Hashimoto subclinical thyroid? Need help please!

I have a list of thyroid tests from the last 10 years (below). Early this month I was tested for thyroid peroxidase antibodies and confirmed positive with 110 (ref range >100). I also tested strongly positive on ANA (1:640 nucleolar) with negative auto antibody screen. I have had many hypo symptoms for years but I have always been told tests were 'normal'. The most recent tests were to investigate the regular night sweats I've been having for about 6 months now.

Tsh(0.27-4.2) T4(12-22)

04/04 3.60 14.1

10/05 2.27 17.7

11/06 2.48 15.9

04/09 1.95 10.03 4.31

08/09 1.91 13.8

01/11 4.87 15.1

08/13 3.05

05/14 2.84

07/14 2.95 13.07

The GP does not see a need for a follow up of any kind. Is it worth getting a referral to see an endo privately regardless or will I just be dismissed until my tsh gets high enough to meet the nhs reference range? If there is an open minded endo in the midlands I'd love to hear. Also, do you consider regular night sweats as a symptom of hypothyroid? Do you think my blood tests support my experience of hypo symptoms?

I'm lost as to what my options are. Any advice extremely welcome. Thank you very much in advance!

Endo recommendations to Sybilla via Private Messages please in line with guideline #24, thank you, Clutter.

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  • Welcome to the forum, Sybilla.

    email louise.warvill for a list of recommended endos. You will need a referral letter from your GP for most private endos.

    Your TSH is high enough and your FT4 low enough to cause you hypothyroid symptoms but, as you say, NHS don't consider a diagnosis of subclinical hypothyroidism until TSH is >5.0. You could go back to your GP and ask for a 3 month trial of Levothyroxine to see whether it helps your symptoms. Make sure your next thyroid blood test is early in the morning when TSH is highest.

    These links may help you to formulate an argument to persuade your GP. Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

    If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

    In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

    thyroiduk.org.uk/tuk/about_...

    thyroiduk.org.uk/tuk/diagno...

    thyroiduk.org.uk/tuk/about_...

  • Thank you Clutter. I saw a locum GP yesterday, who was very feisty and without me even asking told me she would not put me on medication. Reluctantly, she gave in on the issue of referral to endo so I know I have a letter to go out soon to a local endo, I know nothing about. I would like to use this opportunity wisely and go to an endo who specialises in thyroid and is likely to see beyond the test result and the nhs ranges. If I can receive a list of specialists that would be a great help. Many thanks!

    Ps do you know if night sweats are possible in hypo rather than hyper?

  • Sybilla,

    Sweating can sometimes be a Hashi/hypo symptom but night sweats are more commonly related to menopause. Early menopause is a hypothyroid symptom. Ask your GP for a blood test.

    email Louise about endos as I advised in my first reply. Unfortunately there are few thyroid specialists as most endos seem to be diabetes specialists with thyroid as a bit of an add on. When you find someone you think may be promising post a question asking whether members have experience of the endo and for replies to be by Private Messages.

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