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[Doctor Name][Address][Town, State Zip][Date]Dear Dr. [Last Name]:Thank for providing a copy of my blood work. Although it appears my TSH is within the normal range, I am concerned over my persistent symptoms of hypothyroidism while taking [insert medication name], which is a T4-only medication. My symptoms are taking a serious toll on the quality of my life and I would like to discuss some additional tests and treatment options available that I hope will help me regain my health.I want to monitor not only my TSH, but also my Free T4, Free T3, Reverse T3 and antibody levels (TgAb & anti-TPO). According the National Academy of Hypothyroidism, T4, which is an inactive hormone, must be converted into T3, the active hormone, which is used on the cellular level. I also understand that Reverse T3, which is also inactive, can bind to T3 receptors and block active T3 activity. Also, I feel it is to monitor the following items to ensure they are in optimal ranges. Vitamin D via the 25(OH)D test, selenium, iron, ferritin, and cortisol. These are all crucial to proper thyroid hormone activity. Knowing this information I have a suspicion is, that perhaps, my Free T3 is low and/or my Reverse T3 is elevated due to conversion problems from various sources (i.e. high or low cortisol, low iron, low ferritin, low selenium, high reverse T3, etc.). Since I have not made much progress on T4-only medication, I would like to give T4/T3 combination treatment a try after you receive the results of my above reference lab work. After speaking to several friends who made the switch and are feeling much better, I would like to switch to (be specific with your preference: Natural desiccated thyroid, such as Naturethroid, WP Thyroid, NP Thyroid, Erfa or Armour. Or Generic Levothyroxine, Synthroid or Tirosint plus Cytomel). The American Thyroid Association (ATA) released the results of a study titled, Desiccated Thyroid Extract vs Levothyroxine in the Treatment of Hypothyroidism on April 28, 2013 (Volume 6, Issue 8, Page 3). The results suggest that there may be a subset of patients in who desiccated thyroid extract might be a reasonable treatment option. I have also attached a list of additional article citations from the ThyroidChange website that discusses improvement in patient symptoms due to T4/T3 combination treatment. (Print out and attach the ATA Article and Thyroid Change article list). Unfortunately, I seem to be one of the patients who find T4-only medication to be insufficient in relieving my symptoms of hypothyroidism. I am hoping that this change will help me regain my health. Thank you for your consideration.I look forward to discussing this with you at my next appointment.Sincerely,[Your Name][Contact Information] ................
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