing Hypothyroid. Mainstream Doctors are too busy making $money to really care! Can you provide the name /E-mail for the woman Doctor in Australia ,who is helping you?

December 13, 2010 at 7:09 pm
(30) Brian Hutchins says:

So I wanted to thank the article writer for this one. I have been seeing an ent doctor when I should have been seeing a specialist. Thanks again.

February 4, 2011 at 12:13 pm
(31) Elli Longo says:

This article rings so true for me. After waiting more than four months to get an appointment with one of the Top Endo’s in John Hopkins Hospital, he took appr. six minutes and declared me Subclinical and never asked me about my problems. My TSH is either 7.68 or (get this) 0.03 and from his standpoint ” you have hashi ” thats all, take another blood test in six months. The only Blood test he ordered was a T4!!!! I really wasted my time and money, for that he charged $ 468.- and I am still feeling like crap! Plus he could not explain to me why my TSH bounces like that with no in between. HELP

February 25, 2011 at 9:20 am
(32) Gogo says:

As an endocrinologist, I can safely say that many of my consults are from non-endocrinologists who have difficulty interpreting thyroid results. Anyone with a thyroid problem should see a thyroid specialist who is trained by an accredited endocrinology fellowship program and has an MD or a DO. It’s that simple. I can get patients booked into see me the next day, so it is a myth that you have to wait months to see one. And I spend at least 40 minutes with every new patient, and call my patients back myself. I take very good care of my patients, and I have a busy practice, because I am a good physician. Hollistic medicine might be interesting, but it doesn’t have the pathophysiologic backing that real endocrinology has.

June 3, 2011 at 1:44 pm
(33) christine says:

Are you in Texas by chance ? I am having a horrible time with my hypothyroidism and who knows what else, doc thinks maybe perimenoupause. He mentioned Bio-Identical Hormone Replacement Therapy, still got my ovaries and truthfully a little leary about that ..

May 27, 2011 at 3:32 pm
(34) Lisa says:

I am under the care of Dr. Boris Catz, a thryoid specialist, and I must say that he spends hours with his patients and he listens to everything and NEVER goes by test results but more by what the patient tells him. Which is then, of course, confirmed by SPECIAL tests that he orders. My GP, my rheumatologist, even the immunologists at UCLA never diagnosed my Hashimotos, even with abnormal thyroid test results that came and went. Even my TSH, Free T3 and T4 were normal when I first saw Dr, Catz, but he knew to ask for the Antibody tests and those were way off…and then the Ultrasound showed the slight swelling…And no Synthroid for me…just very low dose of Cytomel and I feel great, not to mention I am losing my belly quite nicely. I have a friend who is on Syntroid and she was never told about soy. Catz told me everything I could not eat and I get seen every two weeks, for now. So, I also do not agree that a “thyroid specialist” endocronologist is not the right way to go. It all depends on the doctor.

January 7, 2012 at 8:19 pm
(35) thyca says:

This is a load of crap. There are good endocrinologists just as there are good and bad GPs. I had thyroid cancer and I’m still with a wonderful endo who gives me all the info and attention I could ask for. She explains every test (yes, T3 and T4, not just TSh). I’m sure she’s a diligent with her diabetes patients. I wouldn’t trust my thyroid health care with anyone else. You need to stop bashing doctors just because they aren’t holistic.

January 7, 2012 at 8:19 pm
(36) thyca says:

This is a load of crap. There are good endocrinologists just as there are good and bad GPs. I had thyroid cancer and I’m still with a wonderful endo who gives me all the info and attention I could ask for. She explains every test (yes, T3 and T4, not just TSh). I’m sure she’s a diligent with her diabetes patients. I wouldn’t trust my thyroid health care with anyone else. You need to stop bashing doctors just because they aren’t holistic.

May 9, 2012 at 5:15 pm
(37) Pat says:

I feel SO grateful to Mary Shoman for giving so many of us HOPE. I am learning so much from her books and the others she recommends. After 15 years of increasingly poor health (even though I led a healthy lifestyle), fibromyalgia, chronic fatigue, and several autoimmune conditions, only after my eye began protruding was I diagnosed with Hashimoto’s, then soon added to that was the diagnosis of Graves (though I disagree, I feel I do have Hashimoto’s and Thyroid Eye Disease but NOT Graves). At the second appt. when my endo added the Graves diagnosis, I asked what I should do. She said NOTHING I could do or not do would matter. Thank God I found an acupuncturist, Lisa at EBT, who put me on a leaky gut repair and systematic food sensitivity finding protocol. She is saving my life. I had suffered horribly from fibromyalgia, swollen knees, severe carpal tunnel, and poor sleep. Within a couple of months I could do stairs with no knee pain, had no sleep problems (unless I eat wheat, corn, or soy by accident) and no longer need carpal tunnel surgery. My cholesterol is lowering, and hope is returning. I still have a long way to go to return to good health, and my Thyroid Eye Disease is still a problem, but it is not progressing as rapidly as it was, and I have hope it will also return to normal, though I realize I will need corrective surgery to repair the damage. Here is a heartfelt “Thank You” to people like Mary Shomon and EBT’s Lisa.

