I have a question I've been meaning to ask here for quite awhile. I know this is the opposite problem most people with thyroid issues have, and I'm greateful for that. I've never had any "real" issues with my thyroid, but I sympathize with how difficult it can be to manage for those who do.
My mom and brother both had hypothyroidism, and both were able to go off thyroid medication at some point, and have not had to go back on. Almost every doctor I've talked to has looked at my like I have two heads when I say that.
I started seeing an endocrinologist as an adult for reasons unrelated to my thyroid. During routine labs, she said my TSH was high. My T4 was normal, always had been.
I'm not a doctor, but nearly everything I've read says that high TSH with normal T4 is considered "sub clinical" and not it's not necessary to treat unless there are symptoms. I've never had symptoms. She still recommended Levothyroxine, and since I'm not a doctor, I deferred to her expertise. She's raised my dose once, because my TSH was just barely high, but again, T4 normal, no symptoms.
My most recent visit, my TSH was normal, but my T4 was actually slightly high. Still no symtpoms of hyper or hypothyroidism. She wanted to recheck my labs in 6 weeks. 6 weeks later, and it was the same. T4 slightly high, TSH normal. She told me that for some people, T4 is not reliable, and kept me on my current dose.
Again, knowing I am NOT a doctor, but reading multiple sources, I've always understood T4 to be more reliable and TSH to be less reliable.
My PCP is actually also an endocrinologist, but his specialty is diabetes (in addition to internal medicine). I've thought about asking him if he would be willing to manage my thyroid medication dosage on his own, but I hesitate for a couple of reasons: one, I'm not sure what insurance will do with that... Will my well visits suddenly become specialist visits? I also don't want to undermine my current endocrinologist, or come across as "doctor shopping" because I'm not "getting what I want." I don't mind taking the medication, and have no side effects, and I don't see that it does any harm, but at the same time, if I don't need to be on it...
Should I just let my PCP bring it up at the next appointment? He asked about it last time. Do I ask him his opinion without asking if he'd be willing to manage my thyroid levels? Or do I just leave it be, since I'm not really experiencing any issues either way?