Thyroid Question

kc2000

New Member
I posted this under Health and Fitness but now realize it is probably better in this category. I'm new to the forum and exploring a possible career change and becoming a pilot. I was diagnosed about 6 years ago with hypothyroidism and have been on medication since. Occasionally, my numbers come back elevated and my doctor adjusts the meds and then my numbers return to normal within a month or so. In reading various discussion boards, it sounds like as long as your TSH levels are normal, you can obtain a First Class Medical. That said, is it possible for an airline to know that I am hypothyroid during the interview process and for that to influence their decision to hire? With a condition like hypothyroid, I'm also wondering about the wisdom of making a career switch when this could be an ongoing issue for the rest of my life, potentially grounding me if my numbers come back elevated. I would appreciate insight from anybody who has dealt with this issue. Thanks.
 

DE727UPS

Well-Known Member
Where I work the depth of interest in medical stuff is "can you hold a first class". I once lost my medical due to my TSH numbers being slightly out of range. Went on synthroid which required a waiver and it took several months. Got my numbers in range and went off the medication. What's crazy is the FAA actually increased the acceptable range for TSH numbers to the point where it never would have been an issue for me in the first place.

Anyhow, I'd talk to an AME about what it will take to get a waiver if your numbers did come back elevated and if you can control it with medication that is FAA approved.
 

kc2000

New Member
Where I work the depth of interest in medical stuff is "can you hold a first class". I once lost my medical due to my TSH numbers being slightly out of range. Went on synthroid which required a waiver and it took several months. Got my numbers in range and went off the medication. What's crazy is the FAA actually increased the acceptable range for TSH numbers to the point where it never would have been an issue for me in the first place.

Anyhow, I'd talk to an AME about what it will take to get a waiver if your numbers did come back elevated and if you can control it with medication that is FAA approved.
Thanks for the response. In researching this topic across various discussion boards, your experience seems similar to others in that it can be corrected but does require some time before returning to flying. My real concern is how being hypothyroid will affect my ability to get hired and remain employed. TSH numbers are such an easy thing to correct with medication, I'm surprised even slightly out-of-range lab results can ground you for an extended period, especially when "normal" ranges vary depending on the lab and even person. I'm 34 years old with a family looking to make a career change. I'm realizing that the risks of making the switch may be too great in my situation considering there are others who depend on my income.
 

FlightSurgeon

Well-Known Member
Hypothryoidism currently is a CACI (Conditions AME Can Issue) disease, meaning that if criteria are met at the time of your AME medical examination you will not be grounded. The criteria can be found here:


Note that the TSH requirement states "normal TSH within the last 1 year."

My advice would be to go for your yearly endocrine visit 3-4 months before the medical, make sure everything is tuned up, get a good TSH reading, and show up to the AME every year with a letter from your endocrinologist and that TSH lab. Shouldn't be an issue.

Unfortunately I can't speak as to what your employer will and won't ask you.

Best Regards,

Aaron Florkowski, MD
FAA designated Aviation Medical Examiner
www.kansascityame.com
 

kc2000

New Member
Hypothryoidism currently is a CACI (Conditions AME Can Issue) disease, meaning that if criteria are met at the time of your AME medical examination you will not be grounded. The criteria can be found here:

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/C-CACIHypothyroidism.pdf
Note that the TSH requirement states "normal TSH within the last 1 year."

My advice would be to go for your yearly endocrine visit 3-4 months before the medical, make sure everything is tuned up, get a good TSH reading, and show up to the AME every year with a letter from your endocrinologist and that TSH lab. Shouldn't be an issue.

Thank you for the response. That approach makes a lot of sense and is very reasonable. Others seemed to suggest that the moment I have a lab that is not within normal limits is the moment I become grounded. From what you are saying, it sounds like all that is required is that my labs are within normal range and my PCP can sign off on my health at the time of my AME exam; elevated TSH numbers wouldn't immediately ground. Is that correct?

Unfortunately I can't speak as to what your employer will and won't ask you.

As it relates to the question about an employer, I guess I am wondering if they are legally allowed to ask about my specific health or if the only thing they can do is confirm I have a First Class Medical.
 

DE727UPS

Well-Known Member
"Others seemed to suggest that the moment I have a lab that is not within normal limits is the moment I become grounded"

That's they way it was like 4 years ago. I do know the TSH range was relaxed (widened) and the medication I was on required a waiver. The PDF file above says the medication I was on in now acceptable and you are good if within the last year you had an acceptable TSH reading. I think you'll be fine with just monitoring it once a year and get a note from the your doctor that you don't have any symptoms. I'd find an AME that is willing to work with you or perhaps has another client with your same issue he's already working with. That should give you the confidence to proceed.

As to your concern about whether you will be able to get hired as a pilot, I would see if you can find some regional airline recruitment folks to talk to. There is a great demand right now and I'd think they would be able to give you a good idea if you'd be a candidate in spite of your medical issue.
 

kc2000

New Member
Thanks, I'm glad they've changed how they handle it! It makes so much more sense now. And I appreciate the suggestion on finding the right AME and reaching out to a recruiter, its good advice.
 
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