I had ever increasing thyroid auto antibodies and many symptoms but my rheumatologist and primary doctor never referred me to an endocrinologist. Wasn’t ever told I officially had Hashimoto’s (mother had it and sister had thyroid cancer). I had a thyroid nodule I found on my own CT scan for cervical spine surgery. After lobectomy of the suspicious nodule, the pathology confirmed Hashimoto’s and only then did I get prescribed levothyroxine for hypothyroidism. You shouldn’t need to have surgery to get treated for Hashimoto’s. Your TSH level that is optimal for you may be much lower than the maximum of the “normal” range. I would not be able to get out of bed if my TSH was over 2 and feel much better when TSH is lower than 1.0 (ideal would be ~0.5). If you are not getting relief of symptoms to help you function optimally, pursue other doctors who understand optimal TSH levels tailored to their patients’ symptoms vs. “normal” reference ranges and no treatment if you fall into that range. I have suffered for 7 years unnecessarily and wasted too much money trying to get answers and treatment to improve quality of life. This should be a simple solution for those with thyroid autoantibodies and symptoms and family history of Hashimoto’s. We wonder why our healthcare system is so expensive with poor health outcomes. This is a simple example of that. Are doctors, medical practices, insurance companies, pharmaceutical companies, employers, government, etc. motivated and incentivized to really care about our health and quality of life? Are we getting value from what we are paying for with our insurance premiums, deductibles, copays and coinsurance and time spent dealing with the healthcare system??!! My experience is definitely NO! Be a strong advocate and voice for your own health and do not settle!