Write a letter that states the various reasons you have requested thyroid testing and the fact that this doctor has refused. Send a copy to the HMO or insurance company's consumer liaison, along with your request that testing be approved. Keep a signed copy for yourself.

Bring your Risks and Symptoms Checklist to your doctor and ask that it be included in your medical chart after the doctor signs and dates it, indicating that he/she has read and discussed it.

Instead of saying, "I can't lose weight," say, "I'm eating 1,500 calories per day on a low-fat diet, doing 4 hours a week on the treadmill, and 2 hours a week of muscle-building exercise, and I'm gaining 2 pounds a week." Rather than saying, "I'm tired," explain that you need to sleep 10 hours a night instead of 8 hours, and you're still exhausted by dinnertime. "Get more sleep, get off the couch, exercise, and don't eat so much." Many people go into the doctor saying, 1 m just so tired, and weight!" Insist that the doctor sign it, place a copy in your charts, and give you a copy. Quantify your symptoms as much as possible. Show the doctor articles about thyroid disease that reflect your symptoms. Ask for a thyroid test. But if you have no options, here are a few tips: Be persistent but unemotional.

When faced with a doctor who is oblivious or resistant to what may be very obvious thyroid symptoms, or won't test when asked, the best option is to find another doctor, even if you have to pay for it yourself. If you describe feelings of anxiety and weight loss, you may, as some young women with hyperthyroidism have experienced, be labeled as anorexic or bulimic. Or you may be told you're experiencing the effects of getting older, working too hard, normal postpartum symptoms, or lack of exercise. Or you may be told that it's your hormones (which in essence it is, but they're talking about the wrong hormones here!). Some researchers estimate that at least 15% of those diagnosed with depression are actually suffering from undiagnosed hypothyroidism. Say fatigue, weight gain, and moodiness to many doctors, and you'll leave the office not with a thyroid test but with a prescription for an antidepressant.

In other cases, you may describe your thyroid symptoms but end up with another diagnosis. Only older people get thyroid disease." " Some patients have even reported that their doctors refused to perform thyroid tests, saying totally off-base things such as; "You're only in your 20s.