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I am managed by my internist and her nurse practitioner. Basically, you are dosed by your lab results so once your thyroid is gone or dead, I saw no need for an endocrinologist. It has worked well. I had a total thyroidectomy so I am not sure how long until there is no thyroid after RAI, but I would imagine if your dose has gone up you must be there. 100 micrograms seems to be an average dose for average weight women. All your internist needs really are current labs. At this point, I only get TSH and have dosed only by that for the past 4 years. Any symptoms are important but as you said, it is hard to tell what is causing them. I keep TSH between 1 and 2. Weight loss can make you require less levothyroxine.