Family Bloods: Think I know the answer but...

[hose1975]

My sister and I both have Ord's (autoimmune thyroid disease WITHOUT a goitre): over 20 years for me (age 40), one year for her (age 26). I think my mum's thyroid is beginning to struggle but would appreciate a community check of the last bloods for which she has results.

TSH 3.7 (not sure of local range; possibly 4.5)

fT4 15.4 (range 10-19.8)

She's tired all the time but doesn't seem to be having too much of a problem with weight gain. I've advised her to go back to her GP and ask for antibody tests on the basis that both daughters have AI thyroid disease, and to ask about a trial of T4.

I believe her TSH is too high at 3.7 but that her fT4 is okayish.

Do others agree?

[shaws]

This is a link from Thyroiduk.org which gives the interpretation of blood tests which will be helpful:

thyroiduk.org.uk/tuk/testin...

On the left-hand side there is also 'signs/symptoms' for each thyroid gland dysfunction.

thyroiduk.org.uk/tuk/testin...

[quiet-hawk-5989]

Just a word of warning. Most people with hyporthyroidism secondary to auto-immune disease, as you are suspecting are unable to convert the T4 in Levo to T3 which is the useful stuff which your Mum needs to get her back to being bright eye'd and bushy tailed. Gluten free diet is an absolute must, even if she has no issue with weight gain as it will be part of the many things that contribute to the flair ups with her auto-immune system. If you can get hold of NDT, she will get T1 & T2 as well as the essential T3.

[hose1975 in reply to quiet-hawk-5989]

I don't think my mother has any pre-existing AI disease, hu5989. Some, but not all, find a gf diet helpful. We do not even know at the moment whether she does have an above-range autoantibody count.

I suspect that the vast majority of people are able to convert T4 to T3 just fine, some for the whole time they need to take it and some for a good few years (20, in my case). NDT is not a magic bullet; many people are fine on mono- or dual-therapy regimens. I think we can all agree that the goal for each of us is finding the right dose of the right medication for that moment in time (i.e. YMMV).

[quiet-hawk-5989]

Sorry, hose 1975, I must have misread your post, I thought you were saying that since her offspring had automimmune disease and her TSH was now showing hypothyroid results that you were suspecting your mother was in the same boat as you (and of course may have been for many years, since many don't show symptoms). According to Chris Kresser, "hypothyroidism is an autoimmune disease in 90% of cases" so it wouldn't be all that surprising if it was, even without the family history. He also suggests that "all people with AITD be screened for gluten intolerance" so I guess it is worth a shot. Here is the reference:

chriskresser.com/the-gluten...

My understanding was that anyone with AI Thyroiditis could not convert T4 to T3 which was the point of defining the cause of AIT (throu the TPO results) - so that they were not put on a T4 only regime???? Otherwise, why bother to differentiate if we don't need to know about the conversion problem?

I totally agree with you that it is horses for courses for all our treatment but my experience of a T4 only regime was that after a while, the T4 backed up in my system as I couldn't convert it and I was extremely and dangerously sick as a result. Hence my little warning to you about asking for a T4 only regime.

[greygoose in reply to quiet-hawk-5989]

I like your thinking, HU, but try telling a doctor that! At best you'd get a blank stare! lol

[quiet-hawk-5989]

I know, greygoose. IMHO it is crime of the century!