In a way, I feel lucky. Both my wife and ex-wife are on thyroid meds. It took my wife almost a year after coming down with Hashimoto's to get put on synthroid (50 mcg now), so I had some inkling of the absurdity of the process of getting a doc to listen while feeling like a whiney crackpot in the process. Still, it took me a couple of months to get this sorted out.

When I came down with the complete blahs over Christmas/New Year's, I had no idea what was going on. Brain fog, no interest in running, just wanted to sit and do nothing. I went to our family practice clinic and said I was particularly worried about the brain fuzziness, since I have a strong family history of blocked head and neck arteries on my father's side. The doc ordered the usual bloodwork for fatigue and a throat ultrasound for the carotids. I got the bloodwork back before the scan. TSH: 3.6. Of course, the doc said the thyroid was normal, since the reference range from the lab was .5 to 4.5. No sense in arguing with the doc that TSH for a euthryroid population follows a lognormal distribution and 3.6 is about a 94th percentile score. But, I did tell the ultrasound tech that my thyroid bloodwork was abnormal, so she included measurements of the thryoid (enlarged) and some swollen lymph nodes nearby as incidental findings. Thankfully, the carotids came back as normal.

The family practice doc offered to refer me to an endocrinologist. I don't know what it is like in the rest of the world, but endo's around here are way too busy treating diabetes. It is usually a 3-6 month lead time for an appointment. This was the route that we took with my wife. Her endo in Albuquerque was great, finally got her on meds, and followed her to a stable level. Again, it took about a year to settle everything, and we are in Denver now as well. I didn't feel like waiting that long.

This led me to an integrative medical practice that specializes in hormones. I came in saying that I had an enlarged thyroid with enlarged adjacent lymph nodes and a subclinical hypothyroid TSH score. They ordered a full thyroid panel and referred me to an ENT for thyroid ultrasound with the possibility of fine needle biopsy if needed. The ENT did not find any thyroid nodules, but ordered a contrast CT scan to check for cancer. I have some risk of thyroid cancer: I worked around radioactive materials and at high intensity/high energy proton accelerator labs when I was in graduate school 20 years ago. Neutrons and activated material everywhere! Meanwhile, the bloodwork came back with TG antibodies elevated (1.6, ref 0-0.9) and TPO antibodies pretty high (160, ref 0-30).

The overall conclusions: significantly enlarged thyroid, large enough to justify a complete thyroidectomy if I want one. It is Hashimoto's thyroiditis. No signs of cancer. Even though I am at the best doc in Denver for getting a thyroidectomy, I still want to give meds and lifestyle changes a chance to work. I'm taking 25 mcg of synthroid now, and have gone gluten free. My wife was already gluten free, so in a way it has made things simpler. I'm feeling better and am getting back into a regular exercise routine.

I did tons of research on thyroid problems when we went through this with my wife. I already knew that the TSH test was widely misinterpreted. Any reading of TSH > 2 should trigger a thyroid ultrasound and a followup bloodtest for the full panel: T3, T4, TPO ab, TG ab. I don't know why the medical establishment doesn't get it.

Yes, thanks for sharing your story and sorry you are having to deal with this. Like most people on this board, I still struggle - particularly difficult is the level of fatigue.

As someone who has had a total thyroidectomy - I totally agree with giving meds and lifestyle a solid chance. My experience was that the medical community I dealt with was just a little too blase when it came to total thyroidectomy - it should be a last resort. With Hashi's - there is a chance that your thyroid will shrink with treatment. Barring cancer or life threatening conditions - a 2nd and even 3rd consultation is not unreasonable before taking a drastic step like total thyroidectomy.

This group has been a great resource for me as well! I just got blood work done again and I'm at 2.6 while on 112 mcg daily. I'm in that spot where I sleep well and don't have any palpitations but the fatigue is killing me. I have no motivation and the brain fog has gotten to the point where I feel like i'm losing my mind again.

I tried going gluten free for a month at one point but didn't notice any differences. To top it off, I'm recovering from some eating issues so a super-restrictive diet is pretty triggering...but I have to admit, I wish food choices would actually make the difference for me.

I wish you and your wife lots of luck and hope you continue to feel well on your current program.