June 11, 2012 at 9:42 pm
(38) Christopher says:

I disagree with this article’s message and believe that it is misinformed and dangerous.

1) Endocrinologists are the most knowlegable in this area by training: Internists get the most training in thyroid disorders second to endocrinologists. Family physicians are also trained in thyroid disorders however their training encompasses adults, Ob and pediatrics so their exposure is significantly less. Endocrinologists are specialists who train for 2-3 years in disorders of hormones of many glands including the thyroid AFTER completing a internal medicine or family medicine residency. Nobody has more training than an endocrinologist.

2) Endocrinologists are in short supply but so are intenal medicine doctors. There are overburdened physicians in every specialty not just endocrinology.

3) Physicians are human and make mistakes- your one example can’t paint the picture for a whole population. Don’t be a medical specialty stereotyper.

4) Please don’t pretend to know how all endocrinologists interpret results and how they use a cookie cutter guideline from an organization you googled. Thats just ridiculous. About.com should really screen these articles for facts.

September 12, 2012 at 2:09 am
(39) Tess says:

I was diagnosed with an underactive thyroid with so called normal range TSH but my doctor was bright enough to have done more research into the thyroid and realise the normal ranges .05-5 are no longer considered normal for everyone and over 2.5 can mean that your thyroid is failing. My TSH levels were 3.2 and if could barely get out of bed to go to work and constantly felt like fainting. I was put on a low dose of medication and started to feel much better but wanted to get a second opinion so I went to see an endocrinologist at Baker IDI in Prince Alfred Hospital Prahran. I was seen by Dr Neale Cohen and I was ABSOLUTELY DISUSTED in his disregards to the new evidence that not all patients with a so called normal TSH levels have a normal functioning thyroid. He was unhelpful and told me I was wrongly diagnosed and that he had no idea why I was feeling better on the medication cause I didn’t have a thyroid problem. And he even stated that my T3 was on the high scale of normal but still he couldn’t help. He then charges me $190 dollars for 10-15min of his time and telling me to eat better and ill lose weight (even though my diet was great but I couldn’t shift the weight). This article is a great relief to read and I’m so disappointed that current endocrinologist are not seeing past the old guidelines. I have booked into to see a holistic thyroid doctor in Sydney and hope I will find better answers. Because waiting a few years until my thyroid condition gets much worse and then being able to see an endo that will finally take me serious when its already to late is not good enough for me.

February 28, 2013 at 6:17 pm
(40) Jan Nathan says:

Doctors specializing in environmental medicine are often good thyroid docs, as are those who treat chronic pain patients.

Of course the very best ones are those who are hypothyroid themselves and did not do well on the standard protocols. They can be in any specialty. . . . .

April 1, 2013 at 5:53 pm
(41) Jeannie says:

I am at a total loss here with my 16 year old daughter who had her thyroid removed in July 2012. She had a large tumor and two smaller ones, but they were not cancerous. It has been a roller-coaster ride since then trying to manage her thyroid medication. I’ve been through 2 endocrinologists that both tell me her levels are in “normal” range, but her symptoms are anything but normal. She has been a real trooper and is doing the best she can, but it is hard to see a smart, talented, positive, and energetic girl go through what she has been through and now feel so awful all the time. Any information or advice on what kind of doctor we should see would be most appreciated! :)

May 27, 2013 at 12:17 am
(42) Nataliec says:

I’m at a loss I don’t know what the heck I need. I had multinodular goitre and had a total Thyroidectomy 17years ago and was told I’d be on oroxine for the rest of my life. Up until about 18months ago I was taking 100mcg of oroxine daily. That has been slowly reduced to the point where my last blood test said I was still receiving too much and I’m now on 75mcg a week. I’m so confused and my GP says there must have been some left over thyroid tissue that spontaneously started functioning again, so that I can now be weened off the meds totally. My fear is if it can spontaneously start working again after all that time what if it spontaneously stops functioning again? How will I know? How long will I have to take action? Will I have to worry about nodules or cancer again in the remaining functioning tissue? Who do I see?

