You Don’t Want an Endocrinologist To Treat Your Thyroid (5 Reasons)

I’m not saying endocrinologists are all bad. There are some that are great.

But I am going to suggest that you will probably get better care by seeing another type of doctor if you have a thyroid problem.

I know this may sound controversial, but my experience suggests that most thyroid patients who see one will not get the special care that they think they will.

And that other doctors are often more informed about newer thyroid therapies.

Here’s why:

Reason #1. They Won’t Order The Right Tests

At most, your endocrinologist is likely to order what is called a TSH with reflex to free T4. 

This particular lab test looks at your TSH and will only evaluate your free T4 if the TSH is abnormal. 

But here’s the problem:

This assumes that the TSH is the best way to measure thyroid function and that other thyroid lab tests are not needed.

While it is true that TSH is the most sensitive marker of pituitary thyroid action, other thyroid lab tests can provide loads of useful information.

Some of these include free T3, total T3, reverse T3, and thyroid antibodies.

But if you were to ask your endocrinologist to order these tests they would probably scoff at you and tell you that they aren’t necessary.

The reason? They don’t really care about the results.

Having abnormal thyroid antibodies doesn’t change the fact that they want to give you levothyroxine.

Having a low T3 doesn’t matter to them either because, guess what, they still want to give you levothyroxine.

And what about having a low total T3? It won’t change their recommendation of levothyroxine with a side of more levothyroxine.

This is very unfortunate because meta-analyses show that over 50% of thyroid patients prefer taking T4 + T3 thyroid medication!

But guess what? You can’t differentiate which patients should take T3 on top of their levothyroxine without looking at free T3 and total T3 levels.

Unfortunately, you can’t expect your endocrinologist to check these lab tests.

Reason #2. They All Treat The Same Way

I shouldn’t say all because there are a handful of endocrinologists that don’t do this but the vast majority fall into this category.

Without having ever met your endo, I can say with a high degree of certainty that he or she will only check your TSH and recommend levothyroxine based on that value.

It doesn’t matter what lab tests you requested, what the results of those lab tests show, or how bad you are feeling, this is going to be their recommendation.

From their perspective, if your TSH is fine then you are fine. Period. End of story.

And this sort of mentality exists among virtually all endocrinologists. 

Why?

Because this is how they are taught. 

In fact, this is how all doctors are taught including family practice doctors and general practitioners. 

I know because this is exactly how I was taught. 

And this method of treating hypothyroidism is referred to as the standard of care.

Having a standard of care is great for patients because it means that no matter where you go in the United States, you can expect to get the same treatment.

But it only works if the treatment works.

And when it comes to thyroid management, there’s a lot of research and data to support the idea that doctors are failing thyroid patients.

If you don’t believe me, take a look at this survey of over 12,000 thyroid patients which shows, on average, they give their doctors a failing grade of 5 out of 10 and that they rate the need for new thyroid treatments as a 10 out of 10.

Does that sound like a group of people that is happy about how they are being managed?

I can tell you from personal experience that thyroid patients who take combination thyroid medications like Armour Thyroid and liothyronine have much, much higher satisfaction levels.

Reason #3. Endocrinologists Don’t Have Special Knowledge

It makes logical sense that a doctor who specializes in a specific disease would know more than a general practitioner about that condition.

And it is true in many situations, especially uncommon or rare diseases.

But hypothyroidism is not rare or uncommon.

It’s estimated that almost 12% of the population in the United States has hypothyroidism which translates to 39 million people.

But beyond this, the bigger problem has to do with how endocrinologists look at the disease:

To them, it’s a solved issue.

As far as they are concerned, if you are taking levothyroxine and your TSH is normal then whatever symptoms you are experiencing must be due to something else.

This is why you hear so many stories from thyroid patients who go in complaining about weight gain, hair loss, and fatigue, only to be told that they are getting older, that they are depressed, or that they should eat less.

Which is probably why surveys show that hypothyroid patients complain about the same symptoms for 10+ years without seeing any improvement:

And why many thyroid patients end up getting placed on anti-depressants instead of receiving changes to their thyroid medication.

