High TPO, low normal testosterone, LH and FSH and high normal TSH

For the best part of 20 years I have had various symptoms including exhaustion (particularly after exercise), low mood, anxiety, general aches, inability to concentrate, forgetting the names of people I have know for years, low libido, dry eyes, cold hands/feet and a constant pressure in my head which sometimes develops into a migraine. Over the last 12 months these symptoms have progressively worsened to the point where I just cannot function at all.

Medical history:

Diagnosed with Gilbert's Syndrome 27 years ago

Many hypoglycaemic episodes over the last 20 years where my blood sugar has dropped to 2.0 to 2.2 mmol/L (regardless of whether fasting or after eating)

Psoriasis on my elbows and nails for 25 years

Low Vitamin D (18.5) December 2016

Blood tests over the last 10 years have shown TSH levels ranging from 2.4 to 5.8

Father, grandmother, uncle and cousin on same side of family receiving thyroid treatment

Recent blood test results:

TSH 4.4 0.50 - 5.00

TPO Antibody 228 0.00 - 6.00

Serum testosterone 12.7 8.30 - 30.20

Serum SHBG 30 14.00 - 71.00

Serum prolactin 106 73.00 - 407.00

Serum LH 1.3 0.60 - 12.10

Serum FSH 1.7 1.0 - 12.00

Serum cortisol (9am) 285 101 - 536

Total vitamin D 98.2 >49.90

Looking at the above the TPO antibody is high and I would suggest that, although they are in range, testosterone, LH and FSH are low and TSH is high?

I have a follow up appointment with the endocrinologist next week and would welcome some advice on what I should discuss.

4 Replies

  • Your TPO shows that you have Hashimoto. Your TSH is too high, you should be offered treatment.

    Are you taking Vit D supplements, your level is horrendously low?! If so, at what dose?

    Have you had your B12, Folate and Ferritin tested? All need to be at optimal levels to help with T4 to T3 conversion. Selenium also help conversion and lowering of antibodies. As does a gluten free diet.

    Sorry, no idea about the other hormones, but everything works together so you may see some improvement when adequately medicated.

  • High TPO means you have Hashimoto's.

    If you google Gilbert's syndrome and Hashimotos you can see there is known link

    Also many/most with Hashimotos find adopting gluten free diet helps improve symptoms & lower antibodies

    Hashimotos also linked to gut infections like HPylori or candida

    Gilbert's syndrome may also be linked to gluten issues - see google

    But don't expect an endo to have any interest in gut function or gluten issues. They might test for coeliac- but if result is negative are unlikely to suggest trying gluten free. But as you have Hashimotos you don't have to be coeliac to still find great improvements going GFree

  • You have Hashimotos Thyroditis. Auto immune, very common.

    Gluten and Casein free will help you to feel much better also nightshades can be a problem, potato, tomato, aubergine.

    Potato makes me feel flu like and aggravate joints and bursitis.

    Dr Datis Khazzarian has brilliant books on Hashimotos.

    You also sound like your B12 could be low.

    Heal gut, over 70% of immune system is in the gut. good probiotic phi naturals10/30 is good. Turmeric, cinammon, collagen powder are all helpful.

    Vitamin D needs to be over 60

    B12 over 600 preferably higher. Under 500 can cause neurological changes.

    You need thyroid meds.T4 is what you'll be offered which works for some but a lot of us with Hashimotos don't convert T4 to T3 which is the active hormone that we need! I can highly recommend NDT (natural Dessicated thyroid) but you'll have to buy privately.

    Disgraceful that Drs haven't discovered this before in the years you have been ill 😩

  • Currently taking 5000iu Vitamin D daily after 8 weeks of taking 20000iu 3 times a week.

    Based on the advice above am I right in saying it will be obvious to the Endo that I need T3 & T4 and he will therefore prescribe either NDT or more likely synthetic versions of both T3 & T4?

    Or is it more likely I will need to push for a trial of T3 from the off rather than see how I go on just T4?

    And will my Gilbert's Syndrome, Reactive Hypoglycaemia and Psoriasis have any bearing on the course of treatment?

    Seeing the endo tomorrow so any advice today would be greatly appreciated.

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