Your primary care doctor

Two of the most common complaints that primary care doctors hear are "I'm always tired" and "I'm depressed." This is not much to go on, considering that fatigue can indicate a variety of medical problems, or that your life is busy, you've been under a lot of stress, or you're not getting enough sleep. Before you go to the doctor's office, take a good look at what's going on in your life and note anything that strikes you as unusual, as minor as it seems. Remember, with thyroid disease, even symptoms that may sound insignificant, such as "I'm always thirsty" or "I feel cold all the time" may suggest a thyroid problem.

Here are some other tips to foster a good doctor-patient partnership:

• Be thorough about your family's medical history. Even if you think you know it, there may be some family members whose health you're unsure of. It may be helpful to make a family tree listing all the conditions family members have had and bring it to your doctor.

• Before your visit, prepare a list of questions or write down symptoms you may forget to mention.

• If you are diagnosed with thyroid disease, become informed. Ask your doctor for literature on your condition. Then be sure to write down any questions you have. Also write down important information your doctor gives you so you won't forget it after you leave the doctor's office.

Finding a specialist

Depending on your condition, you may see several different kinds of specialists over the course of treatment. But initially, you may be referred to either an endocrinologist or a thyroidologist. A thyroidologist specializes in thyroid disease, but not all endocrinologists do. Many treat mostly people who have diabetes.

So it may be wise to do a bit of your own homework to find a doctor who specializes in thyroid disease or who sees a significant number of thyroid patients (see "Resources" below). Once you have some names, call the offices to verify that the doctor accepts your health insurance and to set up consultations. If the doctor is an endocrinologist, find out how many thyroid patients the doctor sees each year versus the number of diabetes patients. If thyroid patients are few, you may want to go elsewhere. Once you've settled on a doctor, make sure to find out if your health plan requires a referral from your primary care physician.

When you visit the specialist, be sure that you fully understand any tests and procedures that the specialist recommends for you. Request literature on the procedures and write down any questions or concerns that you have about them. The more you know, the more active a participant you can be in deciding which therapy is right for you. If, after your questions are answered, you are not convinced that the treatment your doctor recommends is right for you, you can seek a second opinion.