Thyroid antibodies

For the first time I had my antibodies checked to see if the problem is my pituitary and here are the results:

In theory I have both Hashimoto's and Graves!!!??? Is that possible? My GP says there's nothing she can do about my treatment (currently 100mg of thyroxine).

Anyway, here are the results of the only test I've had for anti-bodies:

7 Apr 2016

Anti-TPO Antibodies: 784 U/ml (0.00 - 150.00U/ml)

Anti-Thyroglobulin Abs.: 2346 U/ml (0.00 - 150.00U/ml)

Serum TSH level: 1.85 MlU/L (0.27 - 4.20mlU/L)

GP says she can't get me a T3 test! Although at the hospital I got one where blood tests are sent to. It's all madness! She says that as only 4% of the NHS budget is spent on GP service is the reason why.

She wont deal with my TSH levels because "they're within range", claiming that upping my dose, currently 100mg or adding T3 might damage my heart further, which is news to me.

Furthermore she said that until the NHS alters the 'within range' figures for TSH, there's nothing she can do.

So I'm buggered, there's nothing I can do short of going private, which I ain't gonna do!

[Hidden]

You can get a private blood test for T3 without 'going private' and you can also top up with some T3 and see if it helps, buying the T 3 yourself and, obviously, being cautious and sensible about taking it. 

you can check your nutrient levels with a private blood test to. Links to providers are on the thyroid uk homepage.

[Hidden in reply to Hidden]

Aspmama: I got the only T3 test I've had a few weeks ago and it was 3.4 (tho no ref ranges were supplied). Apparently that's too high but the fact is, my GP won't change anything, claiming her hands are tied.

I've had my various vitamin levels checked and so forth and aside from being low on D3/K2 which is pretty typical for the UK, they seem to be ok. I take 1000mg of D3 every other day and that seems to do the trick.

Getting my nutrients checked is not the problem! The problem is obviously my pituitary gland!

[eeng]

I don't think the Anti-Thyroglobulin Abs are the same thing as graves antibodies.

labtestsonline.org.uk/under...

[Hidden in reply to eeng]

I think you're wrong. I checked that page awhile back precisely because I wanted to find out more about the T3 test. In any any case, they want £200 or thereabouts, and it won't tell me anything I don't already know. It's the treatment I want!

[Clutter]

Wbowles,

eeng is right.  The antibody tests you have had are positive for autoimmune thyroiditis (Hashimoto's) which causes 90% of hypothyroidism.  Graves Disease is diagnosed by positive Thyroid Stimulating Immunoglobin &/or Thyroid Receptor Antibodies.

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

FT3 3.4 is usually low, near the bottom of range.  A Levothyroxine dose increase will raise FT4 and FT3 and bringing down TSH won't cause heart damage.    Read Treatment Options in thyroiduk.org.uk/tuk/about_...  Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Why do you think you have a pituitary issue?

[Hidden in reply to Clutter]

I've read all this. Why my pituitary gland? Because it produces TSH and is dependent on the thyroid actually responding to the TSH and producing the required amounts of T3 and T4, which clearly it ain't. Just check the numbers of the antibodies! Even my GP recognised that. That's why I know I have Hashimoto's or more accurately, chronic immune thyroiditis. Moreover, my thyroid gland is now fraction of the size it used to be which surely tells me that it's slowly being destroyed by my antibodies.

I don't know why my GP talked about my heart, perhaps because for the first time in quite awhile (since I started on Levo) I'm getting heart palpitations and as I've had a heart attack and two stents fitted, she might be a little leery of raising my dose?

My GP surgery is really bad at sending on emails to my GP, I think I'll just have go there with it.

But I'm getting a little desperate, I can't do my daily exercises because of the palpitations (it freaks me out!).

[Clutter in reply to Hidden]

Wbowles,

If you had secondary hypothyroidism (pituitary dysfunction) you would have had low-normal TSH with FT4 bottom or below range at diagnosis.  Atrophied thyroid gland is not a pituitary issue it is due to Hashimoto's progressively destroying the gland beyond the point where it can produce hormone in response to TSH stimulation.

Palpitations can be caused by under medication as well as over medication. Recent research finds no association with TSH and atrial fibrillation.  You can email a request for patient access to the full text of the study below.

press.endocrine.org/doi/abs...

