One tactic I've used for inadequate or absent medical care is to alter my
thyroid dose myself.  My doctor greatly reduced my Levoxyl for a 36 year
full thyroid replacement because he was unable to interpret the low TSH
results while I was on heavy prednisone (prednisone suppresses TSH) and
would not run free T3 and T4  to do a true evaluation.  I responded by
carefully and slowly dosing myself up with the lowered prescribed Levoxyl
and some old Armour while waiting 6 mo for an appointment with someone who
could help me.  I don't know what else one is supposed to do when the
available medical care is poor or nonexistent.

  By the time my thyroid status was evaluated I was still hypothyroid (not
by the TSH measure, however) even with my self dosing.  Another option is to
have my thyroid status measured at a commercial lab that takes patient's
orders and dose accordingly.

Another tactic on another medical problem, that of being on blood thinner
requiring periodic blood testing which local doctors do not do well or at
all, I arranged to get my own home monitor (quite a feat) and measure
myself, altering my dose of Coumadin as needed.  Since I've taken my medical
care into my own hands I've not  had the Coumadin crises of excess bleeds or
throwing a clot to the brain or lung.  I've been hoarding Coumadin and have
about 2 year's supply.  I don't get it- - in my circumstances having
doctor's care is an impediment to my health.

The above actions are not recommended, but I've not found an alternative to
getting adequate medical care in my locality which is especially short on
doctors.

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