The reality is that many of these problems could be solved with the right knowledge, you just aren’t likely to get it from an endocrinologist.

Reason #4. They Are More Set In Their Ways

You might think that seeing a specialist is a good thing because, perhaps, they are more willing to listen to new ideas and treatments, right?

Unfortunately, this assumption is incorrect.

By virtue of the fact that endocrinologists treat thyroid patients day in and day out, tend to be less likely to listen to alternative treatments.

I can’t tell you how many times thyroid patients reach out telling me that their doctor told them that they shouldn’t do X, Y, or Z.

But why on earth would you listen to someone who hasn’t helped you feel better for years and years?

It doesn’t make any sense, but so many people have been conditioned to believe doctors that they don’t even recognize what they are doing.

This idea of being set in their ways is further reinforced due to echo chambers.

Continuing education conferences, where new research and treatments are presented, are often supported and partially funded by pharmaceutical companies that have a financial incentive to support their own medications.

As a result, your endocrinologist just isn’t likely to hear about natural treatment options, even though simple things like changing your diet, exercising regularly, and getting more sleep have a profound effect on your thyroid.

When was the last time your doctor asked you about these things? Or did they just check your lab tests and make adjustments to your medication?

Most thyroid patients get the latter.

Reason #5. You Won’t Be Able To Convince Them To Change

The last one is kind of an extension of #4. 

Many thyroid patients read information like this and they think that they can take this information to their doctor and they will be both happy to learn something new and eager to implement the new changes. 

Again, unfortunately, you couldn’t be farther from the truth. 

Listen to this story:

When I was in my first year of practice out of residency I had some amazing success with a husband and a wife who were among my first-ever patients. 

Collectively they lost some 50+ pounds, had more energy than they could remember, got off several medications for blood pressure and cholesterol, and were overall doing fantastic. 

They were obviously excited by these changes and they went to their doctor to tell him about me and what they were doing.

Instead of the doctor being happy about their success, he was upset that they went to see me and questioned my credentials and methods. 

This is despite the fact that so much good had been done in their lives. 

I learned pretty quickly that most doctors are really not interested in learning more or trying new things and they even feel threatened when they find someone who has more success than they do. 

This isn’t a universal thing but it does exist and it’s more prominent than you would think. 

The moral of the story is that doctors are not likely to change what they are doing even in the face of amazing success and positive results from others. 

It’s optimistic to think that they will change their mind and try something new and I do think it’s worth a shot, but don’t be surprised when they are not interested at all. 

For most thyroid patients, it’s far better and more effective to seek out a second opinion instead of trying to get your existing doctor to work with you.

Who To See Instead

With all this said, who should you see if not an endocrinologist?

Here’s what I would do:

First, start with someone who takes insurance and is local to you. Preferably your primary care doctor.

Test the waters to see if they are open to new therapies, trying new medications, and ordering the more advanced thyroid lab panel. 

For most people, they won’t be completely willing to do everything you ask, but they may be somewhat receptive.

If they are, stick with them for 3-6 months to see if you can get the help you need.

If they aren’t, just move on and try to find a new doctor.

As far as which type of doctor to see, here’s where you will find the best results:

• Doctors who specialize in anti-aging medicine, bio-identical hormone management, functional medicine, integrative medicine, or natural medicine.

The biggest downside to these doctors is that they are typically expensive and don’t take insurance.

In addition, they may not even be local to you, depending on where you live.

But, in my opinion, the extra price is worth the right treatment because it’s often the difference between having symptoms like weight gain, hair loss, and fatigue versus not.

Let me leave you with this thought:

No one cares more about your life and your symptoms than you do.

And when you put how you feel in the hands of someone else, you won’t get anywhere near the same level of care that you would give yourself.

While some of this may seem discouraging, there are things that you can do to help yourself starting right now.

As I mentioned previously, simple things like changing your diet, exercising more, and taking the right supplements can have a big impact.

If you want to see which supplements I think are best for your thyroid then I’d recommend checking out this article next.