______________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Hidden in reply to Clutter]

Clutter,

I think you're confusing issues here. Let me quote from the late Dr Lowe if I may:

"Hashimoto's disease should more properly be called chronic immune thyroiditis, and can be detected chemically by the presence of antibodies, the rise in TSH, and low blood levels of thyroid hormones. Where the TSH rises, but the thyroid hormone levels remain in range, the condition can be called subclinical hypothyroidism. It is worth noting that the antibody levels may diminish as hypothyroidism becomes established, or where treatment with thyroxine is given."

My 'low' TSH is because I'm taking Thyroxine but that doesn't mean the Thyroid is making enough T3 and T4.

The fact is, going by an (incomplete) blood assay doesn't reveal the answers, surely that's the main reason this forum is here?

As you can see from the antibodies numbers above, my pituitary is producing mucho antibodies which are attacking my thyroid gland.

PS: Thanks for the link on atrial... I've emailed them and hopefully I can get it for my GP.

[Clutter in reply to Hidden]

Wbowles,

The pituitary gland doesn't produce thyroid peroxidase or thyroglobulin antibodies.  Only the thyroid gland produces thyroid peroxidase and thyroglobulin.  The antibodies are produced in response to thyroid peroxidase and thyroglobulin spilled into the blood stream when your own immune system attacks your thyroid gland.

TSH is a pituitary hormone which responds to T4 and T3 levels.  TSH rises when T4 and T3 are low, and drops when T4 and T3 are higher. 

Levothyroxine replaces low T4 which converts to T3.  Most people on Levothyroxine will be euthyroid when TSH is 1.0 or lower (which is still within range), and with FT4 in the upper range.

__________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Hidden in reply to Clutter]

I never said it did. I said it produces TSH (but then so is the Thyroxine). And yes, obviously the antibodies are produced by the immune system but it's the central role of the pituitary gland (as well as the hypothalmus and the adrenal gland) that together make the system function. This is surely why it's so difficult to treat sometimes, there are just so many variables.

What's frustrating is the medical 'profession' who now it seems diagnose by the numbers and precious little else.

And once more, why the pituitary? Because my TSH has gone up and down like a yo-yo, which is why I got my antibodies tested, because when TSH varies wildly, it points to an issue with the pituitary gland, or so I'm informed here.

[Clutter in reply to Hidden]

Wbowles,

"TSH going up and down like a yo-yo" indicates pituitary is functioning well. 

TSH fluctuates according to circadian rhythms (see graph in link below) which is why early morning testing is advised.

healthunlocked.com/thyroidu...

Hashimoto's kills thyroid cells which dump hormone into the blood stream raising FT3 which conversely causes TSH to drop.  As the gland atrophies it is less able to produce hormone and TSH rises which is why Hashi patients need Levothyroxine dose increases periodically.

Doctors adjusting dose to target a specific TSH level is also a common cause of fluctuating TSH.

_______________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Hidden in reply to Clutter]

Dear Clutter,

Yes there are variations, time of day, medications etc, but 0.52 in one month to 77.0 in the next is normal? All I'm trying to do is ascertain what the antibody numbers tell me about my condition and what I can do about it.

I've been taking Levo for nearly 8 years and aside from the first three years (which was a nightmare for me, until my body 'adjusted'?) I've been on 100mg and it seemed to do the trick, although I still feel chilled if the temp drops below 22 but now my nails are brittle again and I'm getting palpitations, which I haven't had for ages.

[helvella in reply to Hidden]

It could simply be a typo, but in this unforgiving medium, it is what we, the readers, see that we have to go by.

You posted:

"As you can see from the antibodies numbers above, my pituitary is producing mucho antibodies which are attacking my thyroid gland."

Which is what Clutter was referring to.

[Hidden]

Whoops! Yes, that's NOT what I meant to say. What I meant to say was that the if the pituitary isn't working correctly then it's that that triggers the immune system to attack my thyroid gland. But it's all by the way really.

[greygoose in reply to Hidden]

No, even that's not true. The pituitary has nothing to do with the immune system. Hashi's can be caused by all sorts of things - excess iodine, leaky gut, etc - but not by a faulty pituitary. If your pituitary wasn't working correctly, you would have a low TSH with low FT4 and FT3 - the frees would be low because the pituitary isn't producing enough TSH - Thyroid Stimulating Hormone - to stimulate the thyroid gland to make hormone.

If you were diagnosed as being hypo, your TSH must have been high - they Don't diagnose easily! If your TSH was high, and your Frees low, then there is nothing wrong with your pituitary, it's doing its job. But the gland has been partially destroyed by the immune system and therefore cannot respond to the TSH. That is why you have symptoms.

And both antibodies say you have Hashi's, not Graves. Which is one less problem.