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GEN: HypothyroidismFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Tue Mar 22 18:29:02 2005
Recently saw a 30 YO P1001, now around 11 weeks, who went to another gyn who just stopped Ob. I don't know the doc well, other than by name. Anyway, the patient conceived on letrozole, and the other doctor put her on Armour thyroid despite apparently normal TSH and Free T4 values. The patient really didn't know exactly what the deal was, and I thus repeated those labs and they were normal. I sent a copy of my dictated note to the other gyn, who called today. He told me he was doing a lot of hormone work, and that a subtle low level of Free T3 is her problem, best supplemented by this preparation which is 80% T4 and 20% T3. He also mentioned compounding pharmacies that can make T3, and that they way to diagnose and follow a low T3 is by following her basal temperature, which was low and would be low if, say, her thyroid requirement increased (as is often the case) during pregnancy. He also told me that the endocrinologists poo-poo this line of thinking, since the Synthroid people fund all of the research anyway. She is on 1/2 grain, which is a pretty small dose, he said, and it may/should be increased to 1 grain. I'll do a medline. . .any thoughts? I have mine :). Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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