Do I have Hashimotos?

[cat_alli]

I would appreciate it if someone can help me interpret some test results. I have hypothyroidism & am on levothyroxine (100 mcg daily at present) but am feeling so low in energy I'm preparing to go back to my GP better prepared & researched than before. I'm looking at some of my old blood test results and am finding myself confused.

On 20.03.2013 my result sheet shows "Thyroid peroxidase antibody level 728" but no range or abnormal test marker is shown. It goes on "Ser tiss transglutaminase lev (c) Text: Negative for IgG and IgA tissue transglutaminase antibodies". Does this mean I have Hashimoto's or not?

On 15.01.2014 my Serum T4 level was 12.8 n/mol/1 (range 70-140).

On 28.04.2014 my results were Serum free T4 level 17.1 (range 9-23); Serum TSH level 0.01 (range 0.3-4.2); Serum T4 level 12.8 (range 70-140).

I understand the last two paragraphs but not the thyroid peroxidase antibody one.

Many thanks.

[Clutter]

Cat-Alli, Thyroid Peroxidase antibodies 728 is positive for Hashimoto's. IGA and IGB TTG is the test for coeliac disease (gluten intolerance) which is negative.

Your TSH 0.01 was suppressed and FT4 just over half way through range so you appear to be optimally medicated. I don't think more Levothyroxine will be helpful but if you can persuade your GP to test FT3 and that comes back low, some Liothyronine (T3) added to a reduced dose of Levothyroxine might be helpful.

Low ferritin, vitamin D, B12 and folate can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms. See whether you can persuade your GP to test.

[cat_alli in reply to Clutter]

Thank you so much for your reply. I'm amazed my GP didn't tell me. I've had some of the other tests done & have rectified low levels (e.g. vit D) but am going to get everything tested now.

Is it 'normal' to have wildly fluctuating results? If I'm on 50mcg Levothyroxin my TSH has been as high as 11.49 (range 0.27-4.2). But on 75 or 100mcg my TSH has been as low as 0.01 (range 0.3-4.2). T4 & T3 were within range on all dosages.

Many thanks.

[Clutter in reply to cat_alli]

Cat-Alli, GPs don't see Hashimoto's as a big deal. They treat the hypothyroidism caused by Hashi's but not the autoimmune condition itself. Gluten-free diet is helpful in reducing Hashi attacks and antibodies in many people.

50mcg was a starting dose and too low. 75mcg is enough to suppress the TSH of many people. As long as FT4 and FT3 are within range you are not overmedicated.

Hashimoto's can cause TSH fluctuations. As it attacks the thyroid gland it destroys thyroid cells and as they die they dump thyroid hormone into the blood stream which alters TSH. It often makes people feel hyper and hypo at the same time or in succession.