Help with puzzling test results please.

I have a friend who was diagnosed with Hashimoto's some years ago. Her most recent tests revealed

T4 15.2

T3 not tested

TSH 3.05

Antibodies 146

The T4 looks a bit low to me and the TSH a bit high, but she claims to feel fine - she's on 50mcg Levo . However she is concerned about the antibody results and can't get any sense out of her GP. Any thoughts please?

[shaws Administrator]

This link maybe informative and this is an excerpt. The fact that your friend is on levothyroixine is helpful:-

In this study, German researchers reported that use of levothyroxine treatment for cases of Hashimoto's autoimmune thyroiditis where TSH had not yet elevated beyond normal range (people who were considered "euthyroid") could reduce the incidence and degree of autoimmune disease progression.

In the study of 21 patients with euthyroid Hashimoto's Thyroiditis (normal range TSH, but elevated antibodies), half of the patients were treated with levothyroxine for a year, the other half were not treated. After 1 year of therapy with levothyroxine, the antibody levels and lymphocytes (evidence of inflammation) decreased significantly only in the group receiving the medication. Among the untreated group, the antibody levels rose or remained the same.

thyroid.about.com/cs/hypoth...

Another link:-

thyroiduk.org.uk/tuk/resear...

thyroid.about.com/cs/hypoth...

[marram]

You say she claims to feel fine, have you some doubts, then?

Her TSH is fairly high to the point that in the USA she would be considered hypothyroid, and if she were not already taking thyroxine, she would be given it. But the TSH is not the true measure of hoe the thyroid is, clinical symptoms are the most important factor. If she does feel fine, and she does not have any lingering symptoms, than it is no cause for concern.

The antibodies, however, are a different matter. There is a body of evidence that a gluten-free diet can reduce antibodies, and in the case of your friend, that could be an avenue to explore to avoid damage to the thyroid.

[Hidden in reply to marram]

Thanks Marram. No, I don't have any doubt that she feels fine - I'm just surprised that she does! With a TSH of 3 I felt dreadful.

It was really the antibodies that concerned her, and I was unable to advise as I have no experience of this. What does a reading of 146 signify, and should she be doing something to reduce it? You seem to be suggesting that doing nothing may further damage her thyroid? I'll certainly let her know about the gluten-free diet. Do you have any useful links please?

Many thanks

Sue

[PinkNinja in reply to Hidden]

Some people have antibodies as a result of their thyroid damage rather than as a result of autoimmune disease. This may be a transitory result and nothing to worry about. It really depends on which antibodies were tested. Usually they test two types of antibodies, and maybe other tests, to determine if it is autoimmune.

I would also feel very unwell with a TSH of 3 but we are all different

[PinkNinja]

Without the reference range for the T4, it is difficult to tell. Her T4 is above the reference range my local lab uses (7.8-14.4). However, it is the lower end of other reference ranges.

If she is feeling fine, it could be that this is the right level for her. If you have your doubts about how well she is feeling, just keep an eye on her and if she starts showing obvious signs of hypothyroidism, gently suggest she might need to see her doctor about a higher dose.

As for antibodies, it really depends which antibodies were tested. She could ask for a printout of her results from her GP but if she is feeling fine, she might not want to do that.

Sometimes when people start on levo, they feel so much better than they did that they don't realise they still aren't fully well. She could be completely well, but if she isn't she will probably start to realise later on, in which case you can advise her to get a printout of her result and more info from her GP.

Carolyn x

[Hidden in reply to PinkNinja]

Thanks Carolyn. Sorry I forgot to say her T4 ref range was (12 -22). I'll find out which antibodies were tested and report back.

[Hidden]

Hi Sue

18 months ago when I was feeling absolutely awful my antibody test was 1172.00 (0 - 115 (negative). The test used was Anti-Tg Roche Modular. I am not an expert on antibodies, but from what I understand this indicates, first Hashi's and then the extent to which the antibodies are attacking your thyroid. If I have got this wrong perhaps someone else can give you more accurate information.