advice please - MS & thyroid

Dear all - I'm writing on behalf of a friend who has recently been diagnosed with MS.  She is being considered for a (disease modifying treatment) called Lemtrada, which is associated with thyroid problems.

As part of her pre-screening she had her thyroid function test checked (for the first time I believe) ... she was given the following results via a letter between NHS depts (sorry no range info)...

In terms of thyroid alone, is there anything my learned friends on this forum would glean from these few results:

TSH of 4.54mu/L (repeated a few weeks later 6.16)

free T4 of 14.3pmol/L

Serum Thyroid Peroxidase Antibody 333.5iu/mL (this one seemed to be the one they were concerned about).

Thanks v much everyone

4 Replies

  • We usually have to have the ranges for these tests and the figures are in brackets beside the result. However, now your friend's TSH has risen to 6 I would say she is hypothyroid and her symptoms (I am in no way medically qualified) could be due to being hypo (widespread pain etc plus other symptoms).

    The problem in the UK doctors have been told to diagnose upon the TSH result only and not to diagnose until it reaches 10, whereas in other more civilised countries a patient would be given thyroid hormones when TSH is around 3 with symptoms.

    Your friend should have a Free T3 blood test and a Free T4, plus B12 and Vitamin D (both prohormones) which if low can also result in problems. iron, ferritin and folate.

    Blood test for thyroid hormones should be the very earliest appointment, and don't eat before it. Water can be drunk. This allows the TSH to be at its highest as that what doctors appear to take notice of.

    Vitamin D and MS

  • These are a couple of links:-

    This is a link re Vitamin D and MS

    Some researchers think vitamin D may have potential to prevent MS or reduce the number and severity of relapses.


    Vitamin D plays an important role in developing healthy bones, but researchers are also starting to uncover the role of vitamin D in many other areas of health. It’s now known that vitamin D plays a role in the immune and nervous systems, although the mechanism of action is still being studied.

    Some cells in the immune and nervous systems have receptors for vitamin D. Receptors are found on the surface of a cell where they receive chemical signals. By attaching themselves to a receptor, these chemical signals direct a cell to do something, for example, to act in a certain way, or to divide or die. The vitamin D receptors on nerve and immune system cells mean that vitamin D is somehow affecting the cell.

  • Danzee,

    Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism.  100% gluten-free diet may improve symptoms and reduce antibodies.

    Your friend's TSH has risen within a few weeks so it would be pragmatic for her GP to prescribe Levothyroxine now rather than wait until she becomes overtly hypothyroid with TSH >10.


    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.

  • danzee, 

    Your friends thyroid antibodies are high indicating Hashimotos Autoimmune Disease. TSH is elevated and T4 is (probably) low but without the ranges it is difficult to tell.

    Autoimmune diseases can be defined as a clinical syndrome caused by the activation of T cells or B cells (or both) in the absence of an ongoing infection.

    Multiple Sclerosis has been associated with all thyroid antibodies as can share the same immune dysfunctions. A simplistic round up would be that T-helper cells ( TH) lymphocytes (types of white blood cells) attack foreign pathogens, or in the case of autoimmune disease(s), normal tissue producing cytokines.  There are further subgroups :

    TH1: cell-mediated immunity, dealing with infections by viruses and certain bacteria. They can be pro-inflammatory and are involved in the development of organ-specific autoimmune disease.

    TH2: Humoral-mediated immunity, which deals with bacteria, toxins, and allergens so responsible for stimulating antibodies in response to extracellular pathogens (those found in blood or other body fluids). Not so inflammatory but involved in systemic autoimmune disease (and other chronic conditions).

    My cousin has MS and I have Hashimotos and we have found it helpful to ascertain what dominance we possess in order to manage and discourage the progression of our conditions. He has also benefited from one of the special Vit D research investigations supplementing high amounts of D3.

    I am sorry to hear of your friends diagnosis' as both diseases are progressive. A good read that explains immune system dysfunctions is "Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal?" by  Dr. Kharrazian or "The Root Cause" by Isabella Wenzt. 

    I agree with clutter that medicating thyroid hormone replacement would be beneficial in prolonging the eventual succession of hypothyroid symptoms and Hashimotos attacks.

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