Thyroid results interpretation?

[SashaT64]

Could anyone please help interpret these before I contact my rheumy and GP?

I got these done after last discussion with rheumy when she seemed to be doubting her diagnosis of lupus as I am not responding to HCX and steroids.

I also have neutropenia and thrombocytopenia and low C4 complement levels along with - hand problems, fatigue, muscle aches pains, insomnia, constipation. Dr Google seems to be indicating Hashimotos....

Where should I go next - request referral to endocrinologist? I don’t have a lot of faith in my rheumy. Is this now a rheumy issue? Or should I ask for referral to Lupus Centre - I live near Addenbrooks?

Thanks everyone. Hope you’re all coping with this heat today .

[SashaT64]

And undiagnosed left sided abdominal pain....

[Cathyan]

Hi Sasha. I’m sorry to read about all your symptoms. Have you tried discussing the thyroid results with your GP yet? Although GPs can be poor on their understanding of Lupus as it is rare, they should be reliable at diagnosing thyroid disease.

[miccika1]

Dr Google says Conditions associated with elevated serum TPOAb levels include the following:

Hashimoto disease (90%-100%) [2, 3]

Graves disease (50%-80%) [4]

Other autoimmune diseases (eg, type 1 diabetes mellitus) (40%)

Pregnancy (14%)

Sporadic multinodular goiter, isolated thyroid nodule, and thyroid cancer

[harmony2]

@sashaT64,

Auto-antibodies may be a sign of autoimmune disorder (though not always). Autoimmune immune disorders are usually treated by a rheumatologist. Though, yes, an endocrinologist would also have ideas about diagnosis in the case of thyroid irregularities but might send you back to Rheumatology to proceed with treatment and keep monitoring you for any other autoimmune issues because sometimes we develop more than one (if we have one) and also because autoimmune issues tend to be variable in their presentation (i.e. have flareups, periods of constant baseline symptoms, and every once in awhile slight improvements) therefore, depending upon lots of factors, sometimes they may need monitoring by a Rheum.

I do agree with the above reply @Cathyan stated even a GP might be able to Interpret this but I think you’re going to get a lot more mileage out of a rheumatologist or endocrinologist. I would suggest Rheumatologist since you already have a connection with the rheumatologist (I acknowledge you don’t have a lot of confidence in him or her). However, they seem to have a lot more leeway for ordering blood labs (tests) when many GP surgeries now are quite conservative for ordering laboratory tests because cost adds up fast and often show little. Furthermore there is a lot of factors that are considered in making a diagnosis not the blood work alone and a rheumatologist should be far more informed about all those factors than your GP would be

Just to highlight an important point: positive auto-antibodies do Not mean that with one hundred percent certainty you have an autoimmune disorder. many people have some auto antibodies that never develop into any autoimmune disease. Some individuals on future tests have the antibodies sometimes show up and sometimes not. They never evolve into an autoimmune disorder. Which is something to thank God for! It’s interesting that your other thyroid tests show up as normal.

Another possibility is that, in the future, possibly your body may develop some known diagnosis but you’re really just in the very emerging stages of the symptoms without a full disorder having developed.

if you go back to Rheum and she thinks there is no clear diagnosis, you may just wish to ask the rheumatologist to Not close out / discharge your case. Each clinical Commissioning group has different rules on this (UK).

In summary, I would ask to see the Rheum again and when you speak to that individual that you would just be very humble and teachable and say you’re just really want to understand what is going on with your body. Explain that you’ve had massive changes to what was probably a once healthy body I didn’t have many limitations and now it seems daily impacted by a myriad of symptoms which on the surface appear not very related. Maybe indicate that you’re looking for helpful explanations and you’re not fishing for a diagnosis that doesn’t exist but you truly want to understand the myriad of confusing uncomfortable and life changing issues which are affecting you every day.

You clearly have a host of very mixed symptoms which must be terribly difficult for you and you probably do need a consultant to help pull this together.

You are genuinely seeking help and guidance from somebody who is medically trained and has a much bigger understanding of how all these different disorders symptoms could possibly make sense and anyways forward in receiving some treatment or management of the symptoms.

[SashaT64 in reply to harmony2]

Thank you Harmony2. You are spot on I just want to understand what is going on do that I can try to help myself as much as possible. I don’t want to be seen as trying to undermine the Drs so take your point exactly about being humble and teachable!

I will contact them and send them a copy of the results and see where we go.

[harmony2 in reply to SashaT64]

Thank you for your reply❣️

As you will probably relate to, energy and mental focus come in limited quantities so I often wonder if it’s worth the mental energy to weigh in so I am chuffed it was worth something to you. Blessings on your next steps. H

[KayHimm]

Hi Sasha - I don’t think they treat thyroid disease until there is a change in function. For that reason, I would doubt you would be sent to an endocrinologist but would be monitored by your your GP or rheumatologist through thyroid tests. I bet your doctors won’t be surprised you have these antibodies since you have systemic autoimmune disease. Many people develop thyroid disease. I have been monitored for many years with labs and ultrasound.

Best of luck.

K