June 22, 2013 at 3:07 pm
(43) joanne says:

I have psoriasis and psoriatic arthritis (autoimmune diseases) and I believe that I have hypothyroidisim i have not been able to see docs recently no ins but when i did i asked them to check for thyroid (my mom had a goiter) and they said no nothing wrong there even though i have a lot of the symptoms. Now that i have health care i am going make sure i get to see an Endocrinologist.
Do you believe since they are autoimmune diseases if you have one you are more likely to get the other and do you think they are connected. I have gone on the forums on inspire and a lot of the people who suffer with psoriatic disease have hypothyroidisim as well. What is the test I should ask for when i see an endo. Sorry about small caps and abrevs. I have the arthritis in my hands as well and am hurting some right now.

September 26, 2013 at 11:03 am
(44) Az Tahir MD says:

I fully agree with you. I am receiving many patients who have seen endocrinologists and are still symptomatic. Their symptoms are ignored and they are told that is in their head or they have depression anxiety etc.. However treating their thyroid comprehensively, trying different thyroid medications adding thyroid nutrients , avoiding thyroid damaging foods improve their symptoms and they feel better. Interestingly many times their cholesterol, angina, obesity, fatigue , heart failure and other conditions improve as well.
Dr Tahir MD (www. drtahirmd.com )

September 26, 2013 at 11:06 am
(45) Az Tahir MD says:

I fully agree with you. I am receiving many patients who have seen endocrinologists and are still symptomatic. Their symptoms are ignored and they are told that is in their head or they have depression anxiety etc.. However treating their thyroid comprehensively, trying different thyroid medications adding thyroid nutrients , avoiding thyroid damaging foods improve their symptoms and they feel better. Interestingly many times their cholesterol, angina, obesity, fatigue , heart failure and other conditions improve as well.
Dr Tahir MD www. drtahirmd.com

October 10, 2013 at 1:58 pm
(46) John Reynolds says:

The thyroid gland is an important organ that helps regulates body metabolism. It is located in the front of the neck just below the voice box. The thyroid gland secretes two main thyroid hormones – thyroxine (T4) and triiodothyronine (T3). The secretion of T3 and T4 by the thyroid is controlled by the Pituitary gland, a small organ at the base of the brain, and the Hypothalamus, a structure in the brain. The pituitary gland secretes thyroid stimulating hormone (TSH) to facilitate the release of thyroid hormone (T3 and T4).

http://www.oregonnaturalmedicine.com/

November 7, 2013 at 9:39 pm
(47) EatWell says:

Or, find an integrative endocrinologist who specializes in both endocrinology and functional medicine. I work with one and she is the BEST!

November 25, 2013 at 9:21 pm
(48) Help says:

So, where do you find a dr, who listens? anyone in the tri-state area who is good?

December 1, 2013 at 1:15 pm
(49) Amy says:

Hey Eat well! Who is your doctor! I would be willing to go anywhere in the United States!

December 18, 2013 at 7:30 pm
(50) Robyn says:

One of the major problems with this is a very simple one. Most insurance companies simply won’t cover the cost of seeing the specialists you recommend. My insurance company refused to even cover the lab work ordered by a holistic physician in my area. So unless you can afford all of the out of pocket costs of seeing a naturopath, most people simply cannot go this route.

I have thyroid cancer and as such see an endocrinologist at a large cancer hospital. She is a thyroidologist and therefore only treats thyroid cancer patients. Her hope is that in the years to come, we’ll see more endocrinologists who choose thyroid health as a specialty. But the battle is an uphill one as thyroid disease patients are seen as not “critical.” In other words, we don’t tend to go into crisis as quickly as diabetics do. So we get the short end of the stick when it comes to how quickly we’re seen and how long the visit is with the doctor.

January 28, 2014 at 1:56 pm
(51) DavidEm says:

Hey Amy,

I see that EatWell hasn’t responded to you, but I have to agree with her. I work with Dr. David Kalin in Tampa, Florida who is also an endocrinologist who focuses on functional medicine and he works WONDERS.

I can honestly say that the best part about working here is watching people come in with little to no hope and seeing them go through life changing transformations within months if not weeks.

The sad thing, is that the real reason he is able to do this is simply because he runs the proper tests, listens to the patients, & comes up with an INDIVIDUAL program for them (no one size fits all).

It’s just weird thinking about how many other people could be helped if most physicians’ heads weren’t stuck up so far their own A** with the “I know everything and always will” mentality they are trained in medical school.

If you want more information on Dr. Kalin and his beliefs (which tend to lean much more towards the more natural/practical side of medicine than the traditional “western medicine” doctors) you can see them here: http://www.agemanagementoptimalwellness.com/thyroid.html

January 28, 2014 at 1:58 pm
(52) Alex says:

Is there a way to find a good thyroid doctor around me area? (In Tennessee)

February 12, 2014 at 9:24 am
(53) Thyroid Doc in Baltimore? says:

Can anyone recommend a good endocrinologist or functional medicine doctor in Baltimore? Or Pittsburgh?

March 4, 2014 at 10:31 am
(54) Charlotte says:

Most family doctors are woefully oblivious when it comes to thyroid issues. They can only effectively treat a patient when the thyroid is balanced. I never trust them to adjust my meds. They simply don’t understand the delicacy. If a test comes back showing out of normal range, I immediately make an appointment to see an endocrinologist.
Graves Disease since 1990.

March 19, 2014 at 4:01 pm
(55) Rose says:

I need a doctor who will treat adrenal insufficiency and then treat the thyroid problems. I live in DFW area, and cannot find a Dr. who will listen to me, and do a 24 hour saliva test for cortisol level. My early morning level is 6. Also, my TSH is 70.9, and T3/T4 levels are lower than normal. Synthroid didn’t work, and now dessicated is making it worse, and I’m having severe low cortisol level symptoms, which includes rage, inability to handle anything, etc I had a total colectomy a year ago, and that seems to be when everything got out of whack. Can anyone help me to find a doc, who isn’t too expensive to help me before I die?
Thanks

March 19, 2014 at 10:34 pm
(56) Viola says:

My mother was sick for over a decade with debilitating fatigue, borderline TSH, body aches, foggy mind, weight gains, memory loss, and feeling depressed. She saw an endocrinologist, Dr. Shirwan Mirza, in Auburn , NY. He spends over an hour with every patient at first visit, and 30-40 minute at follow up visits. he looks at every organ system, analyzes roots of problems and puts everything i the context of the whole body. He is a big advocate of nutrition and exercise. He diagnosed my mom with subtle underactive thyroid, Celiac disease, vitamin D and B12 deficiencies. He uses very new laboratory reference ranges that you can find only in prestigious medical journals. He considers himself a specialist in the whole body and links all the systems together in the context of metabolism and nutrition. After gluten- free diet, my Mom’s migraine completely resolved. I hope each doctor approached his patients as thoroughly as he does.

March 20, 2014 at 1:13 pm
(57) kelly says:

My question is the the symptoms of hypothroidism resolve or clear up once you are on the appropriate treatment or dosage of medication?

April 2, 2014 at 8:04 am
(58) Gwen says:

Can anyone recommend a good doctor in the Houston area? I have been battling Hashimoto’s for 22 years, originally diagnosed by my then OB/GYN. He is 3 hours away & retired. I have not found another doc since who really knows much about Hashimoto’s. I was seeing an endo, but felt like he undid all that the doc I loved did. Dumped him & found a doc listed on the Thyroid Top Doctors website. He is expensive & does not accept insurance. He did run all kinds of tests including saliva tests, all thyroid tests, cortisol, glucose, parasites, vitamin deficiency… everything except reproductive hormones. He felt like my issues were menopause related & put me on compounded hormones without checking my levels & 6 months later still hasn’t checked them. When I call his office my calls are not returned for 3-5 days & his assistant seems annoyed with me. I feel like I’m bothering him; like he doesn’t have time for my ‘menial’ issues.
At the prices he charges & I’ve paid, I expect a phone call back at least the next day… and it’d be nice if he would call, & actually test before prescribing expensive meds.

Also, has anyone been on Tirosint (expensive!!)?

May 7, 2014 at 11:17 am
(59) Pamela says:

I have a TSH of 3.50 and a low total T4 score. (A free T3 was not performed by the nurse practitioner seeing me, though I requested it and was told it would be.) I was referred to an endocrinologist who refused to give me an appointment. They said that due to my TSH score being within the normal range (for this lab this range was .5 to 4.5), there was no need. I happen to know the recommended ranges are .5 to 3.0 since 2004. yet some labs have not revised. I found the National Academy of Hypothyroidism and they recommend that if your TSH is over 2. you likely have a problem. It’s very frustrating and scary with all the symptoms I am